Single-Payer Healthcare argument

[PaDem]

I'm a proponent for a single-payer healthcare system. Of course there are all kinds of anti-single payer talking points that are bandied about, most of them meant to disinform. The one talking point that is the trickiest to refute for me is the argument that suggests that a single-payer system would have a detrimental effect on innovation and that it would drive the best and the brightest out of the medical field because the incentives would no longer be present. I'd be curious to hear how other DUers would respond to that argument against a single-payer system.

[gatorboy]

1. Check other countries that use a universal healthcare system

and see if this is a problem for their system. There sure are enough of them to study!

[youngdem]

2. Nonsense

Nothing about all disbursements coming from a single source for all medical payments would have any effect on ingenuity, unless you are talking about stifling insurance billing scam innovation.

There is no inherent reason that a national program could include payment for all manner of treatments, and there could also be a procedure through which experimental or new treatments could be paid for if no existing treatment could work.

I do honestly believe that innovation will likely suffer a little because of the nature of bureacracies, but this is happening now all the time under insurance programs...People are told all of the time that they are not eligible to receive coverage for an experimental or 'unnecessary' treatment.

We would just have to be careful to err on the side of paying for things instead of not, and trusting that an audit system with the Doctor's medical license on the line (and his ability to get paid by the single payer system) would be an effective deterrent from prescribing unneeded treatments.

[fwiff]

3. Because care would still be private

It's not about nationalizing all the doctors and hospitals, so there would be competition and plenty of capitalism to go around.

The only role the govm't would play is paying the bills.

In the best proposals I've seen (IMO), (one is the Physicians for a National Health Program http://www.pnhp.org/ ), all it really does is provide care to everyone and cut out the middleman- the insurance co.'s, so everyone using any tier of the healthcare industry doesn't have to pay twice.

And anyone who says that doctors and hospitals would get less paid to them from the govm't is dead wrong. The insurance co's have established the lowest payments for years.

[Sapere aude]

7. What would drive the government to pay more than insurance companies do now?

If the single payer system would reimburse providers more that insurance companies do now you could bet your pippie we would have a single payer system.

The pressure from the right would be to lower reimbursements I think. It is they attack on what they call entitlements that makes me think that.

[Solo_in_MD]

4. To other points to consider include miltiary medicine and NCLB (unintended consequences)

[Sapere aude]

5. If doctors were paid less for their services they may choose not to practice and there may be a

shortage of new doctors. I speaking as a controller of a medical clinic. IMHO most doctors are in it for the money and not for humanitarian reasons. I think in a single payer system there will be pressure to lower reimbursements to clinics like ours. The doctors are paid a percentage of the cash received and if that cash went down so would their compensation. That is the reason here in CA many doctors do not want to see Medical patients. Most insurance companies base their reimbursements on Medicare. They pay a percentage of Medicare. Some pay more than medicare some pay less. In a single payer system I think the insurance companies would go out of existence. That job would be taken over by a government system I think. The government would probably pay Medicare rates. The insurance companies already have a hard time getting qualified employees at the salaries they pay. The government may pay less. That means there may be less qualified people there than in private insurance.

I think we need a single payer system so that everyone has coverage, but there will be less doctors who have to see more patients for less money and I don't know if people will be willing to enter the field if that is true.

I don't know how other countries do it.

[TahitiNut]

6. Alarm systems take away incentives for burglary.

:shrug:

The question is "Who's receiving the incentives?" It's sure as Hell NOT the care providers! It's the paper-pushers at the insurance companies.