Positive conservative views on "single payer" health care

[Valjean]

And raising prices beyond bounds for older drugs just because they can should be grounds for a long term in the slammer.

But the drug company executives would say just the opposite. They're legally bound to maximize profits for their shareholders.
A failure to raise the price of a $5.00 vial of insulin to $300.00, or charge $700.00 for a 2-pack of Epi-pens that you could buy in Britain for $69.00 (and that cost maybe two dollars to manufacture), when the opportunity to do so presented itself, could, as you say, land them in the slammer. It would certainly get them dismissed from the Board of directors.

This is the brave new capitalist, neoliberal world of American healthcare. American healthcare cares little about health, and a lot about making money. If patients die or go bankrupt it doesn't matter. The industry executives see maximizing profits as both a legal and moral imperative. Their consciences are clean.

 

[Revoltingest]

What would you call forcing people to try medicine B instead of medicine A prescribed by their doctor? The hope is that a cheaper medicine will do the trick... it’s an experiment forced upon the patient with the goal of reducing cost for the insurance company.

This is not experimentation.
But as with all procedures, results will be studied by epidemiologists & health care analysts.

 

[siti]

All this time I've been thinking this was about "single prayer" health care. I thought it was a thread about faith healing only working if you are so faithful you don't feel the need to ask more than once!

 

[Valjean]

Sometimes the Right seems to shoot itself in the foot:
Koch-backed study finds ‘Medicare for All’ would save U.S. trillions

 

[sun rise]

But the drug company executives would say just the opposite. They're legally bound to maximize profits for their shareholders.
A failure to raise the price of a $5.00 vial of insulin to $300.00, or charge $700.00 for a 2-pack of Epi-pens that you could buy in Britain for $69.00 (and that cost maybe two dollars to manufacture), when the opportunity to do so presented itself, could, as you say, land them in the slammer. It would certainly get them dismissed from the Board of directors.

This is the brave new capitalist, neoliberal world of American healthcare. American healthcare cares little about health, and a lot about making money. If patients die or go bankrupt it doesn't matter. The industry executives see maximizing profits as both a legal and moral imperative. Their consciences are clean.

That's why our capitalist system is inhuman and wrong when it comes to health care. It's fine when we have a choice of cellphones etc, but is an utter failure when the dollar is placed above people's lives.

 

[Falvlun]

This is not experimentation.
But as with all procedures, results will be studied by epidemiologists & health care analysts.

How is it not experimentation?

I also highly doubt that epidemiologists are studying every single time a health insurance company does this.

Again, I’m amazed that at the beginning of this thread you weren’t even sure that it happened, and now you’re suddenly a fount of knowledge as to the inner workings.

As for “health care analysts”, if they are working for the insurance companies, their goal is reducing costs and increasing profits for the insurance company— actually health outcomes are not the driving factor for these experiments.

 

[Revoltingest]

How is it not experimentation?

It doesn't even remotely resemble FDA drug trials,
eg, no control group.

I also highly doubt that epidemiologists are studying every single time a health insurance company does this.

Could there be something which escapes their notice?
Sure.
But doctors generally don't study effects statistically at all.
Someone must.

Again, I’m amazed that at the beginning of this thread you weren’t even sure that it happened, and now you’re suddenly a fount of knowledge as to the inner workings.

Trying the old ad hom approach, eh?
I don't pretend to know everything, so I ask questions.
But I also observe that my critics have shortcomings too.

As for “health care analysts”, if they are working for the insurance companies, their goal is reducing costs and increasing profits for the insurance company— actually health outcomes are not the driving factor for these experiments.

Knowing people in the business, you underestimate their goals & tasks.
It happens that every single one I know is a Democrat, & they value
better care. They've even proposed improvements to the system during
Bush & Obama admins, but these fell on deaf ears. (They call these
proposals "white papers".)

Even under a single payer system (an inevitability which I advocate),
I fully expect health care analysts to ride herd on front line health care
providers. This approach will detect problems, eg, drug side effects,
unnecessary procedures. It will also identify best practices.

 

[Falvlun]

In Canada hospitals are facilitates which provide the widest range of medical procedures, treatment and care to the public. These owned and ran by provincial and local government. An institution provides limited procedures typically based on one illness or body part. For example cancer or eyes. Each is licensed by government to operate under the Non-Hospital Medical and Surgical Facilities Accreditation Program. These institutions have no ER, no care facilities for in-patient and are out-patient only. Procedures may not be covered by HC at all.

