A universal single-payer, not-for-profit healthcare system could help lift tens of mi

Thanks, Tim ... I like a lot about your ideas, but I still have reservations.

First, if I don't like my cellphone, I don't have to buy one ... my life does not depend on having a cellphone, although you wouldn't know that from the advertising. Fact is, I don't need a phone at all. So, the dynamics of the demand side of the equation are skewed from the get-go. I like the notion of buying my own insurance rather than going with whatever my employer happens to want to offer ... I have no PCP now because there are no providers accepting my insurance taking new patients at this time. Luckily, I'm reasonably healthy and can afford to pay out of pocket.

BTW, car insurance, at least in my home state of Massachusetts, is regulated ... rates are set by the insurance commission, companies have to justify increases and account for the quality of their coverage.

I'm afraid I just don't trust that a so-called free market will operate to my benefit. If vendors/providers operated according to theory, we would probably see lower prices and at least some kind of competition in terms of quality. However, private companies manipulate markets all the time, collecting large profits for lousy quality.

If we cap profits at a reasonable rate of return and regulate marketplace behavior ... that puts us back at square one with government, with all it's ethical pitfalls, back in the picture.

A free market approach does not address the inherent conflict of interest involved in companies that earn a profit out of providing healthcare services or supplies. We already have a free market in the pharmaceutical and biomedical industries and costs have continued to climb. Affordable insurance does me no good if benefit caps do not cover what I need. 5K a year would probably cover most of my basic health care ... but my only chronic condition is high blood pressure which has been easily controlled with diet and exercise. For some people, $5000 would barely cover meds, especially if it has to stretch to cover a family rather than one person.

On the whole, though, I like your proposal.

I just don't think it's the whole answer to keeping costs under control.

I understand you point Tweety, but I would like to remark on the irony of it. Proponents of government mandated, taxpayer funded health care plans often hype the "efficiency" of existing government plans as a means of cost savings over private insurance. Bunk. The paperwork and personnel required for Medicaid and Medicare reimbursement is at least equal to, if not more than that of private insurance. Hence the number of billing clerks at Duke exceeds the number of nurses.

The cost savings of current government plans stems from the pitiful reimbursement they provide and now the denial of payment for sometimes unavoidable, legitimate complications of hospitalization. (See the thread on the end of c-diff testing hospitals.) Hospitals will stay afloat only if they are able to transfer these legitimate costs onto private paying and privately insured patients. That's not government efficiency.

[quote] So, what are we to do? Where's the accountability? It's at the voting booth. It's our government, our health care, and most of us are fighting to regain control of it. We had an election, remember, and threw most of "those guys" out of office. Unfortunately, one of their "spokes-holes," who remains in office, Rep. Senator Mitch McConnell has said, of the auto-bailout imparticular, "Republicans won't allow the taxpayers to subsidize failure." Aw, shucks, Senator Grinch, and as you've noted, ZASHAGALKA, that's exactly what "those guys" have been asking us to do for the last eight years! We can remove the barriers to health care reform that "those guys" have left behind and move forward.

I agree that there's dirty money in politics...so have you joined the fight for public accountability and clean elections? Until then, hopefully, Obama and the new Congress will repeal Medicare part D and restore government's right to use its bulk purchasing power to negotiate lower drug prices. It's a travesty and disingenous to deprive the public sector of resources and then call it a failure. SiCKO!
http://www.viikii.net/videos/watch/7...ko-part-5.html
We've got to end corporate "I've got a Golden Ticket" control of Congress.

It sounds to me like the main reason for your lack of support for single-payer is political fear: you agree that there needs to be change, but you apparently believe that private insurers are too powerful to cut out of the loop, and so you demonize a single-payer solution, and align yourself with the the business interests. The same political calculations and ruminations led Bill Clinton to reject a single-payer system in 1993, even though his advisers understood that a single-payer system would be the least expensive way to provide universal coverage. Instead, he proposed a complex plan designed to preserve a role for private health insurers, and yet his plan backfired. The insurers opposed it anyway, and doomed meaningful reform with their "Harry and Louise" ads. The insurers ability to make a profit depends on their ability to control the system.

So, what's your solution, throw up your hands and surrender? Or, join the fight for freedom from the terrorist insurers, who delay and withhold payment for health care to make a profit. They heartlessly deny therapeutic treatments leaving patients to die; insurance companies rescind policies at whim, leaving patients bankrupt.

Let's talk about fundamental change and an end to "market-based" medicine...that's the "stunning failure" you need to be speaking out against: it's failed to control cost or increase access to care. We don't need mandates to buy defective insurance company product. We need to get to work and expand and improve the single payer system we already have: Medicare.

