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Readers' forum: Single-payer system best

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To RedShirt at 11:28 a.m | 1:28 p.m. July 9, 2009
Much of the power is yours. You just need to look into it. IHC/Select Health is REQUIRED to give you a benefits handbook. Have you read it? Because it will have an exclusion list of things, that they won't pay for, and it's not uncommon that there are exclusions for other insurance, like auto and home. If you need something that is excluded it is your fault for not getting different coverage.
Anonymous | 2:02 p.m. July 9, 2009
Where are all the veterans ready to give up their VA care because it is government run? Surely all you vets think this system stinks and the government should just pay for you to go to a private doctor, don't you? You know, the ones that will give you 5 minutes and hurry on to the next patient so they can bill more?

RedShirt | 2:05 p.m. July 9, 2009
To "To RedShirt at 11:28 a.m | 1:28 p.m." so willthe government give us a handbook listing out what they will and will not cover? Afterall, just like most countries with national healthcare, they don't cover everything, so to get full coverage some people have had to buy supplemental private insurance. Just like Medicare/Medicaid.

If you don't plan or think ahead, yes, it should be your fault. If I am driving and run out of gas, who's fault is it that my car ran out of gas, the manufacturer or my own? For example, who's fault is it if a young couple purchases catastrophic health insurance, then gets pregnant?

If there is always somebody swooping in to "rescue" you from your bad decisions (no consequences for bad decisions), will you ever learn from them?
Comments continue below
Captain Kirk | 3:25 p.m. July 9, 2009
@ Darrel | 12:34 p.m. July 9, 2009
RE: John Locke

Life, liberty ,and property must be considered together.

You can't leave one out and not have injustice.
And they are all interlinked.

A health care provider can't be forced to give up his labor (a portion of his life and his property).
Even to save another life.
Neither can a third party be forced to give up their property to pay for the health care. This would be stealing the labor and life from those people.
This is the specific crime that government exists to defend its citizens against.

Health care is not a right. Health care like all services is someone’s labor. Only the laborer can have a right to it. Otherwise you deny the health care provider a right to his own life, for it is impossible for both he and his patient to have a right to ownership of his labor.

Private charity is the only moral way to handle this situation. We need to bring back the charity hospitals that the government all but ran out of existence.
Red | 3:35 p.m. July 9, 2009
Chad: [single payer is] "a system that cannot possibly be better for those of us that already have insurance."

Wrong, Chad.

Most of the US' epidemic of medical bankruptcies involve people that have insurance.

BBC the other night featured a 24-year-old, covered on his mother's plan, who's running up $4000 a month in co-pays. When he turns 25 this December, he'll age out of his mom's coverage, and he'll only survive if he can cover the full $80,000 a year his treatment costs out of pocket.

A single payer system would be far, far better for this family, even though they already have insurance.
Red | 3:38 p.m. July 9, 2009
Chad: "I do not want some Washington keyboard jockey deciding whether or not my wife gets cancer treatment."

Can't possibly be worse than some insurance company keyboard jockey deciding today.

My sister in law will die an early, painful death because Kaiser bean-counters decided she didn't "really" need the colonoscopy that could have saved her life.
Red | 3:45 p.m. July 9, 2009
Chad: "do you really think that kids will still want to be doctors when they no longer have any control over treatments, scheduling, pay, staff, etc?"

Won't be that different from today. High school dropouts, hired as insurance company screeners, routinely overrule doctors' treatment recommendations right now.

Many -- most? -- doctors today are employed by hospitals, clinics, etc.; or, at the very least, they are part of a group practice and have only a limited say (if any) over the items you list.

We're not being asked to choose between noble, self-sufficient, in-control-of-everything Marcus Welbys and beaten-down, hemmed-in wage slaves; the choice is merely which set of masters is the least damaging.

I'd much prefer the limited control provided by the ballot box to complete domination by profit- and bonus-driven insurance company flacks.
Anonymous | 3:57 p.m. July 9, 2009
"A health care provider can't be forced to give up his labor (a portion of his life and his property)."

He is not "forced" to give up his labor. If he wants to continue to be a health care provider, he can CHOOSE to work within this system. If he no longer wants to save lives for less money, he can do something else.

