Single-payer care would save us all a lot
Regarding the Rocky’s Aug. 2 editorial, “Single-payer baloney”:
Single-payer health care would permit us to avoid a primary effect of private, high-deductible health insurance: high individual out-of-pocket medical bills that rose 59 percent between 1995 and 2005, while unpaid medical bills nationwide increased 60 percent (reported by the American Hospital Association).
One effect is that some hospitals now require up-front payments for individual high-deductible insurance. The “uncompensated care” to hospitals and providers is shifted right back to individuals and taxpayers.
The truth is, taxpayers now pay more than 60 percent of all health costs, enough to cover everybody with greater benefits under a single-payer program if we eliminate the administrative waste of more than 1,500 private insurance carriers that amount to more than 30 percent of all health-care costs.
A. Lentz, Denver
Yep,
We wouldn't be inconvenienced at all by making choices for ourselves. Nor would we have to take responsibility for paying our own way. In fact the only worries we would have would be how much our taxes would go up and how far back in that line out the doctors' door we were.
It's always easier to let the other guy pay the bills.
Lentz grow up and stop whining for the government to make a bigger mess out of health care than they already are responsible for.
Give individuals the ability and the responsibility for their own health care through changes in tax policies and the funding of low and no income health care. If you still want your socialized medicine I'm sure Medicaid can mishandle one more person.
Posted by momma y on August 23, 2007 01:04 AMActually no matter which way we go, single payer or the current patchwork of insurance companies, the health system can't get much more screwed up than it already is.
My wife was giving birth to our son at a big hospital in town on Tuesday at 3 pm and there was NOT A SINGLE DOCTOR in the dedicated maternity ward. The doctor was on call and during the 30 minutes that it took him to show up we have lost our baby. It was fully preventable if the hospital had at least one doctor on staff. That is why we are 48th in the world for infant mortality, even Cuba has lower mortality rate. We are AT THE BOTTOM OF ALL INDUSTRIAL NATIONS in virtually all categories related to health care!!!
In many hospitals you will not find a doctor that works for the hospital. They are all independent contractors that only lease space so if you have a problem TOUGH, hope it's not life threatening.
Posted by on August 23, 2007 02:21 AMWhat is the definition of single payer, sounds a bit like a catchword or a weasel word, is it one or two words?, is it a combination word? And what is the difference between the political and common word definition, And just what the hell does it really mean.
Posted by Allen Campbell on August 23, 2007 04:37 AMlentz 98% of free loaders like you wanting someone else to pay their bills has gone up 99% since 2006. If people like you would pay for your family 55% of the tax payers would save lots of money. while only 13% really believe that the government could provide a worthy medical plan, 100% of them are politicans and they would be exempt from using it as they would not stand in line like the rest of us would.
just look at the way they run Walter Reed hospital. the guy form hawaii had a really great idea to spend money to fix it, oh wait that was his guy in the capitol building that we could never use.
if you want socialized medicine please go to canada or cuba or venezuela and find out how wonderful it is and let us know your findings in 10 years.
I suggest those of you who are opposed to a single payer system think for a minute. Health insurance companies have one goal: to make money. In other words, it is their mission to collect the most money they can for insurance premiums, then - when a covered cost is appied for by the insured party (and those covered costs can change at whim), to pay out as little as possible. Precisely HOW is this better than a single payer plan?
24 countries have single payer plans - the best one appears to be Japan: everyone is covered & it is payed for by a combination of employer payments, taxes & co-pays. They have the highest life expectancy & lowest infant mortality rate - and the cost to the country (based on GDP) is 1/3 to 1/2 what the US spends (which has much lower life expectancy & much higher infant mortality rates). If folks in government are too stupid to look at the existing single payer systems and take the best from them & drop the worst, shouldn't they be fired/voted out of office? Of course, the first thing I would insist on is that as the tax portion comes in it be put in a dedicated fund - perhaps backed by T-bills (maybe we could start buying them back from China) instead of being put in the general fund as Soc Sec is.
Ultimately, when people go uninsured (normally because of low pay & high cost of insurance or because they are healthy & don't anticipate a problem - see Bill Johnson's column today for betting that you won't have a problem) we ALL end up paying, either because they end up using higher cost emergency room services (and the hospital pads that into everyone else's bills) or they have to declare bankruptcy. Can't wait until the folks who are so concerned about horror stories of having to wait for elective procedures run into a major health care problem of their own & have the insurance company who has their health policy determine what the appropriate medical treatment is.
