Check out the letters to the editor today and be edified.
It seems that a guy who speaks for the insurance industry doesn’t like our own Paul DeMarco’s idea for a single-payer health-care system. Well, that settles that. If the middlemen, who would be completely eliminated along with all their lovely profits, think it’s a bad idea, why on Earth should anybody listen to a mere physician such as Paul?
Anyway, for y’all who are too lazy to click, here’s the letter:
Government monopoly won’t help health care
Guest columnist Paul DeMarco (“Really fixing U.S. health care,” June 5) argued that single-payer health care should be implemented in America.
Although Americans are clamoring for health care reform, this is one proposed solution that should be taken off the table.
Under a single-payer system, the government could hold a monopoly over health care coverage, offering only one insurance plan option. If the government decided to reduce funding or deny coverage for medical technologies or procedures, Americans would either have to forgo potentially life-saving procedures or finance them out-of-pocket.
Under the current system, if people are dissatisfied with their plan, they can simply switch insurance carriers.
Any possible savings from a single-payer system would be quickly eaten up by increased use, and bureaucratic inefficiencies would replace functioning free-market systems. The result would be an overburdened, underfunded system that is more cumbersome to navigate than the current one.
We should seek alternatives to a single-payer system to ensure health care for all.ED BYRD
President
S.C. Association of Health Underwriters
Columbia
I was interested in how he brushed over the "any possible savings" part. Savings, of course, would be inevitable, because you would eliminate the third-party profits. Whether that were "quickly eaten up" in the way he suggests or some other way is certainly possible, but not inevitable.
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You mean Brad Warthen is FOR a big government program that takes from the middle class to give to everyone else? Shocking.
Neither you nor Dr. DeMarco have ever addressed what happens to all the jobs that would disappear if private insurance was eliminated. The impact on the economy (both locally and nationally) would be staggering. Downstream effects would also occur – vendors who supply private insurance companies – you know little guys who run janitorial services or service copiers and big guys like technology companies; pension funds that hold stock in private insurance companies; companies that provide outsourced cafeteria benefit plans). Let’s see some real analysis of how a single payer system would be implemented before you just go for the “obvious” solution. You are talking about eliminating an entire multi-billion dollar industry that employs upwards of a million people because you
laughably think the government can do it better than a competitive marketplace can.
You have ZERO evidence that a single payer system would be better for Americans. Do you know anyone who is on Medicare now (solely, with no additional private insurance)? Why don’t you talk to some people on Medicare or Medicaid right now to see how well their healthcare situation is going? Why don’t you go ask a few surgeons what they think of Medicare and/or single pay before jumping on the bandwagon? I can give you several names if you’d like…
Can you guarantee me and my family the same level of care I currently pay for out of my salary at no additional cost? If not, then you’ve got a tough job ahead of you. Just as you drastically misread people’s “emotional” response to the immigration amnesty issue, I expect you are way off course on realizing how strongly those of us with good insurance will fight to keep it.
A “multi-billion dollar” industry. Billions paid out by you and me (and this is generally the “middle class” you speak of; the poor are on Medicaid) to create jobs and produce profits that do not provide medical care.
That you could argue in favor of keeping that cost in the system is very odd, and a testament to the doublethink power of the libertarian ideology. You seem to suggest that it’s just GOT to be better, as long as somebody is making a profit somewhere. Am I misunderstanding you?
And yes, I’m sure you can produce physicians who are against the idea; so could I. What interests me is that these days, one can find physicians who think the way Paul does. That used to not be the case. More and more doctors, businesses and others who deal intimately with this insane cost structure are fed up with it.
For another view of the wonders of a single-payer system, go here:
>> You seem to suggest that it’s just GOT
>> to be better, as long as somebody is
>> making a profit somewhere. Am I
>> misunderstanding you?
No, you are misunderstanding that many of us already have insurance that we feel is very acceptable. You do understand the concept of “insurance”, right? It is meant to pool the risk of a large class of people.
Why don’t we nationalize auto insurance and home insurance while we’re at it?
So you can’t explain what happens to all those jobs, right? No idea on how to handle that little part of the equation.
