7 ms·

vote for candidates who will support single payer.

theandrewbailey 9y ago
It seems like we already have single payer healthcare: the patient. The patient pays up the ass. All the way.
mistermann 9y ago
Changing things so all taxpayers are getting robbed rather than just the individual being treated seems like a sub-optimal solution.
- Devthrowaway80 9y ago
  Yeah, it won't work. It works in every other developed nation in the world, and they all pay less money for better healthcare outcomes, but hey, the US is Totally Special.
  - jsisksod 9y ago
    The US is larger than 50 developed nations combined, so yes, we are Totally Special.
    - icebraining 9y ago
      Then setup a single-payer system per state. What's the excuse against that?
      - Spoom 9y ago
        Before I answer this, let me frame my opinion: I very much want single payer in the United States, and were it plausible to do it on a state-by-state basis, I would support it. Apparently, states are unable to restrict entry into state benefit programs such as healthcare. They can't set up a waiting period for people moving into the state before they are eligible; that was declared unconstitutional by a previous Supreme Court. So if states were to do their own single payer system, in theory sick people could move into the state and immediately gain free healthcare simply by virtue of being a resident. Conversely, they could then move back to their home state that doesn't charge higher taxes. So it wouldn't be feasible on a state-by-state basis unless a future SCOTUS reverses their precedent. This is unlikely in the short term, given the current Court's make up.
      - deleted 9y ago
        [deleted]
      - tehlike 9y ago
        isn't california trying to do this?
  - dsfyu404ed 9y ago
    Except that's not how it works everywhere else. Everywhere else the government shoves a telephone pole up the ass of taxpayers and then takes a few splinters to pay for healthcare.
    - icebraining 9y ago
      Reminder: the US already spends more public money on healthcare as a percentage of GDP than Belgium, the UK, Switzerland, Finland, Canada and many others. http://data.worldbank.org/indicator/SH.XPD.PUBL.ZS?year_high_desc=true http://data.worldbank.org/indicator/SH.XPD.PUBL.ZS?year_high...
    - fiblye 9y ago
      I pay lower taxes than I did in America, and I get better, faster treatment for less money. America isn't special.
    - acdha 9y ago
      In addition to being wrong about the massive cost differential, this disparagement also ignores the fact that U.S. longevity hasn't kept pace for decades: https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus https://ourworldindata.org/the-link-between-life-expectancy-...
    - foobarbazetc 9y ago
      Yeah... you're wrong. Why make these sorts of easily refutable statements?
  - Symmetry 9y ago
    The US already has single payer for a good fraction of the population and we still spend more than other nations on that fraction. The NHS in the UK can decide that certain treatments are not cost effective but in the US we have people raising the cry of "Death panels! Death panels!" at even vague gestures in that direction. And the US had never had a particularly high level of bureaucratic efficiency compared to most countries. Which isn't to say that single payer wouldn't be an improvement on the current system. Just don't get your hopes up for how much money it'll save.
    - dragonwriter 9y ago
      > The US already has single payer for a good fraction of the population No, we don't. Medicare is not single payer, though it has (for a subset of the services covered by Medicare) a default public option; it also has private, partially-public-subsidized pland; Medicaid, at least in many states, is not single-payer, either, even at the state level, even before considering overlap with Medicare and other insurance.
  - mistermann 9y ago
    > It works in every other developed nation in the world The cost side works in every other developed nation? Surely you're aware of how much more expensive health care costs are in the US, so what might you be referring to?
    - Devthrowaway80 9y ago
      Yes, I am aware. One of the benefits of single-payer is the reduction in cost of administration. There are other effects as well - nobody is getting away with billing $600 for a 5 minute visit, for instance.
      - isostatic 9y ago
        Friend of mine ended up in hospital in the US for a while. He had an accountant visit him at his bedside! WTF does an accountant have to do with healthcare?!
- dragonwriter 9y ago
