Single Payer Health Care System?

[JefferyD32]

What is this system that Braun talked about at the debate last night? I have not heard of it before, and am wondering how it differs from the current setup and the plans of the other canidates. Healthcare seems to being downplayed on these boards. It seems it will be a big issue but no one is talking about it, and I am wondering why?

[Clete]

1. Single payer is where all the money resources

are put under one payer usually the government who pays your bills. You pay so much out of your check and when you need health care the health care provider bills the government or whoever is the single payer. Doctors, hospitals and clinics are still in the private sector and they negotiate with the single payer every year to bring fees in line with what is acceptable to them.This way almost 100% of the population can have quality medical care.

Medicare operates similarly, except that Medicare has limitations and pays only 80% of the cost. Also, Medicare approved payments are often less than the health care provider needs to stay in operation, which is why the yearly fee negotiation is necessary. It is desirable to have the government do this rather than a private company because the government can cut administrative costs down to about 4%. On the other hand private companies have to cater to their stockholders so they run adminstrative costs as high as 33% of the money collected.

I think it will be a big issue too. Be prepared for the for profit health care industry to put up a big, dirty and expensive fight like they did when Clinton tried to get a plan started.

[qb]

2. They have single payer in Canada

I think it is the most fair and cost-effective health care system, which is why the Repukes will never let it pass. They have to make sure the HMOs and pharmaceutical companies get their healthy profits. They also don't want any benefits for people who don't "deserve" them (like poor people who don't earn enough to pay taxes).

[TheYellowDog]

3. Single Payer Health Care

sounds real good to me, but I worry about us ending up like Canada, with extremely long waits for non-immediate services like transplants and extensive surgery. Sometimes the wait can be as long as 6 months there.

[qb]

4. The wait in the U.S. is forever

for the millions of uninsured.

[StandWatie]

5. it's shorter here..

because the people who would be in line in front of you are sitting at home dying instead because they don't have insurance.

[Clete]

9. Bullshit alarmist propaganda.

There are no long waits in Canada. As a matter of fact Canadians get more timely care than we do in the privatized medicine system. This is all part of the corporate health industry's propaganda to scare Americans away from single payer. Transplants take as long here because they need to match patient to organ. It's not because of long lines. I pay for my own health insurance and I have to wait sometimes four months for an appointment if it isn't urgent because of the shortage of doctors in my area who will accept HMO's and PPd's.

Our system sucks and Canada has the answer. Go Google Canadian system and see for yourself or maybe some of our Canadian friends can set you straight. You will find out the truth isn't what the propaganda would lead you to believe.

[uptohere]

17. my Canadian friend DID set me straight

when she went home for cancer treatment there was a very long wait. The wait probably didn't matter witht the ultimate outcome but it was not as timely as she would have had here.

There are exceptions to all rules but it didn't work for her.

[Clete]

19. Yes, and how much did she pay out of her pocket

for her cancer treatment? Did she know what it would have cost her here? Methinks that's why she went back to Canada. And how does she know she would have gotten more timely care here? Radiation and chemotherapy are very costly. Could she have afforded it for timely care? Or, would she have been faced like other Americans to spend all her assets to the last $2,000 so she could get Medicaid. If she thinks she had long waits in Canada, imagine the waits when you are on Medicaid, because very few doctors accept it and most patients are forced to go to County Hospitals that are bursting at the seams.

There are many more problems with our system, but this is enough for a short post.

[uptohere]

37. oh yeah saved a bundle

and died rather horribly.

Unfortunately she had chosen to rely on Canadian Health care insted of buying insurance here. She was young, healthy, why spend the money ? It was not a monitary impossibility for her.

Having been through the hell of cancer with my Mom many years ago, I've followed this rather closely over the years. There is no question that she would have been in treatment immediately had she chosen to obtain the insurance available to her.

[amazona]

12. Good Lord, people in U.S. wait longer than that for transplants!

Some U.S. citizens wait years for transplants. Some die waiting. If Canada can service everyone who needs a transplant in 6 months, what is it that they're doing we don't do? It can take a long time to find a match.

What "extensive surgery" is non-immediate other than elective cosmetic surgery? People who need extensive surgery are in emergency situations in my humble experience. Of course there are U.S. doctors who fib a little to encourage women to get unneeded hysterectomies and the like...but if a delay can arise to prevent this sort of thing, wouldn't it be all to the good?

Bottom line, people in Canada and western Europe and even little Costa Rica live longer than we do in the U.S. This to me says that their system must be superior.

[Postman]

28. "non-immediate services like transplants"...isn't THAT immediate??

What exactly are you basing your statement on? We should be MORE LIKE Cananda!!!

