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How many of you think single payer healthcare is inevitable?
Posted on 10/27/14 at 2:47 pm
Posted on 10/27/14 at 2:47 pm
The more I think about this issue, the more convinced I am we are less than 10 years away from single payer in the United States being a reality.
I'm not arguing that it is a good thing, just that it will happen. Does anyone seriously think we will not eventually go the way of the rest of modern Western society?
I'm not arguing that it is a good thing, just that it will happen. Does anyone seriously think we will not eventually go the way of the rest of modern Western society?
12
Posted on 10/27/14 at 2:51 pm to TK421
I think it's inevitable and that it will take longer than 10 years. Oddly, if Republicans defund Obamacare, I think it happens faster. A failure on the part of Obamacare will not lead to more private involvement.
Posted on 10/27/14 at 2:59 pm to TK421
I don't necessarily think it's inevitable, however, if we don't change the way we think about insurance, it definitely has a higher chance of going in that direction.
Posted on 10/27/14 at 3:11 pm to TK421
quote:
How many of you think single payer healthcare is inevitable?
I don't.
For full disclosure, my masters is healthcare admin, and I run a large group practice (in TX), so I'm inherently biased.
I think single payor would create an even larger discrepency in the quality of service provided to the "wealthy" and "non-wealthy". Unless we go full blown communist when we switch over (i.e. physicians work for the govt against their will), physicians will slowly migrate to retainer/concierge practices. That has already been happening. But private payers still pay a premium over MCR at this point, particularly with specialty services (lab, path, imaging) and facility fees, which is the incentive for docs to continue with the current fee-for-service model. And even it is getting more and more difficult. Just personally, we've experienced a 9%-10% cut in reimbursement for our most common procedures just in 3 years. It's difficult to maintain and grow with decreasing profits every year.
If you remove all other payers from the equation except Medicare, you will see both physicians AND patients revolt. Patients who previously paid thousands in premiums per year will just transfer that directly into their phsycinas pocket, as opposed to using the middle man that is no longer required to get healthcare. Physicians will see just how many patients are willing to do that, and the market will adjust accordingly.
You'll be left with foreign med grads and mid levels providing primary care to anyone utilizing MCR, maybe under the supervision of a single physician. The disparity in care would be enormous between those willing to pay for their care VS those who only rely on Medicare.
This post was edited on 10/27/14 at 3:14 pm
Posted on 10/27/14 at 3:13 pm to MSMHater
quote:Is this what happened in any other country that went to single payer?
For full disclosure, my masters is healthcare admin, and I run a large group practice (in TX), so I'm inherently biased.
I think single payor would create an even larger discrepency in the quality of service provided to the "wealthy" and "non-wealthy". Unless we go full blown communist when we switch over (i.e. physicians work for the govt against their will), physicians will slowly migrate to retainer/concierge practices. That has already been happening. But private payers still pay a premium over MCR at this point, particularly with specialty services (lab, path, imaging) and facility fees, which is the incentive for docs to continue with the fee-for-service model.
If you remove all other payers from the equation except Medicare, you will see both physicians AND patients revolt. Patients who previously paid thousands in premiums per year will just transfer that directly into their phsycinas pocket, as opposed to using the middle man that is no longer required to get healthcare. Physicians will see just how many patients are willing to do that, and the market will adjust accordingly.
You'll be left with foreign med grads and mid levels providing primary care to anyone utilizing MCR, maybe under the supervision of a single physician. The disparity in care would be enormous between those willing to pay for their care VS those who only rely on Medicare.
Posted on 10/27/14 at 3:14 pm to TK421
I don't view it as being inevitable and I clearly don't see it happening in the next 10 years.
This post was edited on 10/27/14 at 3:15 pm
Posted on 10/27/14 at 3:14 pm to TK421
Yep. I think it'll happen in tiers. A standard level of preventative and catastrophic care for the masses and the ability to pay extra for boutique/premium preventative and outpatient care. Catastrophic care will likely not be in tiers but who knows.
Posted on 10/27/14 at 3:16 pm to TK421
its inevitable. As long as we are single payer, and not single provider I don't think it will be that bad.
I doubt its 10 years though, more like 25. The mandatory insurance thing was first floated in 92, and we just got that recently.
I doubt its 10 years though, more like 25. The mandatory insurance thing was first floated in 92, and we just got that recently.
Posted on 10/27/14 at 3:16 pm to MSMHater
quote:
If you remove all other payers from the equation except Medicare, you will see both physicians AND patients revolt. Patients who previously paid thousands in premiums per year will just transfer that directly into their phsycinas pocket, as opposed to using the middle man that is no longer required to get healthcare. Physicians will see just how many patients are willing to do that, and the market will adjust accordingly.
Interesting perspective I haven't considered. And again, I'm not saying single payer would be better than what we have now, in many ways it would indeed be worse.
I guess I would wonder how many people would actually behave as you say and why the behavior isn't prevalent in Europe. I know many middle class Europeans that "love" their health care system.
And never discount the possibility of the government heavily regulating fee for service medical practices.
Posted on 10/27/14 at 3:23 pm to FT
quote:
Is this what happened in any other country that went to single payer?
A) Were the political and economic situations for those countires similar in nature to ours?