I have found nothing on the internet to support your position. Everything clearly states that the majority of healthcare in Canada is (in general) publicly funded but privately provided.

From the Healthcare in Canada Wikipedia:
“The government does not participate in day-to-day care...”
“Canada has a publicly funded medicaresystem, with most services provided by the private sector.”
“Canada's system is known as a single payer system, where basic services are provided by private doctors (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate.”

From Canadian Women’s Health Network:
“Although almost all Canadians believe hospitals are publicly owned and accountable institutions, under provincial legislation 95% operate on a non-profit basis. Most of Canada's approximately 850 hospitals are owned and operated by non-profit, voluntary organizations.”
“Since most hospitals are not government-owned, they cannot be "privatized". However, they can be and in some cases are being turned into profit-generating enterprises.” Profit or Non-Profit: Are Hospitals Selling Out? | Canadian Women's Health Network (Sorry can’t scroll up to link—- glitch.)

From maple leaf web:
“. Health care services in Canada are largely delivered by private individuals and organizations, such as physicians and hospitals. These services, however, are financed by governments through public health insurance plans and direct funding to health care facilities.” Canada’s Health Care System: An Overview of Public and Private Participation | Mapleleafweb.com

——-
I’m also not seeing any clear distinction between “institutions” (which I think we call “clinics” or “doctor offices” here) and hospitals.

As it a facade to cover up how much control the government actually has over HC. It's no Medicare as Medicare has plans to pick from. Canada has one plan. Pay your taxes and do not ask questions

I really don’t think it comes as a surprise to Canadians that the government weilds a large amount of control over their healthcare. They know that the government is providing a single payer health insurance for all that covers a specific set of treatments and that the whole shebang is heavily regulated for price and quality. I’m not sure whar exactly you think this “facade” is hiding.

As for your “don’t ask questions”, don’t be silly. You guys can vote. I’ve heard Canadians *****ing about it. There’s a hearty discourse in Canada, let’s not pretend, ok?

 

[Falvlun]

It doesn't even remotely resemble FDA drug trials,
eg, no control group.

That’s why I called them “non-scientific”.

Could there be something which escapes their notice?
Sure.
But doctors generally don't study effects statistically at all.
Someone must.

Absolutely. But to imply that health insurance companies are doing this (with health outcomes rather than profitability as the goal) is laughable.

Trying the old ad hom approach, eh?
I don't pretend to know everything, so I ask questions.
But I also observe that my critics have shortcomings too.

Not an ad hom in the least. You questioned whether something even occurred and now you are trying to claim insight into why it occurs. That’s like saying you don’t know whether cakes exist and then claiming you know the best way to eat cakes.

Knowing people in the business, you underestimate their goals & tasks.
It happens that every single one I know is a Democrat, & they value
better care. They've even proposed improvements to the system during
Bush & Obama admins, but these fell on deaf ears. (They call these
proposals "white papers".)

You know so many people devoted to fixing a problem you didn’t even know existed! Color me skeptical.

Even under a single payer system (an inevitability which I advocate),
I fully expect health care analysts to ride herd on front line health care
providers. This approach will detect problems, eg, drug side effects,
unnecessary procedures. It will also identify best practices.

I agree. But there won’t be a profit motive.

You were trying to sell that insurance companies are somehow performing QC, in an attempt to whitewash their attempts to increase profits at the expense of the health of their customers. Sorry if it don’t buy.

 

[Revoltingest]

That’s why I called them “non-scientific”.

Just because epidemiology isn't an experiment, doesn't make it non-scientific.

Absolutely. But to imply that health insurance companies are doing this (with health outcomes rather than profitability as the goal) is laughable.

It's for both.
Better outcomes benefit both patient & payer.

Not an ad hom in the least.

You do keep making it about me, rather than the issues.

You questioned whether something even occurred and now you are trying to claim insight into why it occurs. That’s like saying you don’t know whether cakes exist and then claiming you know the best way to eat cakes.

I ask questions where needed.
But this doesn't mean I've no knowledge in other areas.

Hey, I've been nice.
I haven't pointed out that you know little of the field of health care analytics.
And I'd never consider saying, "You're only a nurse.".

You know so many people devoted to fixing a problem you didn’t even know existed! Color me skeptical.

I'll color you conflating 2 different things.

