Here is the definition of single-payer health care from Physicians for National Health Program:
"Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.
Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, long-term care, mental health, dental vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care."
Is national health insurance “socialized medicine”?
"No. Socialized medicine is a system in which doctors and hospitals work for the government and draw salaries from the government. Doctors in the Veterans Administration and the Armed Services are paid this way. Most European countries, Canada, Australia and Japan, have socialized financing, or socialized health insurance, not socialized medicine. The government pays for care that is delivered in the private (mostly not-for-profit) sector. This is similar to how Medicare works in this country. Doctors are in private practice and are paid on a fee-for-service basis from government funds. The government does not own or manage their medical practices or hospitals."
3 comments:
I don't pretend to have expert knowledge of these plans but the potential for corruption, manipulation of the system to benefit an elite, and "business as usual" really jumps out at me upon first scanning this website you have linked to.
For Example, just take the 2 following quotes -
Health facilities and expensive equipment purchases would be managed by regional health planning boards
There is a lot of money to be made in facilities construction, not unlike the money to be made in say, a new casino (revisit the Troha situation). It seems that the granting of contracts for equipment could be a lucrative spot for deal-making. And the make-up of the oversight boards would be pivotal as well. Board appointees would have political liasons etc. One thinks of the Powell boy as head of the FCC or the numerous "Brownies" that have been appointed by Bush to serve on various oversight bodies. Though these individuals would be smaller fish in smaller ponds, anyone familiar with small-toen politics is aware of the havoc that can be wreaked. I see no security for the public there.
A single-payer system would be financed by eliminating private insurers
It's normal to bash the big money makers and fantasize about their demise. What would be the economic impact of decimating this industry and its support industries? Just the number of people employed by Blue Cross (or whatever they're called now) is enormous. That's quite an industry to demolish. Even if they all wear black cloaks and have evil laughs, there would be wide-ranging consquences - what's the plan there?
And then to say that the whole she-bang would be managed similar to Medicare. That syatem was not exactly immune to manipulation to benefit the crafty and opportunistic. I do not see how safeguards could be built in to this deal to a significant degree.
It seems these plans ask us to assume the high levels of political corruption will not now happily effect these new systems. I would tend to think corruption will view this fresh turf much the same as a virus would view a pristine petri dish - Wagons Ho! (Yup, viruses talk like that)
Some people are concerned that these new plans will merely shift the flow of the money to new areas, benefitting the public very little. Not unlike Bush's Prescription fiasco. I tend to see it that way myself.
Well that was just my first look at the proposal - kinda not impressed.
From: Kip Sullivan
Date: Mar 24, 2007
My general comment about this email is that Jody (if that is the correct name of the writer) has adopted a strategy common to cynics in many spheres of life, not just health policy, that makes an enlightening discussion very difficult to have. Her strategy is to assume the very worst and make you argue with her doomsday scenarios.
Specifically, she makes the assumption that all government agencies are subject to corruption, and she implies that corruption is less likely to happen to other, nongovernmental institutions (such as corporations and churches). Once she has made this assumption, she gets to project all sorts of dreadful outcomes for a single-payer system.
The question all of us reading her email have to ask is, Do I really want to spend time debating anyone with such a cynical and fringe belief about government or humanity in general? As a general rule, I don't think it's a good idea to spend time debating people who hold such unique ideas. Nevertheless, I've taken a stab at addressing her paralyzingly cynical point of view below.
Jody did ask one interesting and relevant question (about what happens to insurance company employees). Even though she posed that question in a bizarre fashion, I've addressed it below.
For Example, just take the 2 following quotes -
Health facilities and expensive equipment purchases would be managed by regional health planning boards.
"There is a lot of money to be made in facilities construction, not unlike the money to be made in say, a new casino (revisit the Troha situation). It seems that the granting of contracts for equipment could be a lucrative spot for deal-making. And the make-up of the oversight boards would be pivotal as well. Board appointees would have political liasons etc. One thinks of the Powell boy as head of the FCC or the numerous "Brownies" that have been appointed by Bush to serve on various oversight bodies. Though these individuals would be smaller fish in smaller ponds, anyone familiar with small-toen politics is aware of the havoc that can be wreaked. I see no security for the public there."
I hear Jody saying two things in the preceding paragraph: (1) any attempt by any government to control spending in any sector of the economy is doomed to fail because some rich people will find a way to corrupt the agency in charge; (2) conservative presidents or governors will be able to appoint conservatives like Colin Powell's son to head these agencies, and agencies run by conservatives inevitably become corrupt.