Posted by Mary on August 23, 2007 06:20 AMSingle payer would create a monopoly, and monopolies mean higher prices and inferior service. Monopolies are hostile to the consumer, that's we we enforce laws and legislation against them.
On the other hand, competitionb and multiple choices mean lower costs and better service. No system works as well as the one that permits the consumer to shop the system and make choices in his own best interest.
The single payer alternative would make us all dependent on the folks who maintain our bridges, secure our borders, run the post office and set our national energy priorities for our healthcare. The very thought of that is enough to provke a stroke.
Posted by Hank on August 23, 2007 06:54 AMMary,
If you think healthcare is expensive now, just wait until it is free.
Mary,
I suggest you go to Japan and see what you are actually talking about. There are currently 1800 Health Insurance Societies in Japan that provide Insurance. Premiums depend on the employee's annual income, but amount to approximately 8.5% of their salary. An insured person and their dependents must, in addition to contributing the cost of the premium, pay 20 to 30% of inpatient and outpatient costs and make an additional co-payment for prescription drugs. Sound Familiar?
Japanese people are traditionally unwilling to voice displeasure or unhappiness with the government, but rising healthcare costs are causing an increasing number of people to speak out. People are becoming more sensitive to quality of care, hearing of frequent reporting of medical errors, long waiting times for outpatient service in large hospitals, and an extremely short consultation time. Additionally, patients' access to information about their medical records is patchy at best, and the lack of physician peer review organizations or widespread hospital accreditation is causing some concern.
They also have 1.9 physicians per 1000 people compared to 2.7 per 1000 in the US.
Posted by Dravur on August 23, 2007 07:52 AMNo new insurance plan (single payer or as it is now) will be cheaper, only the services rendered will be.
Do you honestly think that the multi-billion dollar health insurance industry will let go of their stranglehold on their livelihood? Who do you think the government will draft to run the system? What would happen to all the employees (and CEO's)? Maybe they can do some of the work that illegals are doing now.
8:54 am is correct. Insurance companies would NEVER let the government take over unless the business was given to them. Can you see Aetna, United, Cigna, BCBS fighting to be the "one" provider endorsed by the government?
Then, the insurance company would have complete control over what was covered (or not). You think things are bad now---just wait until there's no competition. Remember the phone company????
Posted by CWW on August 23, 2007 09:20 AMHas anyone bothered to look at what you pay via premiums for the multitude of insurance companies, doctors and hospitals that exist? Every single one of them has a huge and costly bureaucracy to bill and track payments. Every single one of them uses different information, different codes, different forms and so forth. None of them even use the same tracking numbers. We pay a s___ load of money for those vast number of workers needed to do all this. My view of a single payer system results in one standard form with a standard set of codes which are actually written in English so you can ensure they are only billing for what you had done, tremendous reduction in wasted manpower, and using all that freed up money to reduce overall costs and cover those that are not covered. And until you have a health issue and are not covered by health insurance or are only minimally covered then you really are not in a position to comment on anything because you haven't really experienced this system. We have a child that had cancer and we were in health insurance transition so were using the more expensive COBRA option. Luckily our incomes allowed up to pay the twenty five percent co-pay and quarterly fees but I kept close track of all the documents. It was a time-consuming and frustrating process. There is no statute of limitationn on bills either. We just received another two for care that occurred two years ago. I've seen the enemy and it is us as Pogo said. Insurance is a business. It's goal is to make money. It cannot do that by paying for medical care. Health care should not be a money making business. It should be considered a utility. However, in the long term all these arguments pro and con are meaningless as the system is in the process of change now. Big businesses like the car companies and airlines want to get out from under the health care cost monster and are pushing for change so it becomes someone elses burden. Wal-Mart and other companies have introduced store based walk-in clinics that charge much less and are just as effective. (Obviously the acute care clinics that began popping up in years past were not convenient enough or obvious enough for us to use.) Between just these two we will see massive change over the next decade.
Posted by Been there on August 23, 2007 09:32 AMWatch your taxes increase by at least 35% if this socialized medical plan is adopted.
Posted by legal on August 23, 2007 10:19 AMBeen There,
you said:
"until you have a health issue and are not covered by health insurance or are only minimally covered then you really are not in a position to comment on anything because you haven't really experienced this system."
OK. I qualify. We have Kaiser. I believe it is the model for the Denial-Care in the Funky Winkerbean comic strip.
We are currently trying to survive on less than 30K per year. The co-pays and unpaid elements are quite expensive. The only system that could possibly be worse would be to let the government take over.
