I think the latest episode with SCHIP demonstrates that is indeed what the democrats, and especially the presidential candidates want.  And while some may see that as a good thing, I see only ill coming from anything the government has its hands into.  Some may have good intentions, but for the politicians it is a simple and basic desire.  Power over others.

I respectfully disagree. There are other solutions, just none as seductively "simple" as single payor, which is anything but "simple."

There is little doubt that our insurance-driven health system is broken, but taking the path of least intellectual resistance is not the way to "fix" it - it will only substitute a whole bunch of new, more structural & intractible, problems for the old ones & it will just take another generation or two to figure out it was a mistake, when it will be damn near impossible to undo. It'll end up like social security or Medicare - "untouchable" politically.

Already, the single largest category of healthcare expenditures in the US is administration, overwhelming all other categories of actual health care combined. We already have way too many Chiefs and scarcely enough Indians. To think that giving over all our resources and control of all healthcare transactions to a centralized faceless bureaucracy, one whose only interest is in "properly husbanding taxpayer dollars" and which contributes absolutely nothing to anyone's health in any way shape or form, would be foolish at best, catastrophic at worst. None of the incentives built into our current financing system encourage efficiencty in health care. Quite the opposite - we hand over huge sums of money to huge companies whose sole objective at that point is to keep as much of it as they can, backed up by the law firm of Delay, Deny, Deny Again.

A mixed system of healthcare financing is what most Americans would prefer, according to the data I've seen. A great deal of what is broken about our employer-based and commercial health insurance system could be fixed rather easily by making fraud the only acceptable reason to refuse coverage to a customer and truly spreading the risk the way "insurance" was intended in the first place. What we have now is a bunch of companies in the "premium sales" business, each trying to cherry-pick their way to profits by excluding anyone with so much as a hangnail. Requiring availability of major medical (catastrophic) coverage and returning to the practice of community rating to determine premiums would finally put some real competition back in the insurance industry. Then all the companies would have to focus on managing their investment portfolios instead of trying to nickel & dime us to death. They'd save a ton just in the elimination of their "Pre-Existing Condition Investigation" Departments. The pooling of insurance underwriting information, except for cases of fraud, should be banned. We should also quit subsidizing the qualified Medicare plans when there's no evidence they provide better, let alone cheaper, services.

We could have an affordable multipayor system, with freedom of choice and incentives for real efficiency, with just those few changes. I doubt there are any politicians brave enough to do the right thing, unfortunately. It sounds so easy: simply create the US Ministry of Health & all our problems go away. If it sounds too good to be true, it usually is.

See that is where I get "a solution looking for a problem". Th esystem is no worse off than it was 20 years ago, but the rhetoric is more heated. 20 years ago, people fell through the cracks, and some died as a result of it (just as is happening in every socialized medicine society out there).

There are 2 problems with this heated rhetoric. Number 1 (and the worst one) is that it gives many people the perception that there is a perfect solution. There is not, nor will there ever be as long as any solution is devised and run by man and bureaucracies.

Number 2 is the fact that the rhetoric is making the current system appear to be fatally flawed. The reality is that it is only fatally flawed from the perspective of perfection, an ideal that does not exist in the real world. So the debate is no longer what is the best system, but how can we junk the current system. And that leaves out an important option. That perhaps - at this place and time - the best system is the current system (I am not saying it is, but the rhetoric is not allowing that option to be considered).

In the final analyis, the only difference between Global Warming faithful, and Health care Jihadists is their god, not their mission or their methods.

You are both right and wrong, Dr. Guy. Right in the sense that there is no real crisis of insurance coverage, but wrong about the erosive effects of our increasingly convoluted and micromanaged systems, both private & public. The Personal Physician, as the role was understood in 1980, is on the endangered species list. More later.

can I agree and disagree with you?

Looking forward to the more later.

The Personal Physician, as the role was understood in 1980, is on the endangered species list.

I have a damnably good personal physician and I'm under Medicare!

There is not, nor will there ever be as long as any solution is devised and run by man and bureaucracies.

Yeah, like 400,000 insurance employees designed to nickel and dime or just plain reject health insurance claims.

It's unclear to me whether that is a good thing.  

Consider yourself fortunate to have a good physician. And pray he can keep his practice solvent - there's a good chance you'll outlive the practice.

Yeah, like 400,000 insurance employees designed to nickel and dime or just plain reject health insurance claims.

Replaced by a million government bureacrats with no incentive to get anything right.  At least those 400,000 have an incentive.  It is called profit, as there is more than one player in the game, so we can take our business to another one.  Not so when the government is the only game in town.

It is called profit, as there is more than one player in the game, so we can take our business to another one.

By "profit" I trust you mean reasonable gain, but insurance is notorious for profiteering and rejecting legitimate claims.

 

A mixed system of healthcare financing is what most Americans would prefer, according to the data I've seen. A great deal of what is broken about our employer-based and commercial health insurance system could be fixed rather easily by making fraud the only acceptable reason to refuse coverage to a customer and truly spreading the risk the way "insurance" was intended in the first place. What we have now is a bunch of companies in the "premium sales" business, each trying to cherry-pick their way to profits by excluding anyone with so much as a hangnail.

A fine statement that seems unwittingly to favor a fair system such as we now have with Medicare.

If the government is telling us that they will cover medical insurance for those who don't have it through their employers, how long do you think employers will be willing to keep paying for it? Also, meeting government requirements is already a huge expense for the medical community, how do you get the idea that having the government cover more people will change that?

Employers now are already standing in line to unload this mess[think GM & UAW] in order to compete with foreign companies that do not carry health insurance. "Government requirements" are not as much a hindrance as private insurance.

I don't know Stevendedalus, we literally spent two to three times more time on paperwork than we did on treating the patient. In the office there were admin people whose entire job was either keeping up with government requirements or training us on the latest changes.

I figured there would be differences state to state, but I moved from one ambulance service to another in the same city. You wouldn't believe how many differences there were between the two. If we didn't word our narratives just right, the government wouldn't pay.

That all adds up to a lot of expenses for absolutely nothing. Give the government more to do and they will only make it cost more and do less.

By "profit" I trust you mean reasonable gain, but insurance is notorious for profiteering and rejecting legitimate claims.

Yes, and part 2 of that statement was why they can try to gouge, but will lose out in the end.  If a company is incompetant and rejecting claims just because they can, find another provider.

With the government, you dont have that choice.  Indeed, the only good thing about the government program is that it has spawned a whole industry of lawyers who do nothing but specialize in those type of cases.  And the money those lawyers get do nothing for treatment or for the patient, just fatten their pockets.  And that is on top of the inherant waste of a monopoly/government program.

With the government, you dont have that choice. Indeed, the only good thing about the government program is that it has spawned a whole industry of lawyers who do nothing but specialize in those type of cases. And the money those lawyers get do nothing for treatment or for the patient, just fatten their pockets. And that is on top of the inherant waste of a monopoly/government program.

You're talking about now. There are ways to combat this by taking undue profits out of the whole damn system. Your critcism should be attributed more to private insurance than government's.