Positive conservative views on "single payer" health care

[Revoltingest]

Of course there's quacks. I stil fail to see how an insurance company is a better choice. Another doctor sure. But a company intent on making profit? No thank you.

I shouldn't have emphasized "quacks". There's a problem with western medicine...it's
not as evidence based as we like to believe. Docs will each have their own approach
to things, & they often aren't optimum per research. Some entity, be it insurance
companies or other agency, should give guidance.

Question....
Under a government run single payer system, what would happen to......
- Chiropractors
- Osteopaths
- Reiki healers
- Homeopathy
Would government employ these types?
Will patients be denied their preferred 'treatment'?

 

[SomeRandom]

I shouldn't have emphasized "quacks". There's a problem with western medicine...it's
not as evidence based as we like to believe. Docs will each have their own approach
to things, & they often aren't optimum per research. Some entity, be it insurance
companies or other agency, should give guidance.

Question....
Under a government run single payer system, what would happen to......
- Chiropractors
- Osteopaths
- Reiki healers
- Homeopathy
Would government employ these types?
Will patients be denied their preferred 'treatment'?

I dunno I live in a universal health care system. No one blocks preferred treatment of anyone, as far as I'm aware. Chiro and osteopaths are actually often offered on our private health care though. I think some also offer homeopathy, if that's the preferred choice of a person. Although our dentists can charge whatever they want, since they somehow escaped the Medicare thingy. And if a treatment is objected to, we just go to some other practitioner (who bulk bills.) No harm no fuss. I think I'd far more readily put my trust in a second or third opinion professional than some grubby insurance company regardless of circumstances though.

 

[sun rise]

Who & how?

https://www.cnbc.com/2018/03/28/may...lth-care-middlemen-create-a-lot-of-waste.html

 

[Valjean]

We need a practicing doctor to weigh in on this.
Don't believe everything you hear from critics of the current system.
I've never experienced what he claims.
Does it happen?
I suppose that depends upon circumstances.

I've been an RN for over 40 years, and have worked in a half dozen hospitals in two different states. During that time I've seen healthcare costs skyrocket and the insurance industry insinuate itself more and more into medical decision making.

https://health.usnews.com/health-ca...nsurance-companies-meddle-in-your-health-care
http://www.genfkd.org/study-insurance-companies-rejecting-doctors-orders-save-money
http://www.courant.com/opinion/op-e...or-patient-insurance-0208-20150206-story.html
http://thehill.com/opinion/healthca...ental-problem-your-doctor-doesnt-work-for-you

 

[Valjean]

I don't care what circumstances there is. There is no reason an insurance company should have any say over medical treatment as prescribed by a medically qualified professional. That is insane.

But this is America, and "The business of America is business," to paraphrase Coolidge. Like other businesses, The insurance industry is legally and, it believes, morally bound to maximize profits for its stockholders -- by any means necessary.

Doctors don't always prescribe what is best.
Some oversight with an epidemiological approach is worthwhile.
There are quacks out there....I've had some as commercial tenants.

True that, and healthcare's business model sometimes encourages fraud, overcharging, upcoding, &c. There's an incentive to enter the profession for financial, rather than altruistic reasons.

 

[PureX]

I agree thought that insurance companies have major problems
dealing with their customers, with neither fully understanding
what their obligations & rights are.

That's because they are not interested in their customer's obligations or their rights. They are interested in taking in as much money as they can, while paying out at little as they can. And they are rewarding any administrator in their company that makes this happen. And the government, that should be looking out for the interests of the people in a capitalist economy that does not do so, has been bought off by those same insurance company lobbyists, and all the other corporate lobbyists. So no one is looking out for the rights or well-being of the general population in any of their commercial dealings. And as a result, we are being gouged not just by the insurance companies, but by every company and corporation that can pay the lobbyists to bribe the lawmakers to write the laws that enable them to exploit the public at will. So we're being exploited not just for our health care, but for transportation, communication, energy, shelter, and every other thing we humans now need to live in a modern, inter-dependent society.

 

[Revoltingest]

I dunno I live in a universal health care system. No one blocks preferred treatment of anyone, as far as I'm aware. Chiro and osteopaths are actually often offered on our private health care though. I think some also offer homeopathy, if that's the preferred choice of a person. Although our dentists can charge whatever they want, since they somehow escaped the Medicare thingy. And if a treatment is objected to, we just go to some other practitioner (who bulk bills.) No harm no fuss. I think I'd far more readily put my trust in a second or third opinion professional than some grubby insurance company regardless of circumstances though.