Just blue sky and rainbows…
The way to lower healthcare costs is to work the supply and demand model. It means fixing all the aspects of the healthcare model that the government has its fingers in – the tort system that allows exhorbitant malpractice awards; the patent office that creates artificial monopolies; the Medicare system that underpays doctors for services so that the rest of us have to pick up the cost; local governments that actually can decide whether a hospital can create a new heart center or not; laws that create barriers that prevent a more tiered approach to care — why don’t we allow well trained nurses to do more “triage” type functions (including prescribing some medicines). There are plenty of small tweaks to the system that could improve access to quality healthcare by the poor. That’s what you’re trying to solve, right?
Doug, have you actually used the insurance you claim to be so happy with? My insurance is the biggest nightmare in my life at the moment. I never know why they pay what they do. I end up spending tons of money out-of-pocket. As for the system being competitive? Get real. We’re generally stuck with the plan our employer offers. The state does have some options but the obvious collusion among the companies renders any competition a mirage. What we have now is really an awful version of socialized medicine. The worst of both the free-market and government control all rolled into one gigantic mess.
So the government becomes the single payer and the sole negotiator of what medical care is worth. Why would I think that might more likely push health costs up instead of down? Because I trust market forces more than government workers.
Here’s how it works. Medicare pays X dollars for certain procedure, but the insurance company pays only 90 percent X and keeps the other 10 percent. Without either involved, the hospital bills the uninsured 200 percent X. So the average cost for the procedure might be 140 percent X.
With a single payer system, I’d bet 140 percent X would jump to 160 percent X or higher because doctors and hospitals would have too much autonomy.
Or else the quality of care would suffer because when the profit motive in medicine stagnates, less qualified people will end up practicing medicine.
And, gee, Brad, why would you think an insurance spokesmen would have less bias about our medical system than a doctor? Both, not just the insurance guy, have quite a stake in the situation. In fact, I’d be willing to bet the average physician makes quite a bit more than the average insurange agent.
Bud,
I am very satisfied with my insurance company (United Healthcare) and the options my employer provides for me to choose the coverage I need. Basically, I get X dollars per pay period and can determine the level of coverage I feel meets the needs of my family and my pocketbook. I choose a medium plan with reasonable deductibles, co-pays, etc. and have not had an issue. I also have a tax free healthcare savings account to which I contribute an amount equal to the deductibles plus X for the unforeseen events that come up with three kids. I haven’t filled out a claim form in years. The claims go to UHC, they pay their part, I pay the difference, and then there is an automatic deposit into my checking account within 30 days from the healthcare account.
I can check claims online anytime. It’s a great system. Excuse me if I have doubts that the U.S. Government could duplicate the service.
Now, if you wanted to know something I think the government COULD provide to its citizens, why don’t we start with setting up free, nationwide, highspeed internet and cellphone access for everyone. That would be an endeavor of the scale that could possibly transform our economy, our educational system, and our ability to communicate. I’d rather see the telephone companies go out of business before the insurance companies.
I am thrown in all directions on this issue, Brad. First of all I was just in the U.K. in business for a few days–you know, that place where everybody is dying because they can’t get good treatment–the place where everybody wants to go to another system more like ours. Funny, but somebody forgot to tell the British that–at least I haven’t been able to find those people.
The other side of it was what I’ve seen while living in Germany–the whole thing tends to expand into a huge entitlement system. How can you put safeguards into this thing so that politicians don’t use it to promise the kitchen sink? The Germans have come to the point that they couldn’t sustain this, and have had to start cutting back. My own (admittedly very limited) observation is that they can cut back by eliminating a lot of the “Kurs” or weeks at a health spa that the system often supports, but cutting back, once something is in place, is very hard to do.
How to keep this out of the hands of the sharks in the “free market,” and still keep it lean and trim?
Well, I’ve received health care from both the Navy (when I was a brat) and the private sector. No particular beef with either one, except that the latter was a whole lot more expensive.