Sorry, your argument does not hold water.
RedShirt | 4:10 p.m. July 9, 2009
To "Red | 3:38 p.m." with washington controlling the healthcare, be prepared to wait months to get treatment. Also, you will still have to deal with a private insurance company because, like the UK and other nations have found out, the government can only supply a limited amount of healthcare. They still have to get insurance to either get fast service or to get coverage beyond the government system.

So, the UK not only gets denied by somebody in London, they also get to deal with insurance companies.

Rather than just handing your healthcare over to Washington, why not figure out ways to lower the cost. Turning healthcare over to washington will only increase the costs.
Grimble | 4:24 p.m. July 9, 2009
A few points:

1) The U.S. not only spends more on health care per capita, it already spends more PUBLIC MONEY per capita on health care, than any other country in the world. In other words, our government pays more on health care WITHOUT single-payer than most countries WITH single-payer. That's because our system is so screwed up and we waste so much money on drug marketing, emergency room visits for sniffles, etc.

2) Countries with single-payer also have private supplemental insurance. You can buy it if you want and can afford coverage beyond the single-payer program.

3) We ALL pay for the uninsured. If someone has expensive treatment that pushes them into bankruptcy, the creditor that lose money in that bankruptcy have to make it up somewhere--by charging the rest of us more.

4) By and large, people in countries with single-payer love it. If they didn't, the would have gotten rid of it.

5) If the government is so incompetent, why are the insurance companies worried about competition.

6) IHC and BC/BC together have the vast majority of the market share in Utah. Free market? Really?
Anonymous | 4:36 p.m. July 9, 2009
"4) By and large, people in countries with single-payer love it. If they didn't, the would have gotten rid of it."


Most people in those countries would not change places with our insurance/medical system for ANYTHING!
Spock | 4:55 p.m. July 9, 2009
You're RIGHT ON Captain Kirk. People don't understand the way things work in our country. Reading comments on this website is proof of that. Although comments regarding this topic seem to be somewhat better informed than they usually are. I believe when the government tries to "make things more affordable" we (the people) always end up losing. Look at what happened as a result of government regulations forcing banks to lend to under-qualified home buyers. Now nobody can afford to buy a house and we have nearly 10% unemployment.
By the way, EVERYONE commenting here needs to stop calling it HEALTH CARE.... It's MEDICAL CARE. Health care is something you can do yourself... like exercising more, quitting smoking, and eating better. The government should NEVER be able to mess with HEALTH care. And I'll be damned if my tax dollars provide medical care for people who refuse to exercise, quit smoking, etc. I try to make generally healthy life choices and feel it unfair to pay for others who require more treatment because they refuse to make similar choices.
@ 3:57 | 5:05 p.m. July 9, 2009
No, you are wrong. Re read the post you are commenting about, with emphasis on the idea that you do NOT have a "right" to someone elses labor. That idea went out when the Civil War ended....

If I have a "right" to your labor, then I CAN force you to work for me. Forced work is slavery, even if I give you free board and room on the plantation.
An Observer | 5:28 p.m. July 9, 2009
IF you turn this over to the government,

it WILL be deciding who gets care, who can get care, how much dootor can make, etc, etc, etc,

and WILL make ALL decisions based how to control costs,

because it MUST.

ALL those statistics and foriegn reports and surveys LIBERALS like to quote as facts,

are created by anti-americans, and socialists, and partisan organzations and worse that have an agenda,

and create and manipulate and rig those surveys and stats and such to satisfy their agendas.

The only thing that matters is what is the proper role of government,

and providing medical care for ALL is NOT a proper role,

and is proven financially and economically an unbearable burden,


NOT reports,
NOT stats,
NOT surveys,
NOT sob stories,

or some misguided liberal notion we need to force compassion and charity on everyone by the cold grabbing power of government.


Reality | 10:35 p.m. July 9, 2009
NOBODY IS TALKING ABOUT ADOPTING A UK OR CANADA TYPE HEALTHCARE SYSTEM. NOBODY except Republicans who want to make people fearful of changing the current system.

There are many other types of healthcare systems. France for example, has been rated the best in the world.

My son had to wait 2 WEEKS to see an orthopedist for a broken arm. We had(have) insurance. We live in the U.S.
Drs. in the U.S. spend more time dealing with insurance companies than they do with patients. Instead of practicing medicine they have to spend time trying to figure out what medicines the various insurance companies and various insurance plans will cover, what procedures they will cover etc.
The insurance companies knew this day was coming. Did they change or clean up their practices? NO. They continue to find ways to drop patients. They continue to look for ways not to cover services.