[revcarol]

31. Think a lot of the Canadian figures showing long waits are out of date.

When they first had their plan, all the bugs weren't ironed out, so there WERE long waits.Someone please look up the more recent figures, I don't know how to do it.

And how long HERE to get a transplant? And how long here to get a referral to a specialist IN AN HMO and how many co-pays and deductibles until you finally do get to see that specialist? And how long do VETS wait to get an initial appointment and then how much longer wait to see a specialist, and then Agent Orange problems and Gulf War problems are still not addressed?

And how many DIE because they didn't have health care, so didn't go to the doctor until it was too late?

DK and CMB have the only reasonable plans. By taking exhorbitant overhead and exhorbitant profit out of the equation, we will have enough money for heath care for all.

[JanMichael]

6. France has a Single Payer system that's ranked #1 in the World.

Look it up.

BTW don't fall for all of the "you got to wait sometimes till you die" BS. What do you think happens here with HMO's? Nothing is perfect but they manage to insure 100% of their citezins and keep inflation down to around 9% while we soar at 14%. Oh and they spend around $2,700 a year per person and we're around $4,700.

Go USA!:/sarc:

[Nederland]

18. I tried

...to look it up and found nothing (on Google at least). Do you have a link?

[Clete]

21. Here's a link.

I have to confess I haven't read it yet, but it might help you.
http://www.euro.who.int/document/OBS/EuroHealth6_4.pdf

Here's another link that has gobs on Single Payer including a lot of links to the Canadian health care system.
http://www.pnhp.org/

[JanMichael]

32. Here are a couple of links mentioning the WHO rankings.

The first one that popped up.

http://www.medicalres.com/website/html/worldhealth.html

A really interesting overview of the WHO report.

From the article:

*overall level of health within a population
*health inequalities within a population (how much economic status affects health)
*health system responsiveness (patient satisfaction and how well the system acts)
*responsiveness within the population (how well people in various economic groups are served by the system)
*distribution of costs within the population (who pays?).

http://www.watsonwyatt.com/europe/pubs/healthcare/articles/render_oct.asp?ID=8894

A Guardian article that's fairly in depth.

http://society.guardian.co.uk/health/comment/0,7894,440883,00.html

As you can see they insure 100% but still spend less than us. There is choice and a matter of fact they instilled competition into the system which is a patchwork of services.

Not perfect but, IMHO, much better than us and #1 according to the WHO in 2000. Italy, go figure, does better than us too...Hell 36 countries do better.

[burr]

35. French and English culture clash..

The frustrating part about that article, it shows that the Tories could use the issue of Healthcare and Blairs blunders on the war to beat the Labour Party. But God forbide the Tories doing something that would help the working class in the UK or to pull troops out of Iraq.

The article made France and its healthcare system sound like another nirvana. Maybe I can move to Cote D'Azur!

[salin]

7. I misread the title. saw: single prayer health care system

and thought that was bush's response to healthcare crisis.

[dpbrown]

8. Dennis Kucinich on Universal Single Payer Health Care

Kucinich on the Issues
______________________

Universal Health Care

The Kucinich plan is enhanced 'Medicare for All' -- a universal, single-payer system of national health insurance, carefully phased in over 10 years. It addresses everyone's needs, including the 40 million Americans without coverage and those paying exorbitant rates for health insurance. This approach to healthcare emphasizes patient choice, and puts doctors and patients in control of the system, not insurance companies. Coverage will be more complete than private insurance plans, encourage prevention and include prescription drugs.

Health care is currently dominated by insurance firms and HMOS, institutions that are more bureaucratic and costly than Medicare. People are waiting longer for appointments. Fewer people are getting a doctor of their choice. Physicians are given monetary incentives to deny care. Pre-existing illnesses are being used to deny coverage.

Over time, the Kucinich plan will remove private insurance companies from the system -- along with their waste, paperwork, profits, excessive executive salaries, advertising, sales commissions, etc -- and redirect resources to actual treatment. Insurance companies do not heal or treat anyone, physicians and health practitioners do ...and thousands of physicians support a single-payer system because it reduces bureaucracy and shelters the doctor-patient relationship from HMO and insurance company encroachment.

Non-profit national health insurance will decrease total healthcare spending while providing more treatment and services -- through reductions in bureaucracy and cost-cutting measures such as bulk purchasing of prescriptions drugs. Funding will come primarily from existing government healthcare spending (more than $1 trillion) and a phased-in tax on employers of 7.7% (almost $1 trillion). The employers' tax is less than the 8.5% of payroll now paid on average by companies that provide private insurance.

This type of system -- privately-delivered health care, publicly financed -- has worked well in other countries, none of whom spend as much per capita on healthcare as the United States. 'We're already paying for national healthcare; we're just not getting it, says Kucinich. The cost-effectiveness of a single-payer system has been affirmed in many studies, including those conducted by the Congressional Budget Office and the General Accounting Office. The GAO has written:
"If the US were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs (10% to private insurers) would be more than enough to offset the expense of universal coverage."

