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As someone who has never lived in the US I'm curious as to why there's so little debate about moving towards a single payer or universal system. It seems that t

by tjpnz 9y ago

As someone who has never lived in the US I'm curious as to why there's so little debate about moving towards a single payer or universal system. It seems that the only option ever on the table is tweaking the current system.

mnm1 9y ago
How can you profit off of that?
- noobermin 9y ago
  You don't, but society does. Also, companies can pay less for healthcare, if you need a connection to businesses.
- rocky1138 9y ago
  Why do you need to?
  - mnm1 9y ago
    To make a few people rich at the expense of many others' health and lives. That clearly is the goal of not having a single payer system and the reason for the private health insurance industry existing in the first place.
virmundi 9y ago
Most of the argument centers around one's belief in the competency of the government. If you think they can do things well, you will probably argue for a single health payer system, or maybe a German model. If you think they are incompetent, bought, fools, then you argue against a single payer system. Humorously both sides point to Medicare and Medicaid as evidence of their views.
rifung 9y ago
I think that it's because it's too far to the left to be politically viable. That being said, there is some talk about it, even today for example: http://www.politico.com/story/2017/03/sanders-to-introduce-single-payer-health-care-plan-236516 http://www.politico.com/story/2017/03/sanders-to-introduce-s...
- strictnein 9y ago
  I mean, Sanders talks about it almost every day, so him referring to it is hardly newsworthy.
vacri 9y ago
There is too much money in the US system, and the current employees would never agree to losing what they have. It's far more lucrative to be in medicine in the US than in other countries. In short, it's not just the insurance companies or the administration, but the industry as a whole. You try telling a group of doctors that they have to take a pay cut for the good of society, and they'll laugh you out of the room. This is not to say that doctors don't work hard or aren't worth a lot in a career with a decade or more of training, but it's pretty clear that doctors in the US don't work particularly harder than their foreign contemporaries, yet they earn a ton more.
nerfhammer 9y ago
One, existing medical insurers comprise an industry worth tens of billions of dollars and have shown they are willing to every last cent they have on ads and lobbying to oppose such ideas, which of course completely threatens their existence. Any plan has to find a way to funnel them money in order to avoid that. Two, partisan politics has gotten so bad that it is starting to warp and twist people's brains. "Obamacare" was demonized relentlessly by Republicans even though it was essentially a copy of a leading Republican health care plan at the time. The plan originally came from the Heritage Foundation and was championed by Mitt Romney, both of whom immediately turned around and demonized it as soon as a Democrat proposed it. Third, the US right wing is fairly unique compared to the right wings of other countries, it has immense power, and it generally opposes this kind of thing for a variety of reasons. To varying degrees of justification they would tend to dismiss whatever arguments you might make or empirical evidence you might try to cite. Fourth, the average American has no idea what single payer is, and has absolutely no idea that every other country in the rest of the developed world has something like it. Americans have no idea what life is like in other countries. They might know that Canada has some form of socialized medicine but might assume that to be a curiosity unique to Canada; and have never thought much about whether the Canadian system is any good or not. Fifth, Americans would not generally assume that such a thing in any event is within the realm of possibility or competence of the US government. It's been many decades since the US has attempted any grand national experiment like this. Sixth, because racism. Socialist programs would easily be seen as mostly benefitting other races; even if it was not at all true. Politicians can benefit themselves by exploiting this to varying degrees of subtlety.
hibikir 9y ago
It's a relatively simple mix of economics and politics. If the only thing we changed was a single payer, without changing anything else, prices would continue skyrocketing and the government would either have huge deficits or very high taxes, even compared to most of Europe: US healthcare is that expensive. To make single payer work, what the US would have to do is to also force prices down. This can be done through price controls, like in Singapore, by directly owning hospitals and employing doctors, like a good percentage of Europe, or by increasing the supply of healthcare providers so much that prices must go down. Any and all of those things would cause an upheaval in the healthcare industry: A lot of jobs would be lost, and others would pay a lot less. Many investments, like those of hospitals that compete with each other by being the most luxurious and with the most MRI machines, or pharma companies that expected to be able to charge a whole lot more to US patients than they do in Europe, would go down the drain. Every single bit of extra US healthcare expense an inefficiency is benefitting someone else. More efficiency when driven directly by government mandates, like a single payer system would aim to do, is a wonderful way to lose elections. This is not just why democrats don't really pursue single payer seriously, but why republicans don't propose any changes that would really make the system more market driven: It's hard to rein the profits of an industry that is over 17% of GDP.