I have two general reactions. First, I am unaware of any evidence to support these apocolyptic statements about government. If Jody truly believes all government agencies are vulnerable to corruption, then I think she has to oppose any and all agencies with the authority to allocate large sums of money, including NASA, FEMA, the Pentagon, school boards, and all public utility commissions. She can't just pick on the single-payer boards that would decide which hospitals can buy helicopters, for example. She must call for the elimination of all government agencies, or explain her standards for assuming some are invulnerable to corruption while others are. If she really is opposed to all goverment agencies that oversee the allocation of large sums of money (off hand I can't think of a government agency that does not), I don't see much point in trying to persuade her to change her mind. If that is indeed her position, she seems to be supporting a world without government.
A single-payer system would be financed by eliminating private insurers.
"It's normal to bash the big money makers and fantasize about their demise. What would be the economic impact of decimating this industry and its support industries? Just the number of people employed by Blue Cross (or whatever they're called now) is enormous. That's quite an industry to demolish. Even if they all wear black cloaks and have evil laughs, there would be wide-ranging consquences - what's the plan there?"
Numerous studies have shown that Blue Cross Blue Shield employees wear black cloaks and have evil laughs. Single-payer advocates firmly believe that people who cackle when they laugh deserve to lose their jobs. Single-payer advocates support offering retraining to these evil people so that they can perform jobs in areas where there are now shortages, including nursing, rehab, pharmacy, and medicine. Some people now working in private insurance companies will be needed to run the state or national single-payer system. The retraining will include teaching these people how to laugh without cackling and rubbing their hands together.
It's interesting that single-payer advocates get attacked for job destruction within the insurance industry, but big business, which has destroyed thousands of jobs in the insurance industry by self-insuring, are never included in the criticism. When General Mills, for example, self-insures, it puts insurance industry people out of work. Self-insuring means General Mills stops paying BCBS premiums, and instead acts as its own insurer. Today almost half of all Americans with employer-sponsored insurance get it from a self-insured employer. The job loss associated with self-insuring is apparently ok when big business does it. It is a problem only when single-payer advocates do it. My best guess is that single-payer will be implemented gradually, not all at once. If that happens, then the insurance industry will gradually shrink, and all actors with a stake in the industry will have plenty of time to read the handwriting on the wall and prepare accordingly. In that event, we can say all the paper shufflers at BCBS lost their jobs the way horse-and-buggy manufacturers lost their jobs as the automobile took over -- gradually, with plenty of time for people who made buggy wheels to find jobs elsewhere, maybe even in auto manufacturing.
"And then to say that the whole she-bang would be managed similar to Medicare. That syatem was not exactly immune to manipulation to benefit the crafty and opportunistic. I do not see how safeguards could be built in to this deal to a significant degree."
If Jody would like to provide an example of "manipulation" at Medicare, I'd be glad to discuss it. If she can provide such an example, I would appreciate her also giving an example of what she means by "safeguards" and giving us an example of how the private-sector insurers administer these safeguards today. The issue here is not whether Medicare is perfect, but whether it is better than the insurance-industry-run system we have today. Medicare operates in a fishbowl. Blue Cross Blue Shield does not. That is one reason why waste and mistreatment of patients is so much more common in the private sector than it is within Medicare.
"It seems these plans ask us to assume the high levels of political corruption will not now happily effect these new systems.
I would tend to think corruption will view this fresh turf much the same as a virus would view a pristine petri dish - Wagons Ho! (Yup, viruses talk like that)
Some people are concerned that these new plans will merely shift the flow of the money to new areas, benefitting the public very little. Not unlike Bush's Prescription fiasco. I tend to see it that way myself."
I agree completely with Jody here, but her comment indicates she misunderstands the single-payer proposal.
Geez and I thought I was skeptical about the power of money and government. This person is really paranoid. My personal response is that a commission and a single payer entity is easier to watch and to control. Yes, we know people like Bush, Rove, Cheney, etc. can try to control the process. But, I believe we citizens can and have discovered it and stopped it. It is an uphill battle but it has been done. When it comes to the insurance industry and the drug companies - that's another story.
Where will all those insurance company employees go? I think that's her question. First of all many of the managed care companies provide health care in hospitals and clinics. Our country is facing more and more shortages of workers - especially in health care. With a little re-training I can see most of them moving from pushing paper to actually providing health care.
Craig Brooks
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