From what I’ve heard, Herb, the French and Germans long ago went overboard with this welfare state thing. (Ooh, there’s a shocker for those who see me as a "big government ideologue"). That’s why I welcome the leadership of both Merkel and Sarkozy, even though Sarko isn’t a babe.
And it’s why I prefer a Blair to Old Labour. Not that I think the National Health is anything like perfect. That’s why they argue so much about it in Parliament. But here’s the neat thing about that: Parliament can actually DO SOMETHING about problems in their system. Over here, Congress is too afraid of offending the insurance companies to talk about anything that might actually reduce costs without undermining care. (They’ll sic Harry and Louise on you if you don’t behave, you know.)
Oh boy, wait until you see tomorrow’s op-ed page. Talk about your blind faith in markets. The author of tomorrow’s piece really needs to get off the state health plan (he’s a USC prof), and see what it’s like out here in the private sector. My favorite part in the whole recitation of Ayn Randian platitudes: "Markets are controlled by consumers. Government programs tend to be controlled by special interests." Hey, y’all out there outside academia and the governor’s office: How in control of your health insurance company’s decisions do YOU feel? And "special interests?" What do you call a private company?
I’ll say one thing about this prof, though: His libertarianism isn’t as whacked-out as this Clemson guy’s.
I worry about what would happen to some of these academics out in the real world.
So is the part of the argument for single-payer that special interests will lose their influence over the health care system? Where’s the evidence for that view?
C’mon Brad.. instead of your constant fear of the free market (which provides you with your paycheck), why not put the smallest intellectual effort into the single payor idea (or have Cindi do it for you if it’s too much to handle). Explain some of the details of the single payor system (since you have no capacity to explain what happens to all the employees of the insurance industry you want to destroy).
How will services be allocated? Can a surgeon decide who he treats? Will doctors be able to charge prices above the single payor costs for those who are willing/able to pay? If so, then how will it be any different than the system we have now? Can a person go to the doctor every day with one complaint or another for free? If not, who decides what the limits on office visits are? Will all prescriptions be free? If so, who decides what the drug companies get paid for them? Or will the government take over that industry as well?
Will there be different payments depending on where you live or does a doctor in New York City get the same payment for an office visit as one in Nebraska? Who sets the rates? Who decides when a surgery patient leaves the hospital? Who makes decisions on end of life treatment? Will nurses be paid like school teachers – based on seniority versus ability? Who will control access to expiremental drugs?
There are so many holes in the system you advocate that it is a complete joke. It’s pure “pie in the sky” wishful thinking with a complete absence of logic or intellectual rigor.
You can whine about people who happen to make more money than you whether by luck, intelligence, or perseverance… that’s fine. Your failing is that you want to apply your Big Daddy Brad view of the world to everything that exists outside your realm. Insurance companies are no different than McClatchey Co. that owns The State. They are in business to make a profit.
I’d suggest you take a course in basic economics so you can understand the concept of supply and demand. Any time the government tries to apply artificial restrictions on either side of the equation it results in an inefficient system. Your “idea” is to try and control supply AND demand. It will fail…
As I said before, wait til you start messing with the insurance of the soccer moms out there. The first time they hear that there will be a change in where/when/how they can get medical treatment for their kids, the outcry will make the amnesty opponents look like a whisper. If you’re going to offer a “solution” you better think it through.
Congratulations, Doug. Your hammer has struck the nail a definitive blow.
The soccer moms I know are sick to death with the current mess we’re dealing with now. Most of the questions Doug raises simply show how messed up our current system is. Take for example the question about who decides when a surgical patient will be sent home from the hospital. Under the current system the HMOs have entirely too much say in that decision and many patients are sent home entirely too soon. Under single payer the doctor would have much more say in the matter.
Another question Doug raises concerns the number of doctor visits allowed. Why does this continue to be an issue with those who support the current system we have? Few people want to go to the doctor. I for one never consider cost when making a decision to go. If I’m sick enough to go (or I need some type of preventive procedure such as a colonoscopy) I do so based 100% on medical need. 99.9% of the American public probably does the same. For the few super hypocondriacs out there that might be detered by cost we could have a small co-pay per visit.