We need to make insurance more available to the individual. Changing tax benefits from employers to individuals will make the insurance more responsive to the individual. That is what a free market is..you buy and they sell so they want to sell to you and they offer plans and incentives to accomplish that. Today we take what the big wigs at the company buy and if you want a better plan then you need to be the boss or get a situation like we will have in January where you can get a medical savings account. (His bosses wife is ill so we are going to get the best insurance next year as well as the MSA we have been trying to get for years.)
We also have experienced what government health care would be. My husband is a disabled vet and the VA makes Kaiser look good! Illness is always difficult and issues like insurance will never provide all that we need or desire. Neither will the government. Other countries are not as large, as diverse nor as free as we are. Maybe we need to look at the actual results of such countries plans. We have people coming here for their health care. I am a heart patient and when I was in the hospital there was a woman there whose mother is a Canadian. The woman had a bypass. (I don't have enough heart muscle left for one.) She mentioned that her mother had a bypass also but had to wait almost a year for it.
I have since heard other stories and was able to see for myself when a customer of mine made arrangements to be driven to and from Vail for treatment of a broken leg. He told me that the surgery and rehab he needed was not available in Canada so it was better to fly here once a week for a month and then every few weeks for the better part of a year. We became friends and the issue of health care almost never came up so I can't tell you why or how such a thing happened. He was not able to ski the following year but the year after he brought his family here.
That's two cases where socialized medicine hurt people. Again, if you want the government in charge go on Medicaid. That will show you how efficient such a system can be.
How much money would we save if we completely elimitated Illegal care from our midst ?
Posted by Fresh on August 23, 2007 11:55 AMlegal,
If my taxes go up 35%, then I have to equate how much my insurance premiums will go down (or vanish). Let's see.....
Oh, that's right we all pay for each others healthcare anyway.
How silly of me.
Hank said: "Single payer would create a monopoly, and monopolies mean higher prices and inferior service. Monopolies are hostile to the consumer, that's we we enforce laws and legislation against them.
On the other hand, competitionb and multiple choices mean lower costs and better service. No system works as well as the one that permits the consumer to shop the system and make choices in his own best interest."
Hank, in theory things should bear out this way, however, we're just not seeing that happen with our current privatized insurance system where there are many plans and companies. Prices keep going up, up, up...
It seems that common economic rules aren't applying to healthcare. Why is that, do you think?
Do you think, in part, because of the complex nature of how insurance companies make their profits?
Their profits don't come directly from the premiums they charge, although they need the premiums to fund how they make their profits: through investments. When investment profits decline, they then jack up the rates on their premiums. All this is tied to stock market performance, interest rates, etc.
It just seems to me there are extra complex layers added here that seem to change the usual economic rules in terms of competition and monopolies.
I do agree with you, Hank, that we run the risk of compromised service with a single payer system. Although, I'm sure we can all share a few annecdotes about poor service we receive now. Nevertheless, it's a potential issue that should be examined in full.
However, a single payer does hold most of the bargaining chips in terms of what they will pay, so I see a single payer system as really driving down the costs of healthcare.
That being said, I have heard a "taxes raised by 35%" warning bandied about several times now, and I'm wondering if anyone can provide some credible information backing that assertion up?
Posted by mytwosense on August 23, 2007 01:20 PMsorry for a double post folks, but I didn't fully italicize all of Hank's comments. Round two...
Hank said: "Single payer would create a monopoly, and monopolies mean higher prices and inferior service. Monopolies are hostile to the consumer, that's we we enforce laws and legislation against them.
On the other hand, competitionb and multiple choices mean lower costs and better service. No system works as well as the one that permits the consumer to shop the system and make choices in his own best interest."
Hank, in theory things should bear out this way, however, we're just not seeing that happen with our current privatized insurance system where there are many plans and companies. Prices keep going up, up, up...
It seems that common economic rules aren't applying to healthcare. Why is that, do you think?
Do you think, in part, because of the complex nature of how insurance companies make their profits?
Their profits don't come directly from the premiums they charge, although they need the premiums to fund how they make their profits: through investments. When investment profits decline, they then jack up the rates on their premiums. All this is tied to stock market performance, interest rates, etc.
It just seems to me there are extra complex layers added here that seem to change the usual economic rules in terms of competition and monopolies.
I do agree with you, Hank, that we run the risk of compromised service with a single payer system. Although, I'm sure we can all share a few annecdotes about poor service we receive now. Nevertheless, it's a potential issue that should be examined in full.
However, a single payer does hold most of the bargaining chips in terms of what they will pay, so I see a single payer system as really driving down the costs of healthcare.
