Congressman Admits ObamaCare a Platform for Single Payer

[Bern80]

Any evidence to support your claims?

The other countries like France that have forms of single payer and basic principles of economics.

What about France?

They reported a deficit in their health scare spending of about 8 billion in 2009 is projected to be higer for 2010 and to increase for the foreseeable future which has forced them to cut back on reimbursements.

 

[RDD_1210]

The other countries like France that have forms of single payer and basic principles of economics.

What about France?

They reported a deficit in their health scare spending of about 8 billion in 2009 is projected to be higer for 2010 and to increase for the foreseeable future which has forced them to cut back on reimbursements.

Here is a recent article comparing France's system to ours. It is very insightful and seems we can learn quite a bit from them. It's not perfect but it's something we should be potentially looking at modeling ourselves after

What Can The US Learn From The French Health Care System?

 

[Bern80]

What about France?

They reported a deficit in their health scare spending of about 8 billion in 2009 is projected to be higer for 2010 and to increase for the foreseeable future which has forced them to cut back on reimbursements.

Here is a recent article comparing France's system to ours. It is very insightful and seems we can learn quite a bit from them. It's not perfect but it's something we should be potentially looking at modeling ourselves after

What Can The US Learn From The French Health Care System?

I like parts of it too. The problem is they can't afford it.

 

[Immanuel]

They reported a deficit in their health scare spending of about 8 billion in 2009 is projected to be higer for 2010 and to increase for the foreseeable future which has forced them to cut back on reimbursements.

Here is a recent article comparing France's system to ours. It is very insightful and seems we can learn quite a bit from them. It's not perfect but it's something we should be potentially looking at modeling ourselves after

What Can The US Learn From The French Health Care System?

I like parts of it too. The problem is they can't afford it.

The part in the article about the salaries of doctors in France concerns me. It is one of the big issues I have with the single payer system.

What's going to happen to the men and women graduating from medical school the year Single Payer Health Care take affect. They all will have huge amounts of debt and have to work their entire careers simply to cover those debts. Today's doctors will be forced to take below standard wages offered by the government and still have to pay off their medical school debts.

Are we going to close the medical school (Stanford, Harvard etc.) and send aspiring young doctors to government sponsored schools and not charge them for their education? I highly doubt that.

A single payer system sure seems to me like it would make our lives a lot easier.

In the long run, I think you are right, we can't afford this.

Immie

 

[RDD_1210]

They reported a deficit in their health scare spending of about 8 billion in 2009 is projected to be higer for 2010 and to increase for the foreseeable future which has forced them to cut back on reimbursements.

Here is a recent article comparing France's system to ours. It is very insightful and seems we can learn quite a bit from them. It's not perfect but it's something we should be potentially looking at modeling ourselves after

What Can The US Learn From The French Health Care System?

I like parts of it too. The problem is they can't afford it.

What country has a quality health care system and can afford it?

 

[RDD_1210]

Here is a recent article comparing France's system to ours. It is very insightful and seems we can learn quite a bit from them. It's not perfect but it's something we should be potentially looking at modeling ourselves after

What Can The US Learn From The French Health Care System?

I like parts of it too. The problem is they can't afford it.

The part in the article about the salaries of doctors in France concerns me. It is one of the big issues I have with the single payer system.

What's going to happen to the men and women graduating from medical school the year Single Payer Health Care take affect. They all will have huge amounts of debt and have to work their entire careers simply to cover those debts. Today's doctors will be forced to take below standard wages offered by the government and still have to pay off their medical school debts.

Are we going to close the medical school (Stanford, Harvard etc.) and send aspiring young doctors to government sponsored schools and not charge them for their education? I highly doubt that.

A single payer system sure seems to me like it would make our lives a lot easier.

In the long run, I think you are right, we can't afford this.

Immie

Their system is quite a bit different and yes their doctors make less, but they also don't have outrageous education costs or ridiculous malpractice insurance protection costs.