Over the years, groups and individuals as diverse as Consumers Union, labor unions, the CEO of General Motors, the editorial boards of the Atlanta Journal-Constitution and St. Louis Post Dispatch, and Physicians for a National Health Program have endorsed a single-payer approach. It is sound economics -- what actuaries call 'Spreading the Risk' -- to extend Medicare to younger and healthier sectors of our population, thereby putting everyone in one insurance pool. It permanently saves and improves Medicare, while eliminating duplicative private and government bureaucracies.

While enhanced Medicare for All makes economic sense, it has not made political sense to some, due to the power of the private insurance lobby. The streamlined Kucinich plan is very different than the 1993 Clinton HMO-based plan, a complex proposal that left big insurance firms in a central role. After Clinton's 'Managed Competition' plan failed without coming up for a vote, talk-radio host Jim Hightower asked President Clinton why he hadn't put forward a "simple, straightforward" single-payer plan "instead of all this bureaucracy." Clinton replied, "I thought it would be easier to pass" a bill that left the insurance industry in place. "I guess I was wrong about that."

Related Links:

05/11/2003
Kucinich's 'Medicare for All' Offers No Role for Private Insurers
May 11, 2003 By Juliet Eilperin Washington Post Staff Writer
ANKENY, Iowa, May 10 -- Rep. Dennis J. Kucinich (Ohio), campaigning in Iowa today for the Democratic presidential nomination, outlined how he would transform the nation's health care system into a government-run, single-payer program if elected.

Read full article



05/06/2003
Kucinich proposes health plan
May 6, 2003 By THOMAS BEAUMONT, Register Staff Writer
Davenport, Ia. - Democratic presidential candidate Dennis Kucinich said Monday he would propose raising taxes on employers to pay for a government-run universal health insurance program.

Read full article

[Tandalayo_Scheisskopf]

10. Wanna stem the tide...

Of jobs going overseas to slave labor nations?

Single payer, with its lower costs to all, is one huge step in the right direction. Employers are feeling the pinch too.

[JefferyD32]

13. So what's the problem?

so if this plan makes so much sense, what is the problem? I understand that the medical industry would be against it and would have plenty of money to back up its stance, but it also seems that almost every other industry would be for the system as it would certainly save them money. Companies are spending more and more money to subsidize their employees health coverage and anything to save them money and increase profits they would be for. Why isn't there more support for the single payer system?

[Clete]

20. There is a lot of support for it.

You don't get it from our unbiased news sources though. <sarcasm>
I think the turning of the screw is coming though. Businesses are beginning to realize the benefits of this system for themselves. When they are on board, the propagandists are only going to be able to spin themselves into a grave.

[artr2]

27. The problem is that...

the for profit HMO's & drug companies will spend MILLIONS of dollars to keep us from killing their cash cow. These people are making obscene amounts of profit and they will not give it up without a fight no matter how many poor children & elderly persons die from lack of proper health care.

[uptohere]

36. I can't imagine except they probably don't think that it can happen

it would be terrific for them to stop paying anything for worker's health care but what would the backlash be ?

Like my Dad told me, 'if it looks too good to be true, it probably is'.

[Snow]

11. Yo, guys - I think she was talking about Sheila Kuehl's bill, SB 921

for a single payer system in California:
http://leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_921&sess=CUR&house=B

[qb]

14. Ohhh!.... Well, that's different....... Never Mind!

[Snow]

15. Well, not quite never mind - in fact, take a look -

the bill fair bids to be revolutionary.

[Kat45]

16. Even drs. are getting behind single-payer health ins

JAMA (the Journal of the American Medical Association) recently had a long article about single-payer health insurance being the answer.

[paulsbc]

22. Dean is a doctor

why does he not support it then??

I must admit that Mosley Braun sure sounds impressive when she discusses this topic, but Hillary sound good too and look what she was able to accomplish....

[Lydia Leftcoast]

33. Hillary's proposal was NOT single payer

Like the good centrist Democrat that she is, she tried to appease her opponents, so the plan became more and more complicated, and the insurance companies and the HMOs savaged it anyway.

[burr]

23. Welcome to DU jeff...

If you're interested in this issue, read about Jim McDermott's bill to set up a state run, universal single-payer healthcare system.


<http://thomas.loc.gov/cgi-bin/bdquery/z?d108:HR01200:@@@L&summ2=m&>

[recidivist]

24. Single payer is just a way of camouflaging rationing.

By all means, government should provide universal access to an adequate baseline system of health insurance, with premiums subsidized for low income people. But beyond that, people should be able to shop around and choose different plans. Single payer zealots would prohibit that. Why?

