If I may throw a suggestion into the "suggestion box" re: single payer insurance

[Mind_your_head]

I don't think that most people know what the term 'single payer insurance' really means.

I pay alot of attention to current events - mostly online sources now - and even *I* didn't really understand what it meant.

In my ignorance, I was thinking that 'single payer insurance' meant that everyone paid a flat fee to be covered.

THAT is very far from the truth, which is:


Single payer health insurance is a system by which the health care expenditures of an entire population are paid for through one source – the Federal government or a subcontracting entity – using tax revenue from individuals and employers.

Distinctly different from socialized medicine, whereby the government owns and operates health care facilities, a “single payer system” is simply a financing mechanism. The government collects and allocates money for health care but has little to no involvement in the actual delivery of services. Care is provided privately at hospitals and clinics but paid for publicly.

Individuals are allowed to choose their providers, and physicians are either compensated on a fee-for-service basis or paid salaries by hospitals that receive an annual global budget or by nonprofit health maintenance organizations.

So, my 'suggestion' is to go back to the basics and DEFINE for those unknowledgeable about it....what 'single payer insurance' really means, rather than bantering the term about THINKING that everyone is defining the term the way you do/it was meant to mean.

That is all /<off> ranting suggestion>

[Hosnon]

1. I have one concern about such a system.

(And no, this is not one of those "concern" posts.)

Wouldn't this tend to funnel patients to the best and probably the most expensive, doctors? In other words, it would seem to continuously exert upward pressure on the price of medical care. If the government told us that the same system would be in place for cars, wouldn't most people buy really expensive cars?

My concern is not completely articulated or formed but it is there...what do you think?

[canetoad]

3. Not the way it works here in Oz

There is a schedule of fees for consultations & procedures. For example, say a short visit to a GP is $35 on the schedule. Any doctor who charges that amount is paid by Medicare. If the Doctor decides to charge $40 or $60, then Medicare still only pays the $35 but the shortfall must be made up by the patient out of their own pocket, or their insurer if they hold private medical insurance.

In essence, the medical practitioners don't get to charge what they want and expect the Gov. to pay it.

[Hosnon]

4. I see. I was beginning to think that was the type of solution.

Basically a price control system.

And it works in Oz (Canada, I presume)?

Edit: Who or what sets the base fee?

[Bongo Prophet]

6. Oz = Australia n/t

[canetoad]

8. The base fees

are set by the gov. in consultation with the AMA (Aust. Medical Association)and other peak bodies. In a way it's not really price control; a high end physician to the silver tails can charge whatever he likes as long as people are prepared to pay.

I'm not saying it's a perfect system, but there is room for 'gap' insurers to survive and those medical practitioners who feel it's their duty to become outrageously wealthy.

In working class areas there are plenty of large clinics who 'bulk bill'. This means no actual money changes hands, the practices get their income directly by submitting records to the Gov. for payment. Other clinics require the user to pay then a refund is obtained at a Medicare branch. There is still a lot of room for choice and variation and it cuts off the argument that the Gov. controls your health care etc. The Gov controls the funds only.

[Spazito]

11. What that does, though, is provide a two-tier system...

Those who have the money can go to the "better" Doctor and still have the taxpayer pay for part of it. Why not, instead, have it so ALL GPs get paid the set rate and they CANNOT charge more. Patients cannot choose to see a Specialist without being referred by the GP.

If the patient wants to pay the whole price, without taxpayer subsidy, as happens when the few Canadians go south of the border to get elective procedures they might have to wait a bit for.

[napi21]

2. Best example of single payer is the current Medicare system.

Unfortunately, I think that's the absolute BEST Americans can even hope for! There's no way thee is enough support for totally socialized system now.

[SoCalDem]

5. Politicians deliberately muddy the waters on this issue.. Most of them use the word "insurance".

Insurance is the problem...not the solution..

The government NEEDS to control/operate the facilities and the delivery system for meds and pay the doctors..just like they pay our military ..

[Selatius]

9. You'll never get groups like the AMA to support that. You'd be better off with...

Medicare for All laws. There, the facilities would still be privately run. It's just that the government picks up the tab up to a certain extent, allowing people to go to whoever they wish. I doubt Medicare would pay for elective plastic surgery or pay ultra-high end doctors 100 percent of the amount but rather a percentage of it. Ideally, Medicare should pay for what people need. Anything else beyond that need should be left up to individual discretion.

[SoCalDem]

10. Allowing "some" to still have "insurance" and allowing workplaces to provide it,

just continues the inequities and assures a substandard level of care for poorer people

With the exception of Brazil & Cuba, I don't know of any socialized medicine systems that are all that "into" paying for beautification and/or frivolous surgeries..

The same coverage for ALL, is what keeps they system viable. If select groups are allowed/encouraged to peel off, the remaining pool gets more and more costly to cover.

By removing the employers & insurance companies from the mix, entrepreneurial ventures would also explode..creating MORE jobs.. Many young people with ideas are afraid to start companies because they dare not leave the security of the job the have..

[Bongo Prophet]

7. Good point, it needs to be simple enough to grasp and resonate with people

Paul Krugman makes a similar point here:

A system in which the government provides universal health insurance is often referred to as “single payer,” but I like Ted Kennedy’s slogan “Medicare for all.” It reminds voters that America already has a highly successful, popular single-payer program, albeit only for the elderly. It shows that we’re talking about government insurance, not government-provided health care. And it makes it clear that like Medicare (but unlike Canada’s system), a U.S. national health insurance system would allow individuals with the means and inclination to buy their own medical care.

http://www.pnhp.org/news/2005/june/paul_krugman_on_sing.php