 

[Immanuel]

I like parts of it too. The problem is they can't afford it.

The part in the article about the salaries of doctors in France concerns me. It is one of the big issues I have with the single payer system.

What's going to happen to the men and women graduating from medical school the year Single Payer Health Care take affect. They all will have huge amounts of debt and have to work their entire careers simply to cover those debts. Today's doctors will be forced to take below standard wages offered by the government and still have to pay off their medical school debts.

Are we going to close the medical school (Stanford, Harvard etc.) and send aspiring young doctors to government sponsored schools and not charge them for their education? I highly doubt that.

A single payer system sure seems to me like it would make our lives a lot easier.

In the long run, I think you are right, we can't afford this.

Immie

Their system is quite a bit different and yes their doctors make less, but they also don't have outrageous education costs or ridiculous malpractice insurance protection costs.

I discussed the education costs. What do you propose to do about those who graduate before a single payer system takes effect and suddenly out of the magnanimous generosity of the left, the government starts taxing us in order to pay for the education of medical students?

The Malpractice Insurance issue discussed in your article was intriguing and something that might be workable even under our own system now.

Immie

 

[RDD_1210]

The part in the article about the salaries of doctors in France concerns me. It is one of the big issues I have with the single payer system.

What's going to happen to the men and women graduating from medical school the year Single Payer Health Care take affect. They all will have huge amounts of debt and have to work their entire careers simply to cover those debts. Today's doctors will be forced to take below standard wages offered by the government and still have to pay off their medical school debts.

Are we going to close the medical school (Stanford, Harvard etc.) and send aspiring young doctors to government sponsored schools and not charge them for their education? I highly doubt that.

A single payer system sure seems to me like it would make our lives a lot easier.

In the long run, I think you are right, we can't afford this.

Immie

Their system is quite a bit different and yes their doctors make less, but they also don't have outrageous education costs or ridiculous malpractice insurance protection costs.

I discussed the education costs. What do you propose to do about those who graduate before a single payer system takes effect and suddenly out of the magnanimous generosity of the left, the government starts taxing us in order to pay for the education of medical students?

The Malpractice Insurance issued discussed in your article was intriguing and something that might be workable even under our own system now.

Immie

Thats a really good question and I don't have an answer off the top of my head. However, I think that there has to be some sort of workable solution that we can come up with. To me, that's a small hurdle for a much greater long term good that we can certainly figure out if thats the direction the country decided to take.

 

[Immanuel]

Their system is quite a bit different and yes their doctors make less, but they also don't have outrageous education costs or ridiculous malpractice insurance protection costs.

I discussed the education costs. What do you propose to do about those who graduate before a single payer system takes effect and suddenly out of the magnanimous generosity of the left, the government starts taxing us in order to pay for the education of medical students?

The Malpractice Insurance issued discussed in your article was intriguing and something that might be workable even under our own system now.

Immie

Thats a really good question and I don't have an answer off the top of my head. However, I think that there has to be some sort of workable solution that we can come up with. To me, that's a small hurdle for a much greater long term good that we can certainly figure out if thats the direction the country decided to take.

My issue is not so much with the system, but rather who is in charge. I have lost all faith in the politicians doing the right thing regardless of party.

The Health Care field is in dire need of reform. Some of the issues that were brought up by the bill that passed last year were good starts, but in my opinion, they only scratched the surface.

I have no confidence in Washington actually doing something that will benefit citizens of the U.S. Those who do benefit in the long run will be those with the dollars to affect the vote. Whether or not we end up with a "single payer system", I believe you can count on one thing... it is going to cost the American Taxpayer a hell of a lot of money.

Immie

 

[RDD_1210]

I discussed the education costs. What do you propose to do about those who graduate before a single payer system takes effect and suddenly out of the magnanimous generosity of the left, the government starts taxing us in order to pay for the education of medical students?

The Malpractice Insurance issued discussed in your article was intriguing and something that might be workable even under our own system now.