B) Were those countries deomgraphics even remotely similar to ours? (I.e. over capacity for current HC resources, wildly heterogenous, and extremelyly unhealthy)
C) Did those countries, essentially, decapitate 65% of the healthcare market as we would be doing by dissolving BCBS, Aetna, UHC, et al?
D) Were those countries created and developed with capitalist ideals through their entire economy?
E) Does it really fricking matter what a lilly-white country the size of our average state does in relation to our national policy on anything?
F) Wealthy citizens of those countries created a market for private insurance due to their dissatisfaction with their federal healthcare policy. (see anywhere outside of the UK).
This post was edited on 10/27/14 at 3:23 pm
Posted on 10/27/14 at 3:25 pm to TK421
quote:
The more I think about this issue, the more convinced I am we are less than 10 years away from single payer in the United States being a reality.
I'm annoyed because it ISN'T inevitable. In fact, Obamacare has made it much more unlikely.
Posted on 10/27/14 at 3:26 pm to MSMHater
quote:IDK
A) Were the political and economic situations for those countires similar in nature to ours?
quote:IDK
B) Were those countries deomgraphics even remotely similar to ours? (I.e. over capacity for current HC resources, wildly heterogenous, and extremelyly unhealthy)
quote:IDK
C) Did those countries, essentially, decapitate 65% of the healthcare market as we would be doing by dissolving BCBS, Aetna, UHC, et al?
quote:IDK
D) Were those countries created and developed with capitalist ideals through their entire economy?
quote:IDK
E) Does it really fricking matter what a lilly-white country the size of our average state does in relation to our national policy on anything?
quote:So why did you post all your random, angry questions? This one would have answered my question.
F) Wealthy citizens of those countries created a market for private insurance due to their dissatisfaction with their federal healthcare policy. (see anywhere outside of the UK).
Posted on 10/27/14 at 3:27 pm to TK421
quote:
I guess I would wonder how many people would actually behave as you say and why the behavior isn't prevalent in Europe.
Currently, only 1 in 10 Medicare patients do not have some form of supplemental insurance. People, particularly sick ones, are willing to pay for good care. If you take away their current supplemental options, and only offer medicare, what do you think they would do.
Me, as a manager, if the govt tells me I can't purchase health insurance for my employees, how do you think I will replace said coverage? I'll send you to the physician I'm paying $50K per year to see all my covered employees. Trust me, the cost difference between that and current insurance won't be that great.
Posted on 10/27/14 at 3:30 pm to FT
quote:
So why did you post all your random, angry questions?
Not angry. Really, just the only topic I'm really passionate about.
Your question "dumbed down" an extremely complex issue, and the questions were my best effort at trying to get you to see what some of those issue may be.
I've been here to long. Nothing on this board makes me angry.
Except sunshine pumpers on the rant
Posted on 10/27/14 at 3:31 pm to MSMHater
The 2 main ways that single payer is implemented is either:
1. Government "free" system for all but with private system alongside (Europe) or,
2. Government only, private system outlawed (Canada and N. Korea are only countries in the world with this system)
I presume than an American system would be the Euro model which like you said, would result in a public system for the average Joe and Jane, and a private system for the higher classes.
In other words, it would be a lot like the public school systems in large cites have become.
1. Government "free" system for all but with private system alongside (Europe) or,
2. Government only, private system outlawed (Canada and N. Korea are only countries in the world with this system)
I presume than an American system would be the Euro model which like you said, would result in a public system for the average Joe and Jane, and a private system for the higher classes.
In other words, it would be a lot like the public school systems in large cites have become.
Posted on 10/27/14 at 3:33 pm to TK421
quote:
How many of you think single payer healthcare is inevitable?
I pray that after 2016, Obamacare will be completely abolished. The entire program was the largest waste of taxpayer money i've seen. It is a complete failure and prime example of big government.
I'm hoping something like this returns and a vote is allowed once Harry Reid loses his chair.
American Health Care Reform Act
Posted on 10/27/14 at 3:33 pm to TK421
Yes, I think it's inevitable.
But it drives me crazy when people defend its implementation on the basis of its alleged success in Europe and Canada (which I think are overstated), as though those countries have no systematic distinctions from the United States, and with self-reported rates of patient satisfaction. It would be nice if we could get input from the dissatisfied in those countries, but we'd need a Ouija board to do it.
But it drives me crazy when people defend its implementation on the basis of its alleged success in Europe and Canada (which I think are overstated), as though those countries have no systematic distinctions from the United States, and with self-reported rates of patient satisfaction. It would be nice if we could get input from the dissatisfied in those countries, but we'd need a Ouija board to do it.
Posted on 10/27/14 at 3:36 pm to TK421
Vermont passed legislation in 2011 to enact single-payer statewide no later than 2017. Let's see how that works out for them. (They're behind schedule, by the way.)
Posted on 10/27/14 at 3:37 pm to MSMHater
As MSMHater is getting at, it could work out very well for MD's if they play it right. Think of all the money the health insurance companies make off of premiums. Now give a sizable fraction of that to the MDs as a retainer.
Posted on 10/27/14 at 3:58 pm to white perch
No, I think Obamacare is far more likely to expand.
In other words Single Insurance Payer is the most likely outcome now.
In other words Single Insurance Payer is the most likely outcome now.
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