I agree. But there won’t be a profit motive.

You were trying to sell that insurance companies are somehow performing QC, in an attempt to whitewash their attempts to increase profits at the expense of the health of their customers. Sorry if it don’t buy.

This is going in circles.
I'll agree to disagree.

 

[Shad]

I have found nothing on the internet to support your position. Everything clearly states that the majority of healthcare in Canada is (in general) publicly funded but privately provided.

You could have easily looked up the various medical facilities, their license and ownership.

From the Healthcare in Canada Wikipedia:
“The government does not participate in day-to-day care...”
“Canada has a publicly funded medicaresystem, with most services provided by the private sector.”
“Canada's system is known as a single payer system, where basic services are provided by private doctors (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate.” [/quote]

Facade. The government has far more control. Go look at wage issues.

From Canadian Women’s Health Network:
“Although almost all Canadians believe hospitals are publicly owned and accountable institutions, under provincial legislation 95% operate on a non-profit basis. Most of Canada's approximately 850 hospitals are owned and operated by non-profit, voluntary organizations.”
“Since most hospitals are not government-owned, they cannot be "privatized". However, they can be and in some cases are being turned into profit-generating enterprises.” Profit or Non-Profit: Are Hospitals Selling Out? | Canadian Women's Health Network (Sorry can’t scroll up to link—- glitch.) [/quote]

Wrong again as the site is ignorant of the difference between hospitals and other institutions.

From maple leaf web:
“. Health care services in Canada are largely delivered by private individuals and organizations, such as physicians and hospitals. These services, however, are financed by governments through public health insurance plans and direct funding to health care facilities.” Canada’s Health Care System: An Overview of Public and Private Participation | Mapleleafweb.com

Wrong again as it ignorant of classification differences.

——-
I’m also not seeing any clear distinction between “institutions” (which I think we call “clinics” or “doctor offices” here) and hospitals.

I already cited the license.

A clinic and doctor's office here are almost the same. The only differences are in clinics do not use appointment nor require the doctor to have any individual as a patient. It is used for emergency purposes due to delays within normal GP/patient care. I use on as I have to due to government incompetence. It suspended my doctor but still list him as my GP. Which is pure nonsense since he legally isn't a practicing doctor.... Oh wait that can't be right as government does not have control over anything but insurance according to you.... Hah

I really don’t think it comes as a surprise to Canadians that the government weilds a large amount of control over their healthcare. They know that the government is providing a single payer health insurance for all that covers a specific set of treatments and that the whole shebang is heavily regulated for price and quality. I’m not sure whar exactly you think this “facade” is hiding.

As control is far more in government's hands than the patient does. It is not merely about price and quality (lack of due to rationing). Single payer does not function as real insurance. For example people which risk their health by their own actions like smokers do not face increased costs. The HC costs of their recklessness is passed on to everyone else. Hence it is socialized HC not insurance. Calling it insurance is a facade as it ignores what insurance is.


As for your “don’t ask questions”, don’t be silly. You guys can vote. I’ve heard Canadians *****ing about it. There’s a hearty discourse in Canada, let’s not pretend, ok?[/QUOTE]

 

[Falvlun]

Just because epidemiology isn't an experiment, doesn't make it non-scientific.

?? You’re all over the place. I’m saying that health insurance companies are performing non-scientifically rigorous experiments on people when they force them to go on different medications than the ones their doctor recommends. Your argument was that it couldn’t be an experiment because it didn’t follow FDA procedure— which is ridiculous since the FDA doesn’t hold a monopoly on the word “experiment” and my entire point is that these experiments are being done by non-medical, non-scientists with very little regulatory oversight.

It's for both.
Better outcomes benefit both patient & payer.

“Better outcomes”? Where is the evidence of better health outcomes? The whole purpose— if these policies are coming from health insurance companies—is to increase profits. It’s not to help the patient.

You do keep making it about me, rather than the issues.

I ask questions where needed.
But this doesn't mean I've no knowledge in other areas.

Hey, I've been nice.
I haven't pointed out that you know little of the field of health care analytics.
And I'd never consider saying, "You're only a nurse.".

Your ignorance that this issue even occurred is relevant and makes your sudden expertise suspect. You cannot simultaneously not know about cakes and also know many people who bake cakes.

You have given me no reason to believe you know anything about “health care analytics”.