  > Changing things so all taxpayers are getting robbed rather than just the individual being treated Government programs set maximum reimbursement rates and also mandate cost accounting mechanisms to assure that actual reimbursement is not merely within pre-set rates but also justified by actual provider costs. The government isn't buying services with no advance information about what the charges may be. Private insurers impose similar controls. So single payer (or even universal coverage through private insurers) eliminates the particular kind of “robbery” from undisclosed charges being discussed.
  - mistermann 9y ago
    Do you happen to know if this a part of or discussed in the ACA?
rgbrenner 9y ago
Completely agree. There's no free market in healthcare. They are selling services without providing prices... it completely breaks any market that might exist.
- thephyber 9y ago
  > They are selling services without providing prices... And it takes a state license for them to operate. The state could require them to provide an accurate and up-to-date price menu in order to remain in business. I think the problem is also related to the opaque negotiated prices that "in network" providers negotiate with insurance companies, driving up the cost for uninsured or "out of network" consumers. There are perfectly rational solutions short of single-payer.
joshuaheard 9y ago
Ask Charlie Gard how single payer is working out for him.
- thephyber 9y ago
  Single payer wasn't the problem with his case. No health insurance company would have voluntarily paid for an experimental treatment for him. The state has power, even in the USA, to make decisions for the benefit of children if the state decides that the parents aren't acting in the best interest of the child. There is a perfectly valid argument to be made that the state should not have intervened (this is subjective), but it had very little to do with the NHS being single payer. And by choosing to use the single most emotionally charged case, you are also skipping all of the perfectly rational arguments against the broken health care system we have now.
  - joshuaheard 9y ago
    In the U.S., the doctors do not have standing to appear in court and order treatment, or non-treatment, for a patient. That is solely up to the family, and if there is no family, the court appoints a guardian. There is no way this situation could have happened in the U.S., where the parents were forbid to pay for own treatment. I think it does concern single-payer. I can only think of the quote, "A government powerful enough to give you everything you want, has the power to take everything you need away". In this case, where the government controls healthcare, it can make decisions for you, even if that is not what you want, or are willing to pay for yourself.
    - pjc50 9y ago
      I'm not entirely sure that's true in the US, that people can make medical decisions on behalf of a minor without any legal coverage of whether it's in their best interests, but I'm not familiar enough with US law. However if we look at the facts of this case: http://www.gosh.nhs.uk/frequently-asked-questions-about-charlie-gard-court-case http://www.gosh.nhs.uk/frequently-asked-questions-about-char... "One of the factors that influenced this decision was that Charlie’s brain was shown to be extensively damaged at a cellular level. The clinician in the US who is offering the treatment agrees that the experimental treatment will not reverse the brain damage that has already occurred. The entire highly experienced UK team, all those who provided second opinions and the consultant instructed by the parents all agreed that further treatment would be futile – meaning it would be pointless or of no effective benefit." Edit: oh yes, and the court submissions are interesting reading (via twitter:) https://t.co/Wjs7KrRWMU https://t.co/Wjs7KrRWMU > When the hospital was informed that the Professor had new laboratory findings causing him to believe NBT would be more beneficial to Charlie than he had previously opined, GOSH’s hope for Charlie and his parents was that that optimism would be confirmed. It was, therefore, with increasing surprise and disappointment that the hospital listened to the Professor’s fresh evidence to the Court. On 13 July he stated that not only had he not visited the hospital to examine Charlie but in addition, he had not read Charlie’s contemporaneous medical records or viewed Charlie’s brain imaging or read all of the second opinions about Charlie’s condition (obtained from experts all of whom had taken the opportunity to examine him and consider his records) or even read the Judge’s decision made on 11 April. Further, GOSH was concerned to hear the Professor state, for the first time, whilst in the witness box, that he retains a financial interest in some of the NBT compounds he proposed prescribing for Charlie. Devastatingly, the information obtained since 13 July gives no cause for optimism. Rather, it confirms that whilst NBT may well assist others in the future, it cannot and could not have assisted Charlie.

