Single Payer Healthcare Would Be Better (Guest Voice)
Single Payer Healthcare Would Be Better
by Jim Bell
Thinking that we can solve our health care problems with one bill is wishful thinking at best, and is no where near realistic. Initially, the bills in the House and Senate are taking the approach that the Government should enter the health insurance business and offer health coverage that would ultimately make it all but impossible for the health insurance companies to compete in the healthcare arena. This is like trying to eliminate criminal behavior by allowing the Government to go into the rackets by creating its own gang with the objective of running the current gangs or mafia organizations out of business by out competing them. One of the biggest problems in our healthcare system is health insurance.
The insurance companies don’t make their money by providing insurance; they make their money by denying it. Insurance companies themselves need to be removed from the healthcare equation all together. They are not in the healthcare business. They are just in business. But they are not the entire problem.
While reading the editorial pages of the Denver Post on July 12, I noticed a letter from a Dr. Patrick Messerli, of Durango, CO, who mentioned that when the Mayo clinic takes on new patients, they regularly perform all lab tests over again so they can bill for them. This is a business model of generating revenue by duplicating all tests and procedures once the patient arrives at the clinic. The tests already performed by the patient’s doctors were good enough to get them into the Mayo clinic in the first place but not good enough for clinic doctors to study and decide upon the proper treatment. While it is understandable that an occasional test may need to be repeated to verify or even clarify what clinic doctors must troubleshoot, it is a wasteful policy that requires repeating them all. The Mayo clinic is not the only clinic our there that practices this way. Health insurance is what makes this all possible.
To make matters worse, Time magazine reported that “research by the Dartmouth Institute for Health Policy and Clinical Practice has found that as much as 30% of our annual $2 trillion–plus medical bill may be wasted on unnecessary care, mostly run-of-the-mill diagnostic tests, office visits, hospital stays, minor procedures and prescriptions for brand-name wonder drugs advertised on TV.” All of this is because they can get reimbursed for these items and procedures by the insurance companies.
Then there is the case of a European physician who was conducting research on human DNA years ago. The CBS news magazine 60 minutes did a feature study on him a few years back and found that this doctor, while his research was admirable and would ultimately result in many good applications and discoveries for mankind, was getting rich by selling all of his DNA data to major health insurance companies. The companies involved were in turn using this information to deny health coverage on procedures for ailments and afflictions that could be predicted by studying this DNA database under the guise of, you guessed it, pre-existing conditions. This is another situation made possible solely from the involvement of insurance companies in the healthcare business.
If you, or your family, decide to have your DNA tested to determine if one or all of you are risk for some hereditary disease with serious ramifications, you should not have to be concerned that your personal data will be used against you by your health insurance company when making your decision. But you now have no choice but to consider that possibility because your health care is not determined by your doctor. Your doctor merely recommends. The ultimate decision on your health care is made by some accountant, actuary scientist (insurance longevity predictor) or some other insurance executive or bureaucrat—and that decision is based upon the cost, not the health benefit.
These decisions that insurance companies make for you have much more far reaching effects on your life than whether or not you get the treatment you need. What if you are the minor bread winner for your family and you work for a small business with less than 100 employees. Maybe you are the one who has employer provided health insurance because, say the major bread winner is self employed or is in sales or some situation where there money is better than your income, but there is no health benefit.
So consider if you will, that you develop an expensive medical issue. You go to the doctor, who then refers you to a specialist. The specialist puts you on a treatment that is effective but extremely expensive. The insurance company covers it because it is not something they can refuse. The owner of the small business where you work is now faced with escalating health insurance costs. The company has no choice but to pay it, but now you are under scrutiny. They cannot just fire you, but they can watch you until you make a mistake. They document it and talk to you about it. It may take them a year or two, but eventually they will get you out of there. Now you are looking for a job.
That’s illegal, you say. True, but unfortunately any company can get rid of anyone for reasons other than what they will actually fire you for. If you watch someone long enough, they will make mistakes. Eventually, these mistakes will ad up to termination. Don’t be naïve enough to think that this does not go on, because it does. If the company where you work is small enough, it could make the difference for them between being able to provide health coverage for their employees or not. They could have very little choice but to take this action. This is more unfortunate collateral damage caused by health insurance.
Under the current system you lose access to healthcare when you lose your job. Yes, you can get cobra, but it costs more than your original healthcare coverage cost you when you were employed. The main difference here is that you no longer have any income with which to pay for it. This is a great system, huh?
A single provider system, like the federal government, is a good solution to this. It won’t fix everything, but it is certainly a great place to start. And before you write in and say socialism, socialism, socialism. I have a question for those of you who believe that gobbledygook. Are you healthy and in no real need of healthcare? Because that is who usually hollers the socialism argument. With the single provider system you will not be sent home without treatment for the cancer you have just been diagnosed with simply because you don’t have health insurance or the $40,000 to pay for the treatment. Under the current system that is exactly what could happen to you.
Healthcare should be part of the national infrastructure of support services, just like police and fire protection, education, highways and protection from our enemies. Detractors will argue that to take healthcare out of the public sector will result in less advancement by removing competition from the system. Competition hasn’t produced an efficient system so far. Besides, this will not remove all competition. There would still be government contracts for everything that goes into any doctor’s office or hospital.
Having government provided Police and fire protection hasn’t resulted in lower quality protection, nor has it removed competition from those endeavors. Healthcare is eventually a life and death scenario for all of us, and we shouldn’t have our healthcare decisions made for us by someone who’s main concern is the profit of his or her company and their secondary concern (if that) is your health and well being.
