🚀 go-pugleaf

In article <1993Jan07.183331.2421@ssc.com> fyl@ssc.com (Phil Hughes) writes:
/The more I read the more I realize people just don't understand how a
/single-payer health care system works.  It has nothing to do with having
/the government "responsible" for health care.  It only has to do with
/how the bills are paid.

Whoever pays the bills pulls the strings. If the gov't pays the bills, the
gov't calls the shots, and is responsible. I don't see how this can be
separated.

/Yes, I know the government doesn't know how to do that but look at
/the alternative.  Right now there are thousands of insurance companies
/in the business of providing health care insurance.  They are all in
/the game to make a profit.  Their business expenses are those of
/processing claims plus marketing -- convincing the consumer that they
/are better than the next plan.

This is not different from any other free market industry. The interesting
question is why is this a problem for health care, but not for others
(like bread?). Wasn't it Karl Marx who postulated that "profit" was the
excess of what was charged for over what the worker produced, and therefore
the profit was essentially stolen from the worker?

/Add to these overhead costs the fact that each health care provider
/(doctors, dentists, hospitals, etc) have to deal with thousands of
/different claim forms and procedures.  Thus, doctor's offices spend
/more time dealing with claims that in patient contact time.

Last time I did my taxes myself I lost faith in the idea that the government
can reduce paperwork costs.

/Compare this to Canada.  Each province has one "insurance provider" which
/is the provincial government.  Thus, there are no insurance company profits
/and there is only one claim form.  The processing cost of these claims
/is around 3% (vs the 25% in the U.S.).

The idea that the government doesn't make a profit, so things should be cheaper
is a seductive one. The Soviets tried it for 70 years. The reality is that
the government not only doesn't show a profit, it runs a horrendous deficit,
due to bureaucratic inefficiency and the priority of pork over practicality.

/Additional savings come in the form of one "insurance company"
/negotiating with the providers on rates.  It must work as Canadian

And what is the incentive for the *single* insurance company that is
guaranteed a monopoly? You have all the evils of a monopoly here.

/doctors get paid less than U.S. doctors.

I imagine that this can cause a "brain drain" of the better doctors
emigrating to the US. Of course, one can resort to putting a wall
around Canada to keep them in...

/Now, does this confilct with free enterprise?  No.  Canadian doctors

Yes. Legal monopolies are not free enterprise.

/are paid fee for service, just like in the U.S.  They pick what they do,
/patients can select their own doctors and they can pick how much they
/want to work.  The only limit is that they can only charge the fees
/they agree to for a particular procedure.
/The major saving is in elimination of th 25% overhead for someone who
/has no interest in your health.  They are strictly a middleman.

I submit that the government has no interest in my health either. Only
*I* do, and I want the freedom to be able to hand my dollars to whomever
I choose to for whatever procedure I choose to for my health.
I don't want my health chosen for me by 43% of the voters who don't know
or care about me.

/Are there waiting queues in Canada for service?  Yes.  Why?  Because
/there is a fixed budget.  But that budget is substantially lower per
/person than in the U.S.  Thus, the queues could be shortened or eliminiated
/(not necessarily a good idea) and the cost would still be less than in
/the U.S.

Why are long lines a good idea? A citizen waiting in line is not productive.
I forget how many hours/week Soviet citizens waited in line, but it was
so much it was obvious why the workers were less productive.

The vast experience in socialist countries is that if you artificially set
the price low, then the customers pay anyway in a combination of:
o	Inferior service
o	Long lines
o	Heavy infusion of taxpayer dollars

/I suggest that rather than bitch about single-payer that you offer
/an alternative.  Personally I can't see a better answer than pretty much
/what is is Canada.  If you can, fine, present it.  But I am reasonably
/sure that offering any solution that includes a parasite that eats up
/about 25% of all the money is going to be better or cheaper.

Any product you buy on the free market has maybe 25% of its cost wrapped
up in marketing, many go as high as 60%. These products are *still* cheaper
and better than those produced by nationalized industries.

Ok, here's some ideas off of the top of my head:
o	Put a lid on tort awards.
o	Change the mission of the FDA from:
	"Treatment shall be safe and effective"
	to:
	"If the treatment is not recognized by the FDA as safe and
	effective then the patient must be so informed and must
	specifically authorize its use"
o	Remove the monopoly power of the AMA to restrict the number
	of physicians.
o	Make health insurance and medical expenses fully tax deductible.
o	Toss the idea that all are entitled to the best health care that
	money can buy regardless of cost and individual irresponsibility.

Note that the American health care system is a semi-socialized system
already, so I wouldn't be so quick to blame all its faults on the half
of it that is free.

I also note that you live in America, not Canada.