RedShirt | 8:18 a.m. July 10, 2009
To "Reality | 10:35 p.m." so how is the government going to get more doctors available? Are they going to make it a military assignment?

Without some sort of tort reform or some way to lower malpractice insurance. Right now a doctor looking to be an Orthepedic Doctor gets the privelage of paying $130,000/year for malpractice insurance.

So far I have not hear about how anybody is going to do something to lower malpractice costs.
Red | 9:22 a.m. July 10, 2009
Redshirt: "with washington controlling the healthcare ..."

As I understand it, the current proposal would permit -- not require, just permit -- a limited replacement of insurance-company bureaucratic oversight with federal oversight.

There wouldn't be any more "washington [control of] healthcare" than there presently is insurance company control of same.

Redshirt: "... be prepared to wait months to get treatment."

I had to wait over four months to see my orthopedic surgeon earlier this year. Also, an un- (or under-) insured American may have to go completely without treatment, even if it kills him/her. Your point?

As I understand it, horror stories about current interminable waits for critical procedures in other countries are just that -- horror stories. National health services have, in general, improved with experience; and, for the record, no one's proposing a National Health Service for the US, anyway. Far from it.

Redshirt: "why not figure out ways to lower the cost."

That's exactly what has the insurance industry so terrified. Their spokescritters complain that a public option would lower costs so dramatically that the industry would be forced to modify its 35%-plus overhead!
Captain Kirk | 10:01 a.m. July 10, 2009

An Observer | 5:28 p.m. July 9, 2009 ... is correct.

We need principle based government that does not overreach its proper role. No matter how much we fear personal responsibility and personal charity. It is the correct path and the path that leads to the most prosperity and happiness for the most people.

The overreaching government is what got us in this medical care mess in the first place.

1. Destruction of personal responsibility caused by the welfare state mentality. (frivolous lawsuits, wanting the benefits of someone else's labor)

2. Inflationary policies that have increased domestic costs including medical. Nobody talks about this. Consumer goods are cheap because they come from china. Medical is expensive because it is domestic. So all that government spend & print is getting us.

3.The destruction of Charity Hospitals by Medicare, and inflation, etc

4. The tax code and other laws that pushed us all to corporate payers using prepaid medical plans removed consumerism from the medical market place.

5.Corporate and Government payers are creating unnatural price controls throwing the markets out of balance. (related to #4)

I could go on but I'm out of space.
RedShirt | 10:06 a.m. July 10, 2009
To "Red | 9:22 a.m." you have the same gripe that many people have. Please explain how having the government take over health insurance will get more people to become doctors. Like I said before, an orthopedic doctor pays $130,000/year for malpractice insurance. Other specialties, that also have shortages of doctors, pay similar amounts for their malpractice insurance. So, how will having the government take over health insurance lower the costs.

If you looked into health insurance, the only way for companies to make money is to streamline thier overhead. Unless you work for a company that is self-insured any policy that you get is full of coverage mandated by the state. By moving that control to the federal level, and having government be the primary provider, you eliminate competition, thus eliminating any reason to streamline the operations. It will become a bloated system.

Where do you get your 35% plus overhead costs for insurance? A typical insurance company runs 15% to 20% overhead plus profit. According to The Street (an investment publication) many insurance companies make less than 4% profit. My sources of information are "Medicare versus Private Health Insurance: The Cost of Administration".
Anonymous | 10:45 a.m. July 10, 2009
I've followed this for years, as a business leader and in government. Nick is right. Period. The problem is not government.
The difference between | 1:46 p.m. July 10, 2009
how things "are" and the way many people think things "should be" are often different. Many people on these blogs say how they think things should be (and they should)...but if they are different than this then a person either needs to accept it or change it! Many areas of healthcare are inadequate. I am for trying to change this. Will it then be perfect? No. But we can be on the way to making it better. The issue now is not whether healthcare and insurance are working adequately...it is not. The issues now are in regards as to how we need to change. We will change and we will keep trying until we have better results.
To Anonymous @ 2:02 | 11:24 p.m. July 10, 2009
I am one of those primary care doctors that has to see more and more patients every single year to keep making the same wage, and it is not a high amount, compared with ANY specialist.

