quote:
Are you sure? If.. say.. the government said: no more hip replacements for anyone over 65 years of age... your hospital would still provide hip replacements to 70 year old patients -- because the system is single payer? I'm sorry but I don't believe that. Going to single payer won't make providers suddenly become charitable givers. They could do that now.

I wasn't arguing that they'd provide the same kind of care. In fact, I was arguing that having a single payer would likely change the kind of care for the better (tying payment to outcomes, denying certain kinds of treatments/tests outright in certain clinical situations). Ortho's not my field but there are plenty of fields that over-operate compared to other kinds of care. I think we're saying sort of the same thing in different ways, actually.

As for the politics, I agree with you, at least in the short-term. Most people are mostly ok with the health care they have and are awfully fearful of change. Getting rid of employer-based health insurance would raise wages considerably eventually, but not quick enough to cover the sticker shock of new taxes (I don't think they'd do a payroll tax, but would opt for a VAT instead, though). If the government used debt initially to finance it and deferred new taxes a bit that might make it more palatable.

Still, I think the Dems would be smarter politically to run on a medicare buy-in or public option.

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Posted by Taxing Authority

Houston

Member since Feb 2010

57520 posts

Posted on 9/21/17 at 1:30 am to TigerDoc

quote:
I was arguing that having a single payer would likely change the kind of care for the better (tying payment to outcomes, denying certain kinds of treatments/tests outright in certain clinical situations).

As a doc, I'm surprised you think that congress and bureaucrats. can better determine appropriate care than you can. Perhaps in your case you're right?

But most docs (and patients) don't believe that.

And nothing prevents docs from making those determinations now. It's not like you need permission from the government to make appropriate treatment decisions.

quote:
Getting rid of employer-based health insurance would raise wages considerably eventually

emplyer-based plans are almost universally loved by employees. You think congress is going to take that away?

quote:
I don't think they'd do a payroll tax, but would opt for a VAT instead, though

Except that would undermine any increase in wages and negate what employers would save from eliminate healthcare benefits. Squeeze the balloon however you like. There just isn't enough money.