Jim Bell also writes on his own blog, The Sensible Approach.
Jim Bell
http://thesensibleapproach.blogspot.com
8 Responses to “Single Payer Healthcare Would Be Better (Guest Voice)”
Jim, you've made a good case that fee for services is at the root of the rising costs in healthcare. And you've argued that a single payer approach would be better. I agree with both of those statements. However, you haven't connected the two. If costs are rising because of too many procedures, how would a single payer system which pays for procedures correct that?
My own view is that the dog in the manger is that our cost base is just too high and that's one of the reasons solutions which are working adequately elsewhere are impractical here.
Dave, the connection is made when you consider government oversight. It isn't perfect but it's better than the system that isn't working now and will never work ever in a profit-oriented business model which health care must be in the private sector of a capitalistic society.
Jim is right, we already have had a hybrid of capitalism and socialism in this country for many many decades, even centuries at this point if you remember the US Postal Service/Pony Express Sheriffs and armies on the old US payroll. Apparently it's OK to save lives when it comes to war but not OK when the enemy is a virus, bacteria or an organ failure.
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“Insurance companies themselves need to be removed from the healthcare equation all together. They are not in the healthcare business. They are just in business.”
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I think I'm going to have that statement bronzed and set over the mantel. Maybe a bumper-sticker? Who says there's no silver lining on the current health care “debate”.
BTW, look for insurance bots posing as real people with souls to be out in numbers defending the indefensible, the immoral and dark agenda of the insurance companies. Their arguments will appear reasonable, logical and sceptical of single-payer, but will be utterly devoid of morality.
I think you're making a mistaken assumption. You can have both a single payer system and a fee for services system. They aren't in conflict. The German healthcare system is such a system.
If you're saying that a single payer system would enable some other compensation system, well and good. But Jim doesn't make that argument.
Well it is a free country and competition for already standing services like police and fire protection are already in existence. People can hire personal body guards and have a private fire-suppression crew on staff. It's just that the po' folk need these guaranteed…
Like health care. You shouldn't have to pay with your life for the “crime” of being poor. That's what this entire debate is all about. The poor have numbers on their side and believe me you we're keeping track of how our elected officials handle the guarantee if this inaliable right. It should've been included in the Constitution. Thank goodness our forefathers included language to revamp and make necessary changes that benefit the masses. I'd like to see a new Amendment added that guarantees access to health care that doesn't impoverish people.
Ah, that notorious weasel-word phrase again. WHO'S THE PAYER?
“Medicare for All” (federal health care) has been long sought, and once in a while, even honestly and transparently — as opposed to the weasels with their “single-payer” stunts. (OK, some of them may not be primarily evasive, but more sappy and actually enamored of that euphemistic phrase.)
But leave it to the Dims to not only rush to engage in all kinds of idiocy since the election, but to rush to bungle health care, too. (Is that why Obama is continuing his low-IQ-appealing “campaign” nation-wide?)
I listened to Obama's Cleveland campaign appearance [rolling eyes] and it's notable that none of the pundits, on the networks or in the self-absorbed Blogosphere, made the intelligent note about one thing he said, that he was impressed specifically by having doctors on salary rather than on a fee-for-service basis at a famous clinic, something that in fact goes beyond Medicare (though the federal government could retain Medicare but use capitation payments, and say with a straight face to the satisfaction of the low-IQ government-health-care militants that this does not make Medicare more like the National Health Service of the UK, or that doctors won't effectively be working as employees of the federal government).
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“[inalienable] [fundamental] [human] right. It should've been included in the Constitution. … [remainder mercifully clipped]“
This remains nonsense, as is a “right” [sic] to snazzy clothes, a house, a guaranteed minimum income (using the same reasoning many lefties use), and so on, but sadly, many believe it, so Dems exploit it.
“Well it is a free country and competition for already standing services like police and fire protection are already in existence.”
Once people become dissatisfied with government health care, they'll seek private alternatives. This “private option” is anathema to those who want universal government health care, which is why private duplication of what is to be provided publically is restricted or prohibited. This is true in the case of the Conyers-Kucinich “Medicare for All” bill, for example:
SEC. 104. PROHIBITION AGAINST DUPLICATING COVERAGE.
(a) In General- It is unlawful for a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act.
(b) Construction- Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, such as for cosmetic surgery or other services and items that are not medically necessary.
http://thomas.loc.gov/cgi-bin/query/F?c109:1:./…
That's today's (repeated) lesson, kiddies, though I'll leave y'all with a refresher. (Note that it includes this: “Private health insurers shall be prohibited under this act from selling coverage that duplicates the benefits of the USNHC program.”)
http://conyers.house.gov/index.cfm?FuseAction=I…
http://www.johnconyers.com/hr676faq
The problem is that if the Obama-care private plan is passed that will be it for some time before any other health care “reform” is possible. I think it is time for a little political backbone among the single-payer crowd. We should advocate for a “no” vote on whatever comes out of the House. Plenty of “the enemy of my enemy” logic here, but still a necessity. I doubt, given the evidence from Massachusetts, that the Kucinich state-by-state tactic will work well. Good political theater with little economic viability.
One of my favorite arguments against gov't run healthcare goes along the lines of “Do you want a government bureaucrat making your medical decisions for you?”. It seems to me we already have bureaucrats making our choices, but the ones doing it now work for a profit driven enterprise that is rewarded by denying services. I fail to see how having the gov't do it is worse.