And you seem to be trying to sidestep the whole issue that this isn’t about people who study healthcare or “epidemiologists”— which is certainly required. It’s about decisions made by for-profit insurance companies about patient care that is about increasing profits.

This is going in circles.
I'll agree to disagree.

Do you understand the difference between the goal of a for-profit health insurance company vs the goals of an epidemiologist at the CDC?

 

[Falvlun]

You could have easily looked up the various medical facilities, their license and ownership.

From the Healthcare in Canada Wikipedia:
“The government does not participate in day-to-day care...”
“Canada has a publicly funded medicaresystem, with most services provided by the private sector.”
“Canada's system is known as a single payer system, where basic services are provided by private doctors (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate.”

Facade. The government has far more control. Go look at wage issues.

From Canadian Women’s Health Network:
“Although almost all Canadians believe hospitals are publicly owned and accountable institutions, under provincial legislation 95% operate on a non-profit basis. Most of Canada's approximately 850 hospitals are owned and operated by non-profit, voluntary organizations.”
“Since most hospitals are not government-owned, they cannot be "privatized". However, they can be and in some cases are being turned into profit-generating enterprises.” Profit or Non-Profit: Are Hospitals Selling Out? | Canadian Women's Health Network (Sorry can’t scroll up to link—- glitch.)

Wrong again as the site is ignorant of the difference between hospitals and other institutions.



Wrong again as it ignorant of classification differences.



I already cited the license.

A clinic and doctor's office here are almost the same. The only differences are in clinics do not use appointment nor require the doctor to have any individual as a patient. It is used for emergency purposes due to delays within normal GP/patient care. I use on as I have to due to government incompetence. It suspended my doctor but still list him as my GP. Which is pure nonsense since he legally isn't a practicing doctor.... Oh wait that can't be right as government does not have control over anything but insurance according to you.... Hah



As control is far more in government's hands than the patient does. It is not merely about price and quality (lack of due to rationing). Single payer does not function as real insurance. For example people which risk their health by their own actions like smokers do not face increased costs. The HC costs of their recklessness is passed on to everyone else. Hence it is socialized HC not insurance. Calling it insurance is a facade as it ignores what insurance is.


As for your “don’t ask questions”, don’t be silly. You guys can vote. I’ve heard Canadians *****ing about it. There’s a hearty discourse in Canada, let’s not pretend, ok?

I’m sorry Shad. I’ve provided plenty of evidence for my position. I’ve cited sources that contradict your position. The very definitions of a Beveridge Model vs a single payer national health insurance model contradict your position. I have made a good faith effort.

You have simply replied that I am wrong (without supporting evidence), that the sources are wrong (without supporting evidence), and that the definitions are wrong (without supporting evidence).

At some point, maybe we should consider the possibility that you are, in fact, wrong.

 

[Revoltingest]

?? You’re all over the place. I’m saying that health insurance companies are performing non-scientifically rigorous experiments on people when they force them to go on different medications than the ones their doctor recommends. Your argument was that it couldn’t be an experiment because it didn’t follow FDA procedure— which is ridiculous since the FDA doesn’t hold a monopoly on the word “experiment” and my entire point is that these experiments are being done by non-medical, non-scientists with very little regulatory oversight.

“Better outcomes”? Where is the evidence of better health outcomes? The whole purpose— if these policies are coming from health insurance companies—is to increase profits. It’s not to help the patient.

Your ignorance that this issue even occurred is relevant and makes your sudden expertise suspect. You cannot simultaneously not know about cakes and also know many people who bake cakes.

You have given me no reason to believe you know anything about “health care analytics”.

And you seem to be trying to sidestep the whole issue that this isn’t about people who study healthcare or “epidemiologists”— which is certainly required. It’s about decisions made by for-profit insurance companies about patient care that is about increasing profits.


Do you understand the difference between the goal of a for-profit health insurance company vs the goals of an epidemiologist at the CDC?

You're too late in responding.
I'm just answering alerts before heading out on a trip.
We must agree to disagree.

 

[Falvlun]

You're too late in responding.
I'm just answering alerts before heading out on a trip.
We must agree to disagree.

Oh darn! Have a good trip!

 

[Shad]

I’m sorry Shad. I’ve provided plenty of evidence for my position

No you haven't. You didn't even know about the licensing differences. Put an effort in...

I’ve cited sources that contradict your position.

No you haven't. You have no even named a single hospitals that is privately owned as you claimed. Try again.