Immie

Thats a really good question and I don't have an answer off the top of my head. However, I think that there has to be some sort of workable solution that we can come up with. To me, that's a small hurdle for a much greater long term good that we can certainly figure out if thats the direction the country decided to take.

My issue is not so much with the system, but rather who is in charge. I have lost all faith in the politicians doing the right thing regardless of party.

The Health Care field is in dire need of reform. Some of the issues that were brought up by the bill that passed last year were good starts, but in my opinion, they only scratched the surface.

I have no confidence in Washington actually doing something that will benefit citizens of the U.S. Those who do benefit in the long run will be those with the dollars to affect the vote. Whether or not we end up with a "single payer system", I believe you can count on one thing... it is going to cost the American Taxpayer a hell of a lot of money.

Immie

I agree, legislation passed last year only scratches at the surface of the problem. I dont trust politicians either, but I also don't trust insurance companies. So where does that leave us?

And yes, healthcare is extremely expensive no matter which way you slice it.

 

[Immanuel]

Thats a really good question and I don't have an answer off the top of my head. However, I think that there has to be some sort of workable solution that we can come up with. To me, that's a small hurdle for a much greater long term good that we can certainly figure out if thats the direction the country decided to take.

My issue is not so much with the system, but rather who is in charge. I have lost all faith in the politicians doing the right thing regardless of party.

The Health Care field is in dire need of reform. Some of the issues that were brought up by the bill that passed last year were good starts, but in my opinion, they only scratched the surface.

I have no confidence in Washington actually doing something that will benefit citizens of the U.S. Those who do benefit in the long run will be those with the dollars to affect the vote. Whether or not we end up with a "single payer system", I believe you can count on one thing... it is going to cost the American Taxpayer a hell of a lot of money.

Immie

I agree, legislation passed last year only scratches at the surface of the problem. I dont trust politicians either, but I also don't trust insurance companies. So where does that leave us?

And yes, healthcare is extremely expensive no matter which way you slice it.

I trust the corporate leaders more than I trust Washington. Mainly because every Corporate leader has to feed his family and suffer through the same market conditions we do. Sure they are greedy little bastards, but they have to woo the customer.

Congress is under no such limitation. America will vote in the Democrat or Republican regardless of whether that is right or wrong and much too often it is the incumbent that wins. There is no free market in the game of politics. Once you are in the only way out is by choice or "maybe" raping a young girl other than that, they are shoe-ins.

Immie

 

[Bern80]

I like parts of it too. The problem is they can't afford it.

The part in the article about the salaries of doctors in France concerns me. It is one of the big issues I have with the single payer system.

What's going to happen to the men and women graduating from medical school the year Single Payer Health Care take affect. They all will have huge amounts of debt and have to work their entire careers simply to cover those debts. Today's doctors will be forced to take below standard wages offered by the government and still have to pay off their medical school debts.

Are we going to close the medical school (Stanford, Harvard etc.) and send aspiring young doctors to government sponsored schools and not charge them for their education? I highly doubt that.

A single payer system sure seems to me like it would make our lives a lot easier.

In the long run, I think you are right, we can't afford this.

Immie

Their system is quite a bit different and yes their doctors make less, but they also don't have outrageous education costs or ridiculous malpractice insurance protection costs.

And you don't think those issues can be addressed without government interjecting intself?

 

[Flopper]

There are different ways to pay for health care services. The most common has been paying a fee for each service provided (or, potentially, a fee for a group of services surrounding a particular diagnosis). But that has implications for the volume of services delivered because there's an incentive there to provide more services and collect more money, particularly when the fees for various services are reduced. And it reinforces the notion that we're buying health widgets and not health.

