So how exactly are the providers going to collect the same amount of money as before if the cost to people and employers is supposed to go down.
This is the question you believe any reform proposal should answer? How we can we find ways to keep spending the exact same amount of money, year after year?
It's not hard to predict the effect of your brand of "reform" on the average person's wallet.
[ame=http://www.youtube.com/watch?v=lSPNQ82Sq4E&feature=related]Prediction[/ame]
The reality is that we need to slow the growth rate of spending by improving
value (roughly understood as the quality we get for a given level of expenditures) in the health care system. And we've got a long road ahead of us on that one. But if your goal is simply to protect providers' share of a certain percentage of GDP, you've already lost.
Government will either have to subsidize it to make up the difference and add to the debt as a result or it will have to raise taxes on everyone to cover the costs. This will also allow providers to actually raise the price of what they charge for services.
That is what happens when you subsidize something. When you set a price for a service one factor in doing so is knowing what people will pay and obviously I can charge more to whom money is less of a factor, in this case government.
I'm not familiar with any single-payer proposals that involve providers retaining the tremendous power they currently have over prices. In fact, that's generally one of the primary arguments offered in favor of single payer proposals. At present, prices (i.e. reimbursement rates) are dictated by
provider market power relative to payers; different payers will often be charged different reimbursement rates for a single service based on how much of the insurance market they have cornered. That isn't the case, at least with hospitals, in the only state that currently has all-payer rate-setting (i.e. common reimbursements for all payers set by the state); and
in that state, they're not bent quite as far over the barrel by hospitals:
On average, Maryland hospitals charged patients 20% above the cost to treat them in 2007, compared with a national average of 182%, according to the American Hospital Association.
If you're going to have a bilateral oligopoly, there are advantages to at least have a public entity refereeing; single-payer takes the concept further to pursue some other benefits beyond simply shifting the power to set prices away from providers.