Solution to healthcare problem

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Thoughts?

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I think the quality and overall cost per person for the first tier would be better served by eliminating the need for only doctors to perform certain services, encouraging more provider-consumer transactions rather than this byzantine third party insurance system, and by loosening the AMA's grip on their century long cartel.

But that will never happen except in theoretical internet posts.

What you posited has a decent chance of working better than what we currently have, provided we have a public health corps kind of deal.

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You don't get to choose your doctor - you get whoever is on duty and seeing patients that day. You don't get an appointment - you go to the clinic and get in the queue - like you would at an emergency room, today. 

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Who builds, staffs, and works in these clinics? I sure as hell won't be someone else's employee, especially not if that person in question is the federal government.
That said, why wouldn't you want me to see these patients in my own clinic and the thousands of privately owned and hospital owned clinics already available, work them into my schedule, bill the payer, and move on with life?

What it sounds like you're essentially advocating for is not just a government-funded insurance for all, but a government-run healthcare system to run parallel to the current one. We already have one of those called the VA. It's terrible.

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If you require a hospital stay, you don't get a private room - you get a bed in a wardroom.

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Most hospitals don't even have ward rooms like you speak of at this point. And even if they did, the nurses would still have the same number of patients on the floor to see, and the hospital would have to spend more time paying attention to which people with which diseases could be in a room with another patient or not for public health reasons.

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have brand name drugs

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I am not sure you are understanding the concept of brand vs generic drugs. Brand name Crestor vs Rosuvastatin is hundreds of dollars vs $19/month. They work the same, within X% regulated by data being presented to the FDA. Generic drugs aren't inferior to brand name drugs. A private company that only bought branded drugs would lose its arse very fast.
Now, then you must look at patented new drugs. The new drug that cures CMLeukemia but cost $20,000/course should probably be covered under your "generic" plan before the newest ACE inhibitor given the alternatives (most of which are generic) in that category.
While I think I may understand your sentiment, I like to bring up that it is significantly more difficult to classify necessary vs unnecessary drugs on a formulary than you suggest- i write letters several times a week explaining why I need medications not on formulary to be covered for patients.


Basically, though, what you're proposing is the conversion of Medicaid to a discreet VA-like system with the option for anyone to opt in.

What I think would be better in the current system is national competition with a government option that is designed to meet minimum requirements for cheap.

Unfortunately, healthcare in this country is not a right for the non imprisoned. Because of this, it's a private business which, in order to stay around, needs to be profitable. In order to remain profitable, the premiums of the average man are skyrocketing. If we are going to continue to call it a business and not state that we all have a right to healthcare, then we either need to allow insurance companies to have, at the very least, high and low risk pools with corresponding high and low cost plans.


And while we are on the subject of what preventative care is, I'll point out that I'm mildly upset that I pay monthly for Pap smears, mammograms, birth control, colonoscopies for other people but must pay cash for my own glasses.

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Congress must create federal medical schools now.

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They'd do better by increasing funding for residency spots and letting the schools expand on their own.

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Doctors, insurers, drug companies are all going to get butt hurt because they feel like they will get cut out of the big bucks. Lobbyists going to lobby. People going to get screwed until they raise up and say no more!

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I'm always struck by the fact that every liberal I know personally is a pill-popping hypochondriac who will raise holy hell if there's such a thing as healthcare rationing. I have one liberal friend who would never take a generic drug.

One thing is common with liberals, they don't think their policies will ever affect them personally. Nor do they want it to.

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Doctors, insurers, drug companies are all going to get butt hurt because they feel like they will get cut out of the big bucks.

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Eh, I get that doctor salaries are good salaries for working folks, but they're really not comparable with profits from drug companies and insurers unless you're talking about the head of something like a large physician-owned physician employment group.

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we want to give everyone the exact same access to that healthcare. 

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Do what?

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You don't get to choose your doctor - you get whoever is on duty and seeing patients that day. You don't get an appointment - you go to the clinic and get in the queue - like you would at an emergency room, today.

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I can tell you don't work in the healthcare industry. That would be horribly inefficient and waste tons of money. When a provider has to see a new patient it takes on average about twice as long as seeing one he/she has seen before. In addition, that encounter would likely lead to more tests being ordered, which is another cost factor.

Ok.

It's going to be very complicated to have single-payer outside government controlled facilities.

Medicare and Medicaid somewhat work right now because they are complimented by private insurance and private pay. I've had many doctors, etc tell me that the pay for Medicare and Medicaid is terrible, but it pays the bills and allows them to scale up the resources needed to see the higher-paying regular patients.

The only real solution is a competent government run system as a base, with a private add-on system as you say. However, I have no confidence in any level of our government to provide such a system. And that says a lot more about our government than it does about health care.