Capitation is one alternative to simply paying for each procedure. Instead it pays a flat fee for each person, often in a per-member-per-month arrangement. This has become fairly common in state Medicaid programs, where it's usually known as managed care. Under those arrangements, the state government no longer directly pays providers for each service a Medicaid beneficiary gets; instead, the state contracts with private health insurance plans--called Medicaid managed care organizations (MCOs)--to deliver care to Medicaid beneficiaries. The MCO gets a fixed amount of money each month for each enrollee (perhaps risk-adjusted to take into account whether an individual enrollee is sicker than average or needs more care) and assumes the financial risk for getting care to those enrollees. Generally the MCOs then contract with providers and sometimes find ways to shift some of that risk onto the providers.

Yes, I think you have hit on a major problem with way healthcare services are delivered, Fee for Service. The more services the provider can sell the more money the provider makes. In most business environment the buyer is able to evaluate the service versus the cost. In most cases, this is not possible in healthcare. A person in the hospital dying of cancer and racking up hundreds of thousands of dollars in charges has little incentive to question the need for services. When the doctor says we need to repeat the CT Scan, we assume it's needed. Unfortunately, insurance companies don't do any better job in evaluating the need for service than the patient.

I think what is needed is to pay more for results not services. Do you pay the auto mechanic for trying to fix your car? I'm not saying a doctor should only be paid if he makes you well, but what I am saying we need to introduce mechanisms that focus on results. Pay hospital and doctors higher fees for successful outcomes.

That sounds horribly complex. Why am I way off base in thinking that if we all really want a healthier less expensive system, we as individuals need to start taking MORE responsibility for our health and how our health care dollars are spent? I don't really see how capitation does that. Any solution that makes the individual less financially responsible for the costs of the specific procedures and services their health may require is a system doomed to continuing an escalation of prices for those services.

When you say you think the individual should take more responsibility for their healthcare, I’m not sure what you expect the individual to do. Surely, you don’t expect the individual to take responsibility for paying all medicals bills regardless of cost.

1% of the population is responsible for 30% of our healthcare cost. 60% of our healthcare dollars go to fight serious diseases such as cancer and heart disease. In my experience, people who are seriously ill are not very responsible consumers. When you are fighting for your health and your life, you don’t price shop.

If you expect to do anything about the rising cost of healthcare, you have focus on how healthcare is delivered, not the consumer.

 

[Bern80]

Here is a recent article comparing France's system to ours. It is very insightful and seems we can learn quite a bit from them. It's not perfect but it's something we should be potentially looking at modeling ourselves after

What Can The US Learn From The French Health Care System?

I like parts of it too. The problem is they can't afford it.

What country has a quality health care system and can afford it?

But I thought affordability was the issue we were trying to address. Now your're basically admitting that you've given up on that and are really only interested in allowing people to pay as little as possible and if we can do that by going into debt, so be it?

That isn't a solution at all RDD. You're sacrificing once again the long term for the short term. That debt is going to catch up to some generation at some point. When you can't afford costs of something, something has to give. You're options are:

1)Hope a creditor has enough confidence in you to allow you to go into debt.

2) Cut back on reimbursements

or

3) tax people more.

A solution that no only does not address the cost of resources it probably will cause them to increase. For the upteenth time RDD we agree on the problem. Swallow you're fucking pride for second and admit government isn't the best solution to that problem and for the love of god start looking at solutions that actually address it instead of ones that try to mask it.

 

[Bern80]

When you say you think the individual should take more responsibility for their healthcare, I’m not sure what you expect the individual to do. Surely, you don’t expect the individual to take responsibility for paying all medicals bills regardless of cost.

I expect consumers to take more responsibility because responsible consumer can drive down costs. The fewer option you have the less you care about where your money goes. Most of us try to manage our budgets as best we can. We make concsious choices about what we want and what we actually end up spending money on. For most people there is no choice where their purchase of coverage is concerned. There employer offers a single plan maybe with minor variations in deductibles, the premiums are deducted from their paychecks and they think little more about it.

Think about when you go by a car. You think about things like what you need for a vehicle and who offers the best price and value for what you want. Automakers are able to directly respond to that by lowering prices and/or improving quality. The health insurance industry doesn't have to respond to variables like that because so much of what a peson purchases is predetermined already from what a plan has to cover as regulated by federal and state governments and limitations on plans offered by employers.