Nobel prize winning economist, Paul Krugman, has made the case and supports Universal health care.
http://www.pnhp.org/news/2008/octobe...eate_paul_.php
Dr. Uwe Reinhardt, Professor of Political Economy at Princeton makes the case:
http://www.pbs.org/wgbh/pages/frontl...reinhardt.html
http://worldfocus.org/blog/2009/01/2...3783/#comments
Steffie Woolhandler, MD, co-founder of Physicians for a National Health Plan(PNHP) has a degree in economics, and her organization has also made the case for single payer.
http://www.pnhp.org/facts/singlepayer_faq.php
http://www.pnhp.org/facts/statement_...urance_act.php

The 85,000 members of America's RN union, the National Nurses Organizing Committee (NNOC), and the Institute for Health and Socio-Economic Policy has made the case that a single payer national health plan will stimulate the economy, put people back to work, and provide access to all preventative and restorative medically necessary health care. Read all about it.
http://www.calnurses.org/media-cente...e-economy.html
http://www.calnurses.org/research/pd...study_2009.pdf

Your apparent opposition and lack of trust, (and maybe it's not opposition), stems from the fact that you've been beat up by the current system so much that you've come to accept the status quo. You have a right to your opinions, but I still have hope and believe we can, and must fundamentally change healthcare. I'll take the facts from Krugman, Reinhardt, PNHP, IHSP, NNOC, and Conyers/HR 676, and the facts speak for themselves. Give it some thought and examine the evidence. We've accomplished many social reform despite the overwhelming opposition of powerful special interests. As nurses, patients are our special interest. I have no interest in seeing for-profit medicine continue in this country. What's yours? If Canada can institute a single payer system, we certainly can. Yes, we can!
Will you join us?
http://www.pnhp.org/news/2009/januar..._care_alli.php

Excellent points all. I guess I missed it where people are advocating and saying that the government is more efficient than private enterprise. It's well known and understood that government bureaucracy sucks. I know the irony is that I'm asking for more government payments, which will increase the number of claimants, but that's one of the many things that needs to be worked out. I believe that we have the potential and ability to make it happen, it's going to be tough and hard work, and with the depression going on now might now be the time, but we can do it. We're Americans.

Although, I'm wondering the accuracy of the statement about Duke. When I worked there, we had about 2000 nurses. I'm finding it hard to believe there are over 2000 billing clerks.

No, RN4MERCY, I probably won't join, unless we include mandatory prison sentences for ethics violations and total transparency for all decisions.

My experience with profit-driven healthcare, both as a consumer and as an employee, has left me massively unimpressed with the quality of the product.

But the sweetheart deal perpetrated by Medicare part D is an example of the equally massive failing of a government program to control costs. As is the onerous and increasingly expensive paperwork for both patient care and for reimbursement.

Well, I think we should look at ethics. Yes, there are individuals who cheat the government, but it's not the government, "we the people," who set out to cheat anyone. We can deal with the few individuals who abuse the system separately as we catch them. There's no moral reason to hold up the benefit of a single payer system for the millions of us who need it because of a few.

We provide for the common good...schools, libraries, national parks, clean water, regulatory enforcement services, etc., so why do we not provide tax supported coverage for health care as a non-profit social service as well? However, the evidence is in and corporate insurers have systematically and fraudulently cheated the government and individuals for their benefit at the expense of the rest of us. Their greed is never satisfied. There's no added value to having insurance middlemen, only diversion of precious health care dollars away from the provision of actual care, and into administrative and marketing overhead, and the pockets of shareholders and the inflated bonus checks for wealthy executives.

If we have a single payer, social insurance program, (not socialized medicine), where the government is the payer, and a publicly accountable system for determining payment for services, then urban, rural, public, or private providers will be paid equitably for providing medically necessary care. Collectively we can invest in the care that people need in a more equitable and transparent system. Resources and technology can be placed in communities that need them. Currently, people with money may be getting more tests and procedures than they need, while those without money go without needed treatment.

Look at fire and police protection as socialized protection. Your house has been busted into, and the perps set the house on fire before fleeing the scene. Doesn't matter where you live; the fire department puts out the fire, but you and your neighbors and the businesses that operate in your community pay taxes and contribute to protect your property. Why should you pay to put out someone else's fire? Because you'd want them to help you; it's sound public policy that contains cost and minimizes the risk for increased damage and injury.

So you're injured and sick? Avian flu, meningitis, drug resistant TB? Doesn't it make sense to be able to receive treatment for illness when it's least expensive to treat, before it spreads and causes even more damage? It just makes sense to participate in a tax-supported plan and pay only once (no co-pays, deductibles, exclusions), with guaranteed benefits.

[quote=HM2Viking;3409893]PHRMA wrote the part D bill. /QUOTE]

Because our elected officials sold out tax-paying U.S. citizens and LET them. Why on earth should we believe that any future government program would be handled any differently?