That being said, I have heard a "taxes raised by 35%" warning bandied about several times now, and I'm wondering if anyone can provide some credible information backing that assertion up?
Posted by mytwosense on August 23, 2007 01:33 PMdarn it, still didn't do it right...well, Hank's comments are the first two paragraphs.
Posted by mytwosense on August 23, 2007 02:48 PMmts
The 35% figure is a guess but not an uniformed one.
The perceived failure of the free market in health care is actually the failure of partial government control in health care. People who don't know the cost of a thing have no incentive to find out unless the cost will make a difference to them. Current insurance and the government interference create that situation. The government gives businesses a tax benefit for providing health insurance. This creates a market where the majority of the demand, and money, is in one area. That is the area that the current system markets to. Why offer individual plans when your big money comes from businesses whose main intention is to get the best price not the best coverage?
If you want to get an example of how the insurance companies market to individuals check out all the commercials you see for car insurance. Want to get an idea of how they would market health care insurance in a system of individual responsibility? You might have to find an older neighbor but my mailbox is full of offers from companies wanting to insure us with Medicare gap insurance and others offering "bridge" insurance to cover us between early retirement, what I am technically doing while I decide if the paperwork for Medicare disability is worth it, and retirement. The companies offer much greater varieties of plans and prices than I see in health insurance. AARP, the liberal swamp for seniors' money, offers several plans that offer good coverage at a rate far below the private rates usually found and this is for a group of people who are in danger of extreme health issues.
Before I trust the government on health care I'd let my husband take care of my garden again! This will be the first year we don't get enough veggies to can and freeze for the winter. With a little luck I won't be buying any spices though. And my husband has the same good intentions that the government has with health care and the same lack of knowledge. Same result too...lots of intention...too little action.
Posted by momma y on August 23, 2007 03:06 PMmomma y, I am not a supporter of employer-funded insurance, either. However, I am not convinced in your theory that to simply eliminate it, we will see affordable insurance plans available.
According to this article, employer funded insurance has been steadily dropping in this country. In fact, less than 60% actually receive insurance through their employers - according to this article, anyway.
http://newstandardnews.net/content/index.cfm/items/2498
But healthcare costs and premiums continue to rise. There is no correlating drop in either with reduced employer-funded insurance coverage.
That's why I put forth the question, is the way the insurance industry gets their profits changing typical economic rules regarding competition and choice?
Also, I agree with you that people should be proactive in finding out how much their treatments cost, regardless if they're insured. And it seems you have particular luck in this area. But the reality is, a lot of times the healthcare provider won't give one that information. A friend of mine is trying to "shop around" for a price on an MRI, after being told by her insurance company that her co-pay will be $1200. She inquired with a clinic who flat out told her they "didn't have that information - that rates were different for insured versus uninsured."
So she can't even shop around. As far as I know, there isn't any government regulation forbidding healthcare providers to reveal their prices.
The whole system is just a headache, and your solution to simply eliminate employer tax benefits seems to be ignoring a lot of other factors.
Posted by mytwosense on August 23, 2007 03:35 PMmomma ya, I take it what you're advocating are "consumer-driven healthcare plans," i.e. lower premium, high deductible plans that are paired with tax deductible savings accounts.
I found some interesting information about these plans at www.ebri.org, a benefits policy organization funded by major insurance and finance companies ((UnitedHealth, Kaiser Permanente, JP Morgan Chase, T. Rowe Price to name a few).
According to EBRI, 1.3 million people are currently enrolled in such plans.
A majority of the people in these types of plans don't actually have a health savings account, or at least anything in one, because they can't afford it.
And 44% of the people in such plans spend double the rate of out-of-pocket healthcare costs and premiums than those with comprehensive care plans.
The findings do show that people who gravitate towards these plans are more cost conscious...but it doesn't seem they're getting the deal they're looking for.
I know you place your faith in the "market" far more than you do with your government, so I encourage you to check out even more findings from EBRI, as they are funded by the very groups that currently run our healthcare market.
Again, it's www.ebri.org
Posted by mytwosense on August 23, 2007 04:01 PMLet's see if I got this right: The government is taking our money, in the treasury, and putting it into the bank accounts of insurance companies to save us from socialism?
Sounds like corporate socialism, but I guess they know what's best for us, just like the government. Oh that's right, they are the government. It's more like legalized robbery.
Posted by Stan Broyles on August 23, 2007 04:49 PMmts
I think the real problem with insurance is that people don't know the costs and too many don't care. The case you cite where a care provider refused to quote a price is a prime example of what happens..
