Reply #33: Single payer is a descriptive phrase for how cost are met to pay for Universal Health Coverage. [View All]

[Sunnyshine]

It is the most straight forward imho, which is why it is the best long term solution over hybrid systems.

The British/Scandinavian/Spanish system of single payer,health care providers are simply salaried by the community and have to deliver health care within a fixed budget. This means that there is every incentive for them not to waste funds on unnecessary tests and the use, for example of expensive medical scanning in situations when cheaper - as effective alternatives are available. Comparative effectiveness between hospitals is measured and publicly reported.
Ineffective practice is rooted out because hospitals are public institutions- they cannot profit by providing more care. http://en.wikipedia.org/wiki/Single-payer_health_care

Contrast that with this:

In the North American system of paying for-profit institutions via Medicare type systems (which effectively pay for volume of work in the same way as private insurance), the system may retain some issues of moral hazard. Medicare itself recognizes that the present system rewards failure. For example some hospitals were found to provide excellent service with low re-admission rates, but others had poorer medical performance with higher re-admission rates. Because the system pays for the volume of work done and not the quality of outcomes, this results in the good hospitals receiving LESS funding than the bad ones. Because in this system a doctor in general practice only gets paid when a service is delivered, even general practitioners tend to run tests and treat the "worried well" because giving advice to the patient is not well rewarded by the payment system whereas performing tests is. The doctor earns nothing if patients do not come through the door.http://en.wikipedia.org/wiki/Single-payer_health_care

Single payer advocates have considered all the above. I once shared your pov, but the bottom line is that insurers/private institutions purposely blur the ethics of medicine and tangle up the system by injecting bias into what is an unbiased need. They complicate the PT/MD relationship and ultimately inflate the delivery cost. They are industrial sized filters that should never be applied to health care or the human act of caring for someone regardless of circumstance. I work in HC. That is my take on it.

OP's like these keeps this discussion going. I appreciate the chance to address this topic and thanks for reading my long reply.