What a horrible thought....my federal taxes lining the pockets of homeopaths & bone crackers.
Now, for your enjoyment....

 

[Revoltingest]

https://www.cnbc.com/2018/03/28/may...lth-care-middlemen-create-a-lot-of-waste.html

Don't take this the wrong way, ie, dissing you....
Holy cow, was that article short on actual info!

 

[Revoltingest]

I've been an RN for over 40 years, and have worked in a half dozen hospitals in two different states. During that time I've seen healthcare costs skyrocket and the insurance industry insinuate itself more and more into medical decision making.

https://health.usnews.com/health-ca...nsurance-companies-meddle-in-your-health-care
http://www.genfkd.org/study-insurance-companies-rejecting-doctors-orders-save-money
http://www.courant.com/opinion/op-e...or-patient-insurance-0208-20150206-story.html
http://thehill.com/opinion/healthca...ental-problem-your-doctor-doesnt-work-for-you

My experience with spendy health care was long ago.
It seems that things have changed.
Back in the day, it was so simple & cheap.

 

[Revoltingest]

I've been an RN for over 40 years, and have worked in a half dozen hospitals in two different states. During that time I've seen healthcare costs skyrocket and the insurance industry insinuate itself more and more into medical decision making.

https://health.usnews.com/health-ca...nsurance-companies-meddle-in-your-health-care
http://www.genfkd.org/study-insurance-companies-rejecting-doctors-orders-save-money
http://www.courant.com/opinion/op-e...or-patient-insurance-0208-20150206-story.html
http://thehill.com/opinion/healthca...ental-problem-your-doctor-doesnt-work-for-you

My experience with spendy health care was long ago.
It seems that things have changed.
Back in the day, it was so simple & cheap.

 

[Revoltingest]

True that, and healthcare's business model sometimes encourages fraud, overcharging, upcoding, &c. There's an incentive to enter the profession for financial, rather than altruistic reasons.

And a surprising number of doctors I know entered the field because of family
pressure. Come to think of it....they're all ABC (Americastanian born Chinese).

 

[Shad]

Question....
Under a government run single payer system, what would happen to......
- Chiropractors
- Osteopaths
- Reiki healers
- Homeopathy
Would government employ these types?
Will patients be denied their preferred 'treatment'?

For Canada

Licensed, standards of education and accredited, private insurance only
Licensed, standards of education and accredited at provincial level, private insurance only.
Not treated as a medical field
Treated as a medical field by a few universities. Take at your own risk advisory from Gov. Private insurance only.

Government dictates what is medicine, treatment options and who is a legitimate doctor not the patient. The patient can only select from predetermined options.

*Any field not covered by Heathcare has no real employment options with the HC system practicing their expertise. They may get funding from government programs for the poor and seniors which have funding issues but the average person is not covered. This would be subsiding the patient rather than employing the doctor*

 

[Falvlun]

We need a practicing doctor to weigh in on this.
Don't believe everything you hear from critics of the current system.
I've never experienced what he claims.
Does it happen?
I suppose that depends upon circumstances.

It happens all the time. I work in an urgent care clinic. Patients have to get approval for cat scans and mri’s from their insurance company— and they can get denied. Why does the insurance company get to decide what is medically best for the patient?

Sometimes the pharmacist calls and asks us to change the prescription to a different antibiotic... because the insurance won’t cover the one the doctor chose.

We recently had a patient come in for blood work. He had very painful and itchy eczema all over his skin. He was obviously in a ton of pain, he looked horrible (think small pox victim), and his mental health was taking a beating. The reason? His insurance stopped paying for this particular medication that had been keeping it under control for years. It made him go on a different medication that did not work. He was now having to get various blood work and other tests done to provide proof that he needed his original medication.

This is commonplace.

 

[Revoltingest]

It happens all the time. I work in an urgent care clinic. Patients have to get approval for cat scans and mri’s from their insurance company— and they can get denied. Why does the insurance company get to decide what is medically best for the patient?

Quality control.

Sometimes the pharmacist calls and asks us to change the prescription to a different antibiotic... because the insurance won’t cover the one the doctor chose.

We recently had a patient come in for blood work. He had very painful and itchy eczema all over his skin. He was obviously in a ton of pain, he looked horrible (think small pox victim), and his mental health was taking a beating. The reason? His insurance stopped paying for this particular medication that had been keeping it under control for years. It made him go on a different medication that did not work. He was now having to get various blood work and other tests done to provide proof that he needed his original medication.

