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> I don't think single-payer works the way you seem to think it does in nations where it's been implemented. I don't think single-payer works the way you seem

• twoodfin 9y ago
  The Belgian system contains costs in other ways. For example, doctors (especially GP's) are paid significantly less. Belgium is also over 10x as population dense as the U.S., which offers significant opportunities for more efficient care delivery. Anyway, it's not clear to me that Belgium has anything like a single-payer system[1]: The Belgian population enjoys good health and increasing life expectancy of 79.5 years (2004). Most Belgians have access to health care of high quality, financed mainly through social security contributions and taxation. Compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. That doesn't sound at all like single-payer. [1] http://www.euro.who.int/__data/assets/pdf_file/0007/96442/E90059.pdf http://www.euro.who.int/__data/assets/pdf_file/0007/96442/E9...
  • pg314 9y ago
    > The Belgian system contains costs in other ways. For example, doctors (especially GP's) are paid significantly less. That's exactly the point! Single-payer is much better at containing the costs. The cost of a GP's visit is fixed centrally. And somehow we still end up with more doctors per 1000 inhabitants than the US. > Belgium is also over 10x as population dense as the U.S., which offers significant opportunities for more efficient care delivery. States like New Jersey and Rhode Island have higher population densities than Belgium. Is health care significantly cheaper there? A cursory glance at [3] suggests otherwise. One big difference between Belgium and the US is that damages in malpractice suits are not determined by jury, and hence much lower. > Anyway, it's not clear to me that Belgium has anything like a single-payer system[1]: What is your definition of single-payer healthcare? If I look at wikipedia [1]: Single-payer healthcare is a healthcare system in which the state, financed by taxes, covers basic healthcare costs for all residents regardless of income, occupation, or health status. The Belgian health-care system covers everybody, financed by social security contributions and taxation. The compulsory health insurance is about 75 EUR per year, and amounts to simply another disguised tax. What is not single-payer about that? There are deductibles for doctor's visits (e.g. 6 EUR for a GP visit), but your total healthcare costs are capped at 459 EUR per year (even lower for low-income families). Anything over that is covered by social security. You can get optional, extra health-insurance which can cover additional services. E.g. if you prefer a single room when you are hospitalised, that costs extra. Some extra health-insurance covers nonsense like homeopathy, which is otherwise not covered. Btw, dental care is included in basic coverage. No third-world country situations like [2]. [1] https://en.wikipedia.org/wiki/Single-payer_healthcare https://en.wikipedia.org/wiki/Single-payer_healthcare [2] http://www.washingtonpost.com/sf/national/2017/05/13/the-painful-truth-about-teeth/?utm_term=.e6e240695895 http://www.washingtonpost.com/sf/national/2017/05/13/the-pai... [3] http://www.kff.org/other/state-indicator/health-spending-per-capita/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D http://www.kff.org/other/state-indicator/health-spending-per...