Monday, February 27, 2006

Single Payer Health Care

Count me out.

I think Jeff help Canada up as a model. Doesn't sound so utopian to me.

I'm the first to admit our system isn't perfect, but I haven't seen any proposal that isn't at least as flawed, if not more.

6 Comments:

Blogger Jeff said...

"I think Jeff help Canada up as a model. Doesn't sound so utopian to me."

I did? I thought I was talking about Taiwan. In any case, I believe what I said was that all systems have problems (which isn't anywhere close to calling single payer "utopian"), but that there was no excuse for a system that costs almost twice as much as Canada's (as a percentage of GDP) and fails to insure 40 million people. Canada definitely needs to make reforms; more money needs to be spent, user fees should probably be instituted, and there should also be a role for "cadillac plan" add-ons from private companies. Still, Canada's system still gets higher marks from its public (and those systems in much more socialist countries like Denmark, Finland, etc., get higher marks still) than the US system does from its public.

"I'm the first to admit our system isn't perfect, but I haven't seen any proposal that isn't at least as flawed, if not more."

Are you looking for an alternative only in the pages of TAE or on The Corner?! Seriously, I'd like to know what alternatives you've seen that fall so short of the US system. By what criteria do you judge these alternatives, since we know you can't be considering cost and customer satisfaction?

12:50 PM  
Blogger sexyretard said...

Hi Jeff,

I agree that the Canadian system is superior to most people, most of the time. So far, I do not even hesitate to state that my wife and my son's healthcare would have been just as good, throughout both of their lives, in Canada, and far cheaper besides.

If something goes very wrong, however, I have every reason to believe that superior doctors command the superior incomes that come from the American system.

I kind of think it relates to an HMO. I absolutely love mine; it's very cheap and I get all kinds of preventive services, but I know full well that when I contract complications from the Bird Flu, I'll wish I had real insurance, and that being the kind that pays doctors lots and lots of money.

All the same, I have to agree the Canadian system in superior, just not in all cases. I suppose most Canadians, or at least a whole lot more, may well report being satisfied, without the polling data telling us just how "dissatisfied" the malcontents are, as compared to their grumpy neighbors to the South.

5:24 PM  
Blogger RaginCajun said...

Why a basically unregulated monopoly (the AMA) is allowed to restrict supply and place restraints on trade in the name of quality is testimony to how screwed up things are here.

As Jeff alludes to, this is not an all or nothing. Part of health care is surely a public good, and beyond being a public good there are compelling public interest reasons to provide it. For instance it may be cheaper to provide basic health care to avoid more expensive emergency services. Moreover, even if we were willing to let folks die on the streets or discreetly tucked away where we didn't have to see them (or at least not fund their care and let the compassionate conservatives take care of them through privately funded faith-based initiatives), there may be some public good to providing some level of care. At least I think so.

If it is agreed that at least some level of care should be provided - and I think most would agree, then the next question is, perhaps, how to do that most sensibly. Certainly, some government programs provide income subsidies directly and let beneficiaries purchase what they want directly on the market. Examples are welfare recipients, food stamps (restricted use monetary instruments), and some defense contractors (including Halliburton).

But I don't think the taxpayers should provide income subsidies when there are monopolies that make the services bought with those goods so expensive.

So, it seems to me the horns of the dilemma are to either do some trust busting of the medical-drug complex or nationalize/price regulate parts.

We seem unwilling and unable to do the former, so perhaps we should do the latter.

10:40 PM  
Blogger hurtleg said...

"fails to insure 40 million people" in the US.

This means that about 260 million are covered. Do we want to destroy the system for 13% of the population. Just a little perspective.

From a macro viewpoint we have the best healthcare (quality wise) and most accessible in the world. As far as I know there are no 10 week waiting lists to see a specialist after a referal (even from the hated HMO's).

Your critique of the Canada plan, "Canada definitely needs to make reforms; more money needs to be spent, user fees should probably be instituted, and there should also be a role for "cadillac plan" add-ons from private companies" masks a bigger issue.

With single payer you advocate a crushing tax be placed on individuals or business to fund a system where people can't get to their doctor for 2 or 3 months because of the waiting lists. So like Britain we have the right to pay for the care from a private supplier out of own pocket to compensate for services we are taxed for and not receiving. Might as well cut out the government and middle man and pay for it any way.

I remain skeptical that the government can do better than private business.

I personally have had a very good experience with the healthcare system. When I was in college (1994) I broke my leg in a 3-wheeler accident. I had complications from the first surgery which caused 2 more surgeries, 3 more weeks in the hospital, and my seeing 4 different specialists. I was insured under my parents evil HMO. All of my medical care cost nearly 100k, but my families out of pocket was less than $500. I got world class care that saved my leg (one doctor told me that 5 years earlier it would have been amputated.)

I understand that not everyone gets this level of care, but I am leary of giving up on what I have for belief the government is going to do it better.

1:01 PM  
Blogger hurtleg said...

"fails to insure 40 million people" in the US.

This means that about 260 million are covered. Do we want to destroy the system for 13% of the population. Just a little perspective.

From a macro viewpoint we have the best healthcare (quality wise) and most accessible in the world. As far as I know there are no 10 week waiting lists to see a specialist after a referal (even from the hated HMO's).

Your critique of the Canada plan, "Canada definitely needs to make reforms; more money needs to be spent, user fees should probably be instituted, and there should also be a role for "cadillac plan" add-ons from private companies" masks a bigger issue.

With single payer you advocate a crushing tax be placed on individuals or business to fund a system where people can't get to their doctor for 2 or 3 months because of the waiting lists. So like Britain we have the right to pay for the care from a private supplier out of own pocket to compensate for services we are taxed for and not receiving. Might as well cut out the government and middle man and pay for it any way.

I remain skeptical that the government can do better than private business.

I personally have had a very good experience with the healthcare system. When I was in college (1994) I broke my leg in a 3-wheeler accident. I had complications from the first surgery which caused 2 more surgeries, 3 more weeks in the hospital, and my seeing 4 different specialists. I was insured under my parents evil HMO. All of my medical care cost nearly 100k, but my families out of pocket was less than $500. I got world class care that saved my leg (one doctor told me that 5 years earlier it would have been amputated.)

I understand that not everyone gets this level of care, but I am leary of giving up on what I have for belief the government is going to do it better.

1:01 PM  
Blogger Jeff said...

"This means that about 260 million are covered. Do we want to destroy the system for 13% of the population. Just a little perspective."

Here's some more perspective: only .001% of the population was incinerated on 9/11, so why all the fuss and expenditure of hundreds of billions of dollars? The old system was working pretty well--provided you keep things in perspective. I like my health insurance too. Works fine for me. And if that's the end of the story for you, that should be your point; that as a libertarian, you don't really care whether or not other people have health insurance. That's a perfectly consistent position.

"From a macro viewpoint we have the best healthcare (quality wise) and most accessible in the world."

Prove that. That's the kind of throw-away statement defenders of the status quo are constantly making, so go ahead and prove it.

"With single payer you advocate a crushing tax be placed on individuals or business to fund a system where people can't get to their doctor for 2 or 3 months because of the waiting lists."

There's already a crushing tax on individuals and businesses, equal to that approx. 30% of total health care costs that are eaten up by marketing and G&A expenses, which are unavoidable inefficiencies in a free market system. Go ask the Big Three whether or not they find this to be a crushing tax. It's almost as if the only tax free marketeers oppose is the one imposed by Washington.

7:58 AM  

Post a Comment

<< Home