This is commonplace.

Quality control is clearly less than perfect.
Not a very good system, eh?

 

[Falvlun]

First there's the question of "must use" single payer and "everyone can use" single payer. I'm a supporter of the later. I wish we could have a rational discussion about the best way to get out of the current mess but such is life.

Anyway, I found this conservative view interesting and would like to have more information on cross-subsidies. . The Grumpy Economist: Single payer sympathy?
But a single provider or payer than anyone in trouble can use, supported by taxes, not cross-subsidized by restrictions on your and my health care -- not underpaying in a private system and forcing that system to overcharge others -- while allowing a vibrant completely competitive free market in private health care on top of that, is not such a terrible idea, and follows from my Op-Ed. A single bureaucracy that hands out vouchers, pays full market costs, or pays partially but allows doctors to charge whatever they want on top of that would work. A VA like system of public hospitals and clinics would work too. Like public schools, or public restrooms, you can use them, but you don't have to; you're free to spend your money on better options if you like, and people are free to start businesses to serve you. And no cross-subisides.

Then there's the study that Fox chose to emphasize the cost not the cost savings in their reporting. Whether the assumptions are valid is one thing but giving it weight is that it's a study by a conservative organization with Koch funding: Even Libertarians Admit Medicare for All Would Save Billions

In the report, Charles Blahous attempts to roughly score Bernie Sanders’s most recent Medicare-for-All bill and reaches the somewhat surprising (for Mercatus) conclusion that, if the bill were enacted, the new costs it creates would be more than offset by the new savings it generates through administrative efficiencies and reductions in unit prices.

The report’s methods are pretty straightforward. Blahous starts with current projections about how much the country will spend on health care between 2022 and 2031. From there, he adds the costs associated with higher utilization of medical services and then subtracts the savings from lower administrative costs, lower reimbursements for medical services, and lower drug prices. After this bit of arithmetic, Blahous finds that health expenditures would be lower for every year during the first decade of implementation. The net change across the whole ten-year period is a savings of $303 billion.

What’s your distinction between “must use” and “everyone can use”?

Are you basically just saying that private insurance and and private hospitals can still exist for those who want to pay more?

Are there any national socialized healthcare programs that don’t allow that option?

 

[Falvlun]

Quality control.

Quality control is clearly less than perfect.
Not a very good system, eh?

Not sure what you mean by this.

Edit: and besides I was providing evidence against your skepticism that this even happens. You seem to now be justifying that it happens. I suppose that’s one baby step forward.

 

[Revoltingest]

Not sure what you mean by this.

Edit: and besides I was providing evidence against your skepticism that this even happens. You seem to now be justifying that it happens. I suppose that’s one baby step forward.

I don't justify.
I just explain.
I've no role in health care, except as a reluctant consumer.
I just happen to know a little about the role of insurance companies & their oversight function.

 

[Falvlun]

I don't justify.
I just explain.
I've no role in health care, except as a reluctant consumer.
I just happen to know a little about the role of insurance companies & their oversight function.

fascinating how fast you went from “Does it happen?” to “I just happen to know” why it happens.

Can you explain what you mean by “quality control”?

 

[Revoltingest]

fascinating how fast you went from “Does it happen?” to “I just happen to know” why it happens.

If I don't know whether something happens, is it reasonable to ask?
What I do know, as a result of knowing people who work in health
care analytics & consulting is this role of insurance companies.

Can you explain what you mean by “quality control”?

What I hear is that western medicine is not as evidence based as
we like to believe. Treatment decisions still have much art in them,
which results in less than optimum patient care. Insurance companies
use an epidemiological approach to look at a larger picture than
front line physicians see, eg, which hospitals have good & poor
results for which procedures, which procedures work or don't for
which diagnoses.
One thing seems indisputable....the bureaucracy interferes with
efficient & proper care.

I should add that everyone I know in health care analytics is far
to the left of me...all Democrats, & even one socialist. So their
views aren't tainted by opposition to single payer (something
they all favor) or them dang darned commies in DC.

 

[esmith]

So you want Medicare for all. Which part A or B? How much do you want to pay for part A? Part B?
Are you going to make everyone pay up to 10 years of Medicare premiums to be eligible for part B?
Are you going to charge for Medicare Part B? How much?
Seems you want something but you do not say how you are going to pay for it. You do realize that it will cost $1.4 trillion ($1,400,000,000,000) a year. Source