The very definitions of a Beveridge Model vs a single payer national health insurance model contradict your position. I have made a good faith effort.

Too bad Canada does not use single payer model as I have been telling you. You googled like 3 times and linked the first results. Impressive. I cited actual law. Try again.

You have simply replied that I am wrong (without supporting evidence), that the sources are wrong (without supporting evidence), and that the definitions are wrong (without supporting evidence).

I cited the very license in question. Try again.

At some point, maybe we should consider the possibility that you are, in fact, wrong.

Nope. I live in the system. I use it. I am not wrong about what is going on around me with my own HC. Try again.

 

[Revoltingest]

Oh darn! Have a good trip!

Arrived safely despite many unusually dangerous drivers...tailgaters!

 

[Falvlun]

No you haven't. You didn't even know about the licensing differences. Put an effort in...

Are you talking about the Non-Hospital Medical and Surgical Facilities license you mentioned?

If so, I do not see how it supports your position that the Canadian government owns the hospitals. It’s about the regulations on non-hospital entities.

No you haven't. You have no even named a single hospitals that is privately owned as you claimed. Try again.

I provided proof that the majority of hospitals in Canada are not publically owned. Apparently, they are mostly non-profits.

Naming a single private hospital would no more prove my position than you naming a public hospital would prove yours. Hell, even the US has government-run hospitals.

I have provided evidence to support my position that the hospitals in Canada are not (in general) owned by the government.

Too bad Canada does not use single payer model as I have been telling you. You googled like 3 times and linked the first results. Impressive. I cited actual law. Try again.

Could you cite the law again, because I must have missed it. I really don’t believe that literally every thing I’ve read on the internet about the Canadian healthcare system is wrong. If you have such evidence, please link it.

Nope. I live in the system. I use it. I am not wrong about what is going on around me with my own HC. Try again.

One of the articles I cited even mentioned that many Canadians are unaware that their hospitals are not publically owned. Using a system does not automatically make you an authority on that system. I need a little more to go on than your say-so.

 

[Falvlun]

More evidence:

“National Health Insurance (NHI) systems combine NHS regulation structures and tax financing with the dominance of private actors in the service provision dimension. NHI systems include Australia, Canada, Ireland, Italy, and New Zealand. In the healthcare literature, these countries have been grouped with NHS systems, but some also referred to other categories such as Social Insurance or public-contract in the case of Canada...”

“The decisive difference is to be found in service provision, which remains for the most part in private hands. First of all, compared to NHS countries, in NHI private or societal hospitals add up to a larger share as measured by the number of hospital beds. This said, public hospital beds still outnumber beds in private and societal ownership (with about 60-80% of total), ex- cept for Canada where nearly all hospitals are owned by non-profit organizations. However, service provision in the outpatient, dental, and pharmaceutical sectors is predominantly in private hands.” —Classifying OECD Healthcare Systems
https://www.econstor.eu/bitstream/10419/64809/1/726547131.pdf

Scroll to page 20 to read more. I would particularly draw your attention to the section above this one (National Health Insurance) to the one on National Health Service systems (which includes the UK). In such systems, the majority of hospitals are state-owned (in the UK it’s 90%). It makes a point to highlight state dominance in such a system in contrast to others.

 

[Shad]

Are you talking about the Non-Hospital Medical and Surgical Facilities license you mentioned?

Yes. That is the license used by private facilities.

If so, I do not see how it supports your position that the Canadian government owns the hospitals. It’s about the regulations on non-hospital entities.

See above.

I provided proof that the majority of hospitals in Canada are not publically owned. Apparently, they are mostly non-profits.

No you didn't. You googled and pasted a link which didn't even name a single private hospital. Name one, put some effort in.

Naming a single private hospital would no more prove my position than you naming a public hospital would prove yours. Hell, even the US has government-run hospitals.

No it would refute my point.

I have provided evidence to support my position that the hospitals in Canada are not (in general) owned by the government.

Nope you just google something and pasted it which couldn't name a single privately owned hospital.

Could you cite the law again, because I must have missed it. I really don’t believe that literally every thing I’ve read on the internet about the Canadian healthcare system is wrong. If you have such evidence, please link it.

The license I cited

One of the articles I cited even mentioned that many Canadians are unaware that their hospitals are not publically owned. Using a system does not automatically make you an authority on that system. I need a little more to go on than your say-so.

Yet didn't name a single example. So all you have an assertion from google.