Well, the answer is simple enough if you walk it through. Once a government plan is established, it tends to get fixed in concrete. A common observation, for example, is that Medicare and Medicaid are perfectly adequate 1960's style Blue Cross-type plans. The problem is that medical care has come a long way since then, and Medicare and Medicaid have struggled to keep up.

For one thing, changes in government plans have to be made across the board, all at once, and that can get very expensive. It's easier and cheaper, at least in the short run, to delay the introduction of new procedures, drugs, etc. For another thing, government funded health insurance has to compete with other budget priorities, which will often win out. And last but not least, government plans try to be all things to all people. One-size-fits-all is not a very efficient way to serve a highly diverse market; one ends up with least common denominator solutions that poorly serve many, many people with specialized needs.

For all these reasons, government funded health care over time will tend to lag behind private medical standards. As single payer enthusiasts mostly know, but mostly refuse to acknowledge, the usual outcome is a dual system, with everyone who can afford it carrying supplemental private insurance. This is the case in Europe, and one sees the same thing here with Medigap coverage for seniors.

This ultimately poses a political problem for government, which is seen to be offering substandard care while the wealthy opt out. This is why the hard core single payer crowd often demands that it be made a crime to purchase health care privately. The suppression of alternatives makes it easier to conceal the rationing.

[Clete]

25. Well, excuse me for disagreeing but

Medicare has kept my husband from dying a horrid death from uremic poisoning for four years now, because we could not afford the dialysis he needs to stay alive otherwise. Unlike HMO's and PPd.s, he is able to use this where ever he goes and it is accepted by most health care providers. There is no fear of being cancelled, or of being dropped. The big problem with Medicare is all the holes the anti-entitlement people in government keep shooting into it. And, private insurance won't cover end state renal disease anyway.

Everyone in America would be lucky to have Medicare. It is efficient and reliable and 96% of the money goes into health care not administration.

Every American should have Medicare, a new improved version of it, instead of having their healthcare dollars drained away by profit seekers and gluttonous managers of private health care systems. Incidentally, I have heard every point you laid out from insurance company representatives. Are you one?

[Snow]

30. "Private Insurance is just a way of camouflaging rationing"

By all means, private corporations should provide universal access to an adequate baseline system of health insurance, with premiums subsidized for low income employees. But beyond that, people should be able to shop around and choose different plans. Private insurance zealots would prohibit that. Why?
Well, the answer is simple enough if you walk it through. Once a private insurer plan is established, it tends to get fixed in concrete. A common observation, for example, is that Blue Cross and Blue Shield are perfectly adequate 1960's style Medicaid-type plans. The problem is that medical care has come a long way since then, and the Blues have struggled to keep up.
For one thing, changes in private insurance plans have to be made across the board, all at once, and that can get very expensive. It's easier and cheaper, at least in the short run, to delay the introduction of new procedures, drugs, etc. For another thing, employee health benefits have to compete with other budget priorities, which will often win out. And last but not least, private health plans try to be all things to all people. One-size-fits-all is not a very efficient way to serve a highly diverse market; one ends up with least common denominator solutions that poorly serve many, many people with specialized needs.
For all these reasons, private health insurance over time will tend to lag behind publically funded medical standards. As private payer enthusiasts mostly know, but mostly refuse to acknowledge, the usual outcome is a dual - triple? quadruple?? - system, with everyone who can't afford it carrying supplemental government insurance. This is not the case in Europe, and one sees the same thing here with Medigap coverage for seniors.
This ultimately poses a political problem for corporations, which is seen to be offering substandard care while the wealthy opt out. This is why the hard core private payer crowd often demands that it be made a crime to purchase health care publically. The suppression of alternatives makes it easier to conceal the rationing.

[Lydia Leftcoast]

34. More accurately

private insurance systems are a form of rationing, because they ensure that a certain percentage of the population will be unable to afford medical care.

[uptohere]

39. it will come to that

and along with it will be external private programs that will allow the wealthy to secure their own healthcare with the best docs, at the best hospitals.

And it will become mired in fraud same as Medicare/Medicade...

You might believe the 4% overhead cost attributed to Medicare but I don't believe that for a second.

[slackmaster]

26. If you're talking about Bush's idea you spelled it wrong

That Single Prayer Health Care.

[burr]

29. lololololololllolololollollolol

sorry, just forgot to do it the first time! :yourock:

[newyawker99]

38. Hi JefferyD32!!

Welcome to DU!! :toast:

[gottaB]

40. Hi, Jeffery

Carol has yet to present her full plan, but you can read more about her position on health care here.

If you want to hear what the other candidates said at that forum, you can watch a webcast from cspan.