As for the studies on the health savings accounts the government regulations on such accounts were put there to prevent too many of them being in use. I have first hand knowledge and experience with a friend whose wife had had to have expensive surgery in an emergency. The total was so high that all of their account would have been gone to pay the deductible on their backup insurance. They went to the finance office and got a detailed copy of the bill and sat down with the nurses' charts. Five hours later we came up with errors totaling over ten thousand dollars and that was just from the charting and not from anyone's memory. Needless to say there was no deductable to be paid as the hospital had to decide between losing that much of the payment from the insurance company, which didn't have a contract with that hospital so they paid full price, and gaining half that from the co-pay. (Yes, I helped them. It's one of the few things I can do these days.) We notified the insurance company that we had discovered errors in the bill and to contact my friend for details. Six months later there are no calls from the insurance company.
As for there being no real change while the number of companies providing insurance is going down, it makes perfect sense. The major market out there is still the businesses. A few sales can mean thousands of dollars in commissions while individual sales mean little or nothing and require extra paperwork. We will not find it easy to bring people out of two generations of medical illiteracy but the other options are worse. Look at the VA answers to questions about diabetes they gave my husband.
Sometimes I wonder why I fight so hard when I would be one of those who would gain the most from socialized medicine and won''t live long enough to suffer the consequences. Guess my parents raised me to be responsible for myself. My sister. former welfare queen, tells me I'm nuts to wonder about fling for disability and the doctors confirmed it yesterday. I have only 1/3 of the minimum amount of heart function. I think if you have only 24% of one measure you are disabled and I have like 10%.
I like the reaction my cats have to my posting. (I am confined to a bed or chair and can't even bend to the floor.) They just stole my mouse again. Now I have to use keyboard commands until they come back and do their kitty dances on the keyboard.Think I'll just end my post here.
Guess I shouldn't tell you how I handle the school system and my grand daughter. Hint: even the social worker is too busy to pester my little one more than once a month.
Posted by momma y on August 23, 2007 08:34 PMDravur: "I suggest you go to Japan and see what you are actually talking about. "
Did Dravur go to Japan? Well, no, he didn't go quite that far. But he did go to his computer and typed in www.google.com. Dravur is an expert at one thing: plagiarism. He got to this website: http://www.medhunters.com/articles/healthcareInJapan.html and everything he says comes from it, though he posts as if it comes from him.
He somehow failed to include this statement from the website;
"Q: What is the quality of care in each system?
A: The healthcare available to the average Japanese person is comparable to that in other industrialized nations."
He posts that the Japanese have problems with their health care system. No kidding? The list of countries that don't have problems with their health care system has no names on it.
The World Health Organization ranks Japan at number six and the United States at number thirty-seven. (Back in 1945, the United States was number one.)
The Human Development Index states that Japan spends $2,512 per patient whereas the United States spends more than twice that much, $5,274. I wonder how much better the Japanese health care system would be if it spent more than twice as much as it does? As it is, it covers everybody.
According to the Index, Japan spends 7.6% of its GDP on health care, whereas the United States spends 13.1 percent of its GDP on health care.
I wonder how much worse the health care system in the United States would be if it cut funding by more than half?
Posted by Truth on August 23, 2007 09:00 PMmomma y, you state:
"As for the studies on the health savings accounts the government regulations on such accounts were put there to prevent too many of them being in use."
Two questions:
1) What specific regulations put in place by the government are you referring to?
2) Why would the government, especially the one we've had for the last seven years, want to prevent too many of these accounts being put into use? The Bush administration is a huge advocate of HSAs, as this law signed into legislation just last December indicates: http://www.ustreas.gov/press/releases/hp209.htm
Posted by mytwosense on August 24, 2007 11:53 AM"Why would the government, especially the one we've had for the last seven years, want to prevent too many of these accounts being put into use?"
That's a great question. Mr. Bush has been trying to expand the use of HSA's. I'm not really sure who opposes it. Well, I know who but I'm not sure why. It's pre-tax dollars for the middle-class. What's the big deal.
I have something called an FSA (Flexible Spending Account). It's very similar to an HSA. Except for a weird requirement: I have to spend all the money in my account before the end of the year. Why? I have no idea. I'm a healthy man. I rarely go to the doctor or buy medication. But, before this year is over, I will spend a good chunk of change on needless medically expenses that I would not normally consider.
But, my point is that government involvement skews the market in unintended ways. If I could leave that money in my account year after year and allow it to earn interest (and interest on interest), I'd have a nice pile of cash for medically emergencies. Then, I could purchase cheaper health insurance with higher deductibles.
Posted by John II on August 24, 2007 11:14 PM