Author Topic: what are the implications of single payer health ?  (Read 3015 times)

Offline surfivor

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what are the implications of single payer health ?
« on: March 23, 2017, 12:26:08 PM »
 It seems like some people think single payer health is where we are headed eventually (someday I guess) and many people seem to favor it from what I can tell .. so what are the implications or downsides of that ?
« Last Edit: March 23, 2017, 12:33:33 PM by surfivor »

LVWood

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Re: what are the implications of single payer health ?
« Reply #1 on: March 23, 2017, 01:06:33 PM »
Taxes go way up.
Quality of health care goes way down
Death panels
lottery system for costly procedures
Need glaucoma medication for both eyes? Sorry only one gets treated.
I could go on...

Offline RitaRose1945

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Re: what are the implications of single payer health ?
« Reply #2 on: March 23, 2017, 01:48:06 PM »
There are definitely both good and bad points to it.

The quality of care would likely go down, but the number of bankruptcies due to medical care would go way down. 

More people would be covered and so fewer people would be inclined to use the ER for what should be a scheduled doctor visit.  But that also means demand for standard medical care go up due to people who would otherwise either die or go to the ER.

In my part of the world, we have a lot of people using the ER for their regular dialysis, which means they're using the most expensive resources for maintenance that could be done much more inexpensively.  The ER can't turn them away for lack of insurance or inability to pay, but everyone else can, so they go there once or twice a week.

Offline CPT Morgan

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Re: what are the implications of single payer health ?
« Reply #3 on: March 23, 2017, 02:49:32 PM »
As a point of concern for the heath (pun intended) of the system itself, there are way more negatives than positives.  Any positive would rely on the back of a socialized system that never works well over time.  The worst part is finding out it won't work and having no privatized system to go back to and less qualified doctors willing to continue their practice.

It will surely grow government.  How many feel that is good?

Offline Jack Crabb

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Re: what are the implications of single payer health ?
« Reply #4 on: March 23, 2017, 03:16:04 PM »
A healthcare system with all the efficiency of the DMV and all the compassion of the IRS.

The VA hospital system is single payer.

Offline surfivor

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Re: what are the implications of single payer health ?
« Reply #5 on: March 23, 2017, 03:22:04 PM »

 I am pretty skeptical but I should try to figure out more details ..

 My mother says that single payer would be like medicare. She says that that is the system that elderly people get and according to her it's a good system. So that's her argument

Offline CPT Morgan

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Re: what are the implications of single payer health ?
« Reply #6 on: March 23, 2017, 03:28:02 PM »
My mother says that single payer would be like medicare. She says that that is the system that elderly people get and according to her it's a good system. So that's her argument

That could certainly be a true statement TODAY....  But with the benefits of a non single payer system in place as the ONLY insured option.  She won't sing their praises if we go to single payer.

Offline surfivor

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Re: what are the implications of single payer health ?
« Reply #7 on: March 23, 2017, 03:38:06 PM »
That could certainly be a true statement TODAY....  But with the benefits of a non single payer system in place as the ONLY insured option.  She won't sing their praises if we go to single payer.

 because if single payer was the only option then it wouldn't be that great ? What is the reasoning on that ?

 I really have not thought any of this out. I have heard the claims that socialized medicine works in Scandinavian countries; but then I heard that those countries had not had large numbers of poor people compared to America. I also knew some Canadians who didn't like the Canadian system.



Offline FreeLancer

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Re: what are the implications of single payer health ?
« Reply #8 on: March 23, 2017, 03:48:41 PM »
MediCare is currently probably the least disliked payor by both patients and doctors, which could be construed by some as being good.

The hodgepodge of public and private systems we have now is dysfunctional, wasteful, and economically unsustainable.  If our health indicators showed we were better off than socialized countries, that would be one thing, but we're getting less health benefit for our dollars spent every year.  And none of the stakeholders are willing to give an inch (doesn't matter if we're talking patients, doctors, hospitals, insurance or pharmaceutical companies), so whatever comes next will have to rise from the rubble of what we're using now. 

Offline CPT Morgan

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Re: what are the implications of single payer health ?
« Reply #9 on: March 23, 2017, 03:51:52 PM »
because if single payer was the only option then it wouldn't be that great ? What is the reasoning on that ?

Correct (wouldn't be perceived as good).  Your mother's feeling are skewed by the fact that ALL INSURED are not currently under a single payer system.  If we ever become single payer, she will see a huge decline in care.

Offline RitaRose1945

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Re: what are the implications of single payer health ?
« Reply #10 on: March 23, 2017, 03:52:58 PM »
No system is going to be perfect, or probably even good.

If you are employed and have reasonable management, then private insurance is amazing and wonderful.  If we go to single payer, then there is more demand on healthcare providers (since people who previously were uninsured now can see a doctor, and not just the ER) and odds are good that the quality of healthcare will be stagnant or go down because there's less incentive for research and development.