It seems like we already have single payer healthcare: the patient. The patient pays up the ass. All the way.

Changing things so all taxpayers are getting robbed rather than just the individual being treated seems like a sub-optimal solution.

Devthrowaway80 9y ago
Yeah, it won't work. It works in every other developed nation in the world, and they all pay less money for better healthcare outcomes, but hey, the US is Totally Special.
- jsisksod 9y ago
  The US is larger than 50 developed nations combined, so yes, we are Totally Special.
  - icebraining 9y ago
    Then setup a single-payer system per state. What's the excuse against that?
    - Spoom 9y ago
      Before I answer this, let me frame my opinion: I very much want single payer in the United States, and were it plausible to do it on a state-by-state basis, I would support it. Apparently, states are unable to restrict entry into state benefit programs such as healthcare. They can't set up a waiting period for people moving into the state before they are eligible; that was declared unconstitutional by a previous Supreme Court. So if states were to do their own single payer system, in theory sick people could move into the state and immediately gain free healthcare simply by virtue of being a resident. Conversely, they could then move back to their home state that doesn't charge higher taxes. So it wouldn't be feasible on a state-by-state basis unless a future SCOTUS reverses their precedent. This is unlikely in the short term, given the current Court's make up.
    - deleted 9y ago
      [deleted]
    - tehlike 9y ago
      isn't california trying to do this?
- dsfyu404ed 9y ago
  Except that's not how it works everywhere else. Everywhere else the government shoves a telephone pole up the ass of taxpayers and then takes a few splinters to pay for healthcare.
  - icebraining 9y ago
    Reminder: the US already spends more public money on healthcare as a percentage of GDP than Belgium, the UK, Switzerland, Finland, Canada and many others. http://data.worldbank.org/indicator/SH.XPD.PUBL.ZS?year_high_desc=true http://data.worldbank.org/indicator/SH.XPD.PUBL.ZS?year_high...
  - fiblye 9y ago
    I pay lower taxes than I did in America, and I get better, faster treatment for less money. America isn't special.
  - acdha 9y ago
    In addition to being wrong about the massive cost differential, this disparagement also ignores the fact that U.S. longevity hasn't kept pace for decades: https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus https://ourworldindata.org/the-link-between-life-expectancy-...
  - foobarbazetc 9y ago
    Yeah... you're wrong. Why make these sorts of easily refutable statements?
- Symmetry 9y ago
  The US already has single payer for a good fraction of the population and we still spend more than other nations on that fraction. The NHS in the UK can decide that certain treatments are not cost effective but in the US we have people raising the cry of "Death panels! Death panels!" at even vague gestures in that direction. And the US had never had a particularly high level of bureaucratic efficiency compared to most countries. Which isn't to say that single payer wouldn't be an improvement on the current system. Just don't get your hopes up for how much money it'll save.
  - dragonwriter 9y ago
    > The US already has single payer for a good fraction of the population No, we don't. Medicare is not single payer, though it has (for a subset of the services covered by Medicare) a default public option; it also has private, partially-public-subsidized pland; Medicaid, at least in many states, is not single-payer, either, even at the state level, even before considering overlap with Medicare and other insurance.
- mistermann 9y ago
  > It works in every other developed nation in the world The cost side works in every other developed nation? Surely you're aware of how much more expensive health care costs are in the US, so what might you be referring to?
  - Devthrowaway80 9y ago
    Yes, I am aware. One of the benefits of single-payer is the reduction in cost of administration. There are other effects as well - nobody is getting away with billing $600 for a 5 minute visit, for instance.
    - isostatic 9y ago
      Friend of mine ended up in hospital in the US for a while. He had an accountant visit him at his bedside! WTF does an accountant have to do with healthcare?!
dragonwriter 9y ago
> Changing things so all taxpayers are getting robbed rather than just the individual being treated Government programs set maximum reimbursement rates and also mandate cost accounting mechanisms to assure that actual reimbursement is not merely within pre-set rates but also justified by actual provider costs. The government isn't buying services with no advance information about what the charges may be. Private insurers impose similar controls. So single payer (or even universal coverage through private insurers) eliminates the particular kind of “robbery” from undisclosed charges being discussed.
- mistermann 9y ago
  Do you happen to know if this a part of or discussed in the ACA?