Fact: Every year insurance premiums rise around 8-10%.

Fact: Cost of living and therefore the cost of doing business rises 3-6% yearly (power, supplies, rent, wages to employees, etc.)

Fact: In the last three years combined, reimbursements from many insurers to physicians has increased LESS THAN 1%. Medicare last year almost enacted a 10-15% DECREASE in reimbursement to physicians. They acted very generous when they agreed NOT to cut reimbursements and just hold steady.

To all of you who think that "greedy doctors" are the problem, think again. Your insurers are FORCING us as physicians to see more people each day, in shorter visits, to just break even.

Insurance company PROFITS are rising far faster than physician reimbursements. If any systemic changes are to work, PRIMARY CARE medicine must be valued and rewarded fairly. Having specialists driving this train has historically provided fragmented, redundant, expensive care. A functioning primary care system is vital to the success of any proposal.
Otis Spurlock | 8:18 a.m. July 11, 2009
Unfortunately, Nick gratuitously uses the old Republican stand-by boogie men of Limbaugh, etc to try and scare his point across. He also says that infant mortality and life expectancies are worse in the US. That depends entirely on the socialized country you compare us to.

I am US born but spent several years as an adult in a foreign country under a socialized medical system. The US system IS the MOST inefficient in the industrialized world in terms of percentage of dollars going to actual healthcare and not overhead and waste. Malpractice insurance here is also at least 10x what it is in most single payer countries. This adds enormous risk and dissuades more young people from entering medicine.

HOWEVER, the foreign systems do NOT cover everything! I had to also pay a "mutuelle" or supplemental personal insurance to cover the costs not covered by the single-payer system. There are also times of the week or day when you cannot get any care! You just have to wait.

As far as cost, yes we and our employers pay a bundle, but in other countries you and they pay it in taxes rather than premiums.

Take your pick.
To Anonymous 2:02 p.m. | 8:27 a.m. July 11, 2009
"Where are all the veterans ready to give up their VA care because it is government run?"

Your comment is not relevant. The Vets receive their care in a program subsidized primarily by other taxpayers. Who wouldn't want to be in a system where someone else pays? If I had it, I'd keep it too!

When everyone has this type of system, then you'll see the tax burden rise considerably for all. Are you ready to pay for the health costs of others?
To Reality 10:35 p.m. | 8:38 a.m. July 11, 2009
Um, I lived under the French healthcare system for two-plus years. The best in the world? I wonder who makes that determination.

In France, my son broke his thumb on a Saturday and we couldn't even find a radiology lab to take X-rays until Monday let alone finding a doctor to set it.

You still had to pay for personal insurance anyway to equal the care you can get in the US. What's the point?

Having spoken with several French doctors while living there, most identified malpractice insurance premiums as the biggest drawback to the American system (from the doctors' perspective). For this reason, you see a lot of kids going into medicine in France, but in the US, not so much.

As for US doctors spending more time on insurance forms and administration, keep in mind that they ususally hire people in a multi-doctor office to handle this. In France, there are no admins, the doctor does spend more time with you, but he/she personally handles all of the administrative work too.

Yes, the US system needs change. However, be careful before extolling the virtues of a system you know little about.
Pacific NW | 2:17 p.m. July 11, 2009
I live across the border from White Rock, British Columbia and have many friends who are Canadian. Be careful of giving their system too much credit.

Every day, I see Canadians coming down to the States, paying out of their own pockets to get treatment because they are on a waiting list.

Two years ago, the father of a good friend of ours died up in BC waiting for heart surgery.

There may well be a better system out there, but please believe me when I say Canada is not it. I would also be leary of the systems in places like Switzerland and Scandinavia who only allow millionaires to immigrate. We're not in that boat. If we get as generous as some of the posters on here want, we'll be overwhelmed with move ins from Mexico, etc.
Choose Freedom! | 8:01 a.m. July 12, 2009
Let us have our freedom to choose our health insurance. That's the American way. Those who want a government run health system can choose to do so. Those who want to pay a corporation to control "manage" their health care can choose to do so.

The current system is a disaster, most industrialized countries on this planet offer a government run system and each day it becomes harder for America to compete in a world economy without one.

So have both options available for us to choose from. That way everyone has their freedom to choose.

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