by tjpnz 9y ago

mnm1 9y ago

How can you profit off of that?

noobermin 9y ago
You don't, but society does. Also, companies can pay less for healthcare, if you need a connection to businesses.
rocky1138 9y ago
Why do you need to?
- mnm1 9y ago
  To make a few people rich at the expense of many others' health and lives. That clearly is the goal of not having a single payer system and the reason for the private health insurance industry existing in the first place.

virmundi 9y ago

Most of the argument centers around one's belief in the competency of the government. If you think they can do things well, you will probably argue for a single health payer system, or maybe a German model. If you think they are incompetent, bought, fools, then you argue against a single payer system. Humorously both sides point to Medicare and Medicaid as evidence of their views.

rifung 9y ago

I think that it's because it's too far to the left to be politically viable. That being said, there is some talk about it, even today for example: http://www.politico.com/story/2017/03/sanders-to-introduce-single-payer-health-care-plan-236516 http://www.politico.com/story/2017/03/sanders-to-introduce-s...

strictnein 9y ago
I mean, Sanders talks about it almost every day, so him referring to it is hardly newsworthy.

vacri 9y ago

There is too much money in the US system, and the current employees would never agree to losing what they have. It's far more lucrative to be in medicine in the US than in other countries. In short, it's not just the insurance companies or the administration, but the industry as a whole. You try telling a group of doctors that they have to take a pay cut for the good of society, and they'll laugh you out of the room. This is not to say that doctors don't work hard or aren't worth a lot in a career with a decade or more of training, but it's pretty clear that doctors in the US don't work particularly harder than their foreign contemporaries, yet they earn a ton more.

nerfhammer 9y ago

One, existing medical insurers comprise an industry worth tens of billions of dollars and have shown they are willing to every last cent they have on ads and lobbying to oppose such ideas, which of course completely threatens their existence. Any plan has to find a way to funnel them money in order to avoid that. Two, partisan politics has gotten so bad that it is starting to warp and twist people's brains. "Obamacare" was demonized relentlessly by Republicans even though it was essentially a copy of a leading Republican health care plan at the time. The plan originally came from the Heritage Foundation and was championed by Mitt Romney, both of whom immediately turned around and demonized it as soon as a Democrat proposed it. Third, the US right wing is fairly unique compared to the right wings of other countries, it has immense power, and it generally opposes this kind of thing for a variety of reasons. To varying degrees of justification they would tend to dismiss whatever arguments you might make or empirical evidence you might try to cite. Fourth, the average American has no idea what single payer is, and has absolutely no idea that every other country in the rest of the developed world has something like it. Americans have no idea what life is like in other countries. They might know that Canada has some form of socialized medicine but might assume that to be a curiosity unique to Canada; and have never thought much about whether the Canadian system is any good or not. Fifth, Americans would not generally assume that such a thing in any event is within the realm of possibility or competence of the US government. It's been many decades since the US has attempted any grand national experiment like this. Sixth, because racism. Socialist programs would easily be seen as mostly benefitting other races; even if it was not at all true. Politicians can benefit themselves by exploiting this to varying degrees of subtlety.

hibikir 9y ago

It's a relatively simple mix of economics and politics. If the only thing we changed was a single payer, without changing anything else, prices would continue skyrocketing and the government would either have huge deficits or very high taxes, even compared to most of Europe: US healthcare is that expensive. To make single payer work, what the US would have to do is to also force prices down. This can be done through price controls, like in Singapore, by directly owning hospitals and employing doctors, like a good percentage of Europe, or by increasing the supply of healthcare providers so much that prices must go down. Any and all of those things would cause an upheaval in the healthcare industry: A lot of jobs would be lost, and others would pay a lot less. Many investments, like those of hospitals that compete with each other by being the most luxurious and with the most MRI machines, or pharma companies that expected to be able to charge a whole lot more to US patients than they do in Europe, would go down the drain. Every single bit of extra US healthcare expense an inefficiency is benefitting someone else. More efficiency when driven directly by government mandates, like a single payer system would aim to do, is a wonderful way to lose elections. This is not just why democrats don't really pursue single payer seriously, but why republicans don't propose any changes that would really make the system more market driven: It's hard to rein the profits of an industry that is over 17% of GDP.