rgbrenner 9y ago

Completely agree. There's no free market in healthcare. They are selling services without providing prices... it completely breaks any market that might exist.

thephyber 9y ago
> They are selling services without providing prices... And it takes a state license for them to operate. The state could require them to provide an accurate and up-to-date price menu in order to remain in business. I think the problem is also related to the opaque negotiated prices that "in network" providers negotiate with insurance companies, driving up the cost for uninsured or "out of network" consumers. There are perfectly rational solutions short of single-payer.

joshuaheard 9y ago

Ask Charlie Gard how single payer is working out for him.

thephyber 9y ago
Single payer wasn't the problem with his case. No health insurance company would have voluntarily paid for an experimental treatment for him. The state has power, even in the USA, to make decisions for the benefit of children if the state decides that the parents aren't acting in the best interest of the child. There is a perfectly valid argument to be made that the state should not have intervened (this is subjective), but it had very little to do with the NHS being single payer. And by choosing to use the single most emotionally charged case, you are also skipping all of the perfectly rational arguments against the broken health care system we have now.
- joshuaheard 9y ago
  In the U.S., the doctors do not have standing to appear in court and order treatment, or non-treatment, for a patient. That is solely up to the family, and if there is no family, the court appoints a guardian. There is no way this situation could have happened in the U.S., where the parents were forbid to pay for own treatment. I think it does concern single-payer. I can only think of the quote, "A government powerful enough to give you everything you want, has the power to take everything you need away". In this case, where the government controls healthcare, it can make decisions for you, even if that is not what you want, or are willing to pay for yourself.
  - pjc50 9y ago
    I'm not entirely sure that's true in the US, that people can make medical decisions on behalf of a minor without any legal coverage of whether it's in their best interests, but I'm not familiar enough with US law. However if we look at the facts of this case: http://www.gosh.nhs.uk/frequently-asked-questions-about-charlie-gard-court-case http://www.gosh.nhs.uk/frequently-asked-questions-about-char... "One of the factors that influenced this decision was that Charlie’s brain was shown to be extensively damaged at a cellular level. The clinician in the US who is offering the treatment agrees that the experimental treatment will not reverse the brain damage that has already occurred. The entire highly experienced UK team, all those who provided second opinions and the consultant instructed by the parents all agreed that further treatment would be futile – meaning it would be pointless or of no effective benefit." Edit: oh yes, and the court submissions are interesting reading (via twitter:) https://t.co/Wjs7KrRWMU https://t.co/Wjs7KrRWMU > When the hospital was informed that the Professor had new laboratory findings causing him to believe NBT would be more beneficial to Charlie than he had previously opined, GOSH’s hope for Charlie and his parents was that that optimism would be confirmed. It was, therefore, with increasing surprise and disappointment that the hospital listened to the Professor’s fresh evidence to the Court. On 13 July he stated that not only had he not visited the hospital to examine Charlie but in addition, he had not read Charlie’s contemporaneous medical records or viewed Charlie’s brain imaging or read all of the second opinions about Charlie’s condition (obtained from experts all of whom had taken the opportunity to examine him and consider his records) or even read the Judge’s decision made on 11 April. Further, GOSH was concerned to hear the Professor state, for the first time, whilst in the witness box, that he retains a financial interest in some of the NBT compounds he proposed prescribing for Charlie. Devastatingly, the information obtained since 13 July gives no cause for optimism. Rather, it confirms that whilst NBT may well assist others in the future, it cannot and could not have assisted Charlie.