If you are unemployed, for whatever reason, then private insurance is a pipe dream, and single payer funded through taxes means you can see a doctor for preventative care instead of either waiting for it to escalate to something life threatening and heading to the ER, or showing up at the ER with the sniffles.  Same thing with everyone else - doctors' offices are crowded because everyone now has insurance.

In other countries that have single payer, you can generally bypass some of these issues by paying for separate insurance that means you get in faster or your coverage is more extensive.  You can always pay for better medical care.

And, obviously, taxes go up.

So it comes down to whether you want better quality care for most people, or marginal quality care for everyone with the option for better care if you can afford it, and how much more you are or are not willing to pay to make that happen.

I will say that Jay's homeless, addict son had the exact same healthcare coverage (HMO) that I pay about $150/month for.  He got it for free (to him) along with food stamps and a cell phone (which is really not a luxury anymore if you are actually trying to get a job, though he wasn't).  I don't know if that's the norm for other states or if they do something else.

I'm just saying that you're already paying for healthcare for everyone anyway, whether you do it through single payer healthcare or frequent ER visits for people who are uninsured.

Offline Ken325

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Re: what are the implications of single payer health ?
« Reply #11 on: March 23, 2017, 04:15:09 PM »
I don't like socialism, but it is hard to defend the system we have.  We have the most expensive healthcare system in the world by far.  You can say we have the highest quality but medical outcomes are better in several countries that are far less expensive. Medicare is a scam.  Have you ever seen a doctor outline tens of thousands of dollars of medical care and then they find out you used up your medicare benifits and they just ask you to leave?  No one could pay what medicare pays so they won't even talk to you at that point. 

If I had to fix the problem I would probably pick a limited single payer system.  The catch is I would tell everyone that this system gets you only the absolute rock bottom minimum level of care.  I would give it a discouraging name like "Basic Care".They get this anyway when they show up to a emergency room.  Then I would strongly encourage everyone to get medical savings accounts and supplemental insurance.  The limited single payer system would not cover anything but emergency lifesaving care, immunizations, generic drugs, some mental illness treatments, birth control, and limited  preventive care.  I would run the program as cheaply as I could but I would make it easy to pay for better care or use supplemental insurance.  I would make Doctors and medical facilities post the price of treatments.  You should be able to shop for an MRI or a sleep study on something like Amazon.  I would stop supplementing the drug industry with high prices in America if they charge less in other developed countries like Canada.  It is good if they give deep discounts to developing countries.  I would push for maximum competition.  Allow insurance to be sold across state lines.  I would also limit and means test medicare as that system is going to bankrupt the country in a few years.  The hardest part would be keeping the politicians from expanding free care under the program when the horror stories come in.  The horror stories are necessary to get people to pay for supplemental care.

Hard solutions but you have few choices when there is no money to pay for these things.  If we don't do something the system will crash.

Offline CPT Morgan

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Re: what are the implications of single payer health ?
« Reply #12 on: March 23, 2017, 04:17:47 PM »
No system is going to be perfect, or probably even good.

So it comes down to whether you want better quality care for most people, or marginal quality care for everyone with the option for better care if you can afford it, and how much more you are or are not willing to pay to make that happen.

Given that we arguably have the best medical care available to us today, over any other system, I'll take the one that is best for "most people".  I argue that if we go to a single payer system, we will likely lose the care that "most people" have available to them today and will move to a system that is not only inferior for "most people" but will kill any possibility to go back to the way it was if/when we find that a single payer doesn't work.

Offline RitaRose1945

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Re: what are the implications of single payer health ?
« Reply #13 on: March 23, 2017, 05:23:11 PM »
If I had to fix the problem I would probably pick a limited single payer system.  The catch is I would tell everyone that this system gets you only the absolute rock bottom minimum level of care.  I would give it a discouraging name like "Basic Care".They get this anyway when they show up to a emergency room.  Then I would strongly encourage everyone to get medical savings accounts and supplemental insurance.  The limited single payer system would not cover anything but emergency lifesaving care, immunizations, generic drugs, some mental illness treatments, birth control, and limited  preventive care.  I would run the program as cheaply as I could but I would make it easy to pay for better care or use supplemental insurance.  I would make Doctors and medical facilities post the price of treatments.  You should be able to shop for an MRI or a sleep study on something like Amazon.  I would stop supplementing the drug industry with high prices in America if they charge less in other developed countries like Canada.  It is good if they give deep discounts to developing countries.  I would push for maximum competition.  Allow insurance to be sold across state lines.  I would also limit and means test medicare as that system is going to bankrupt the country in a few years.  The hardest part would be keeping the politicians from expanding free care under the program when the horror stories come in.  The horror stories are necessary to get people to pay for supplemental care.

That's a lot like what I would try for.

Like I said, we already pay for people that don't have insurance when they show up at the ER.  If we at least have a basic system that includes minimal preventative like a flu shot once a year, generic Metformin (something like $5 per month without insurance), and basic prenatal care, then it would cover a lot of the issues that send people to the ER at a much higher cost to everyone and maybe keep them from developing chronic conditions that also cost a bundle and last for decades.

But I agree, keeping politicians from adding on to it would be a major problem.