Look at the big picture. Why do we need insurance in the first place? Why don't we pay our doctors directly? Because the cost of their services are more than what many can afford. THAT is the real root problem. So why are we not focusing on way to make it more feasible for peope to directly pay their providers rather than going through a third party?

If you expect to do anything about the rising cost of healthcare, you have focus on how healthcare is delivered, not the consumer.

Oh yes you very much have to focus on the consumer. At some point you have to acknowledge that consumers have control over the health care costs they may incur. Someone obese with a poor diet is likely going to incur more health care cost than somene that takes care of themselves. It is a HUGE part of the problem with health care in this country. Individuals don't want to admit that the choices they are making are contributing to the problem. Problem identification is key. You can't change what you don't acknowledge. That the choices people make contributes to the problem of the cost of services is an undeniable fact. If you choose to not acknowledge that fact you have little right to expect things to improve.

 

[Flopper]

Not sure if anyone answered the question, what is capitation? Capitation is one of the methods used by insurance companies to compensate health care providers. It is most commonly used to pay primary care physicians or medical groups under an HMO plan.

Basically, the physician receives a fixed monthly fee for the care of a patient regardless of the amount of care. The idea is that the physician has a vested entrance in keeping the patient healthy. In a capitated plan, the physician will emphasis healthy living, and early detection of diseases. However, often patients fear that the physician will be reluctant to delivery services in order to maximize profits. The patient can always ask for specialist who are not capitated. My experience is that capitation is good for people with few health problems where the emphasis should be on early detection and healthy living, but for a patient that has serious chronic conditions, no way.

With that said, I think capitation has the potential to lower cost, if used wisely.

 

[blu]

single payer would be the best thing to happen to this country in a long time

 

[Sheldon]

Here is a recent article comparing France's system to ours. It is very insightful and seems we can learn quite a bit from them. It's not perfect but it's something we should be potentially looking at modeling ourselves after

What Can The US Learn From The French Health Care System?

I like parts of it too. The problem is they can't afford it.

The part in the article about the salaries of doctors in France concerns me. It is one of the big issues I have with the single payer system.

What's going to happen to the men and women graduating from medical school the year Single Payer Health Care take affect. They all will have huge amounts of debt and have to work their entire careers simply to cover those debts. Today's doctors will be forced to take below standard wages offered by the government and still have to pay off their medical school debts.

Are we going to close the medical school (Stanford, Harvard etc.) and send aspiring young doctors to government sponsored schools and not charge them for their education? I highly doubt that.

A single payer system sure seems to me like it would make our lives a lot easier.

In the long run, I think you are right, we can't afford this.

Immie

The UK also has a similar problem with their NHS employees' compensation. I'll have to look the numbers up later.

I think we COULD afford it, just that to do so would take some serious restructuring of government finance. But the way Congress is struggling to do that now, the odds look dim. I guess it's the difference between being possible, versus probable.

 

[Bern80]

single payer would be the best thing to happen to this country in a long time

Yes, people absolving themselves of responsibility is always a great idea.

 

[RDD_1210]

The part in the article about the salaries of doctors in France concerns me. It is one of the big issues I have with the single payer system.

What's going to happen to the men and women graduating from medical school the year Single Payer Health Care take affect. They all will have huge amounts of debt and have to work their entire careers simply to cover those debts. Today's doctors will be forced to take below standard wages offered by the government and still have to pay off their medical school debts.

Are we going to close the medical school (Stanford, Harvard etc.) and send aspiring young doctors to government sponsored schools and not charge them for their education? I highly doubt that.

A single payer system sure seems to me like it would make our lives a lot easier.

In the long run, I think you are right, we can't afford this.

Immie

Their system is quite a bit different and yes their doctors make less, but they also don't have outrageous education costs or ridiculous malpractice insurance protection costs.

And you don't think those issues can be addressed without government interjecting intself?

Haven't seen anything that has led me to believe it can.