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This. Especially - freedom to pick any doctor as they are all in-network. Family had experience with California PCIP insurance (bridge for pre-existing condit

This. Especially - freedom to pick any doctor as they are all in-network. Family had experience with California PCIP insurance (bridge for pre-existing condition after ACA was voted in, but before it took effect). The PCIP was amazing - PPO-like benefits, using MediCare network (close to 100% doctors take it) and quality services. Of course, unfortunately, the ACA/exchange provided policies are nowhere close to how good PCIP was. If we could get the PCIP-like option, it would truly change lives for the better.

mises 7y ago
> freedom to pick any doctor Any doctor? Doctors can take so many patients. Though it may benefit a large number of people, some may end up worse. Those who have the best doctors currently (because they can pay) may no longer be able to have those doctors.
- beat 7y ago
  You realize that's a terrible argument, right?
  - mises 7y ago
    Ok, why? I'm more than open to being convinced otherwise; I'd love to think no one would be harmed.
    - beat 7y ago
      First, it's unlikely that an influx of new patients due to opening networks and increasing coverage would lead to doctors dropping existing patients. On what grounds would that happen? Second, you're at best arguing that we shouldn't go to a fair system of rationing because it would hurt the beneficiaries of an unfair system of rationing. And to take this sideways... my favorite health care model is the Japanese system. It's actually quite similar to the American system (private employer-provided insurance, private providers), but with one key difference... a government commission fixes the prices for all medical goods and services. No more negotiating between providers and insurers. So no "networks". It leads directly to the situation you described. It also leads to costing half as much as the US, for universal coverage and better outcomes. I'll take that trade, thank you.
      - mises 7y ago
        > it's unlikely that an influx of new patients due to opening networks and increasing coverage would lead to doctors dropping existing patients. It wouldn't, but if I needed to get a doctor, I might no longer be able to get a very good one. Remember that cheaper prices for medical care means the smartest, best people may not become doctors. > you're at best arguing that we shouldn't go to a fair system of rationing because it would hurt the beneficiaries of an unfair system of rationing. I don't believe the current system is "unfair". Why is it? Most Americans like what they have; it is the bottom few percent who are unhappy. Is that "unfair"? At what percentage does that become the case? Must most of society change to accommodate a small, dissatisfied minority? Without government regulation, health care would be much cheaper. Why must I purchase coverage for a hysterectomy or for birth control as part of a plan? I will never need these services. Wasted money. What of experimental treatments? I know a person who is alive thanks to an experimental treatment that was reasonably priced. All it amounted to was an antibiotic regimen far outside the bounds of the CDC-recommended one, out-patient. The problem with single-payer is that I cannot do that, because there is a single payer - the feds. I may not pay for my own procedures (and my friend would not have been able to do so), even though this was quite affordable, because it was not on "the list". Fixing prices is a possibility (albeit not one of which I am as fond), though we would need to allow procedures to be done out side of that (for those which were not approved, or for those who could not get availability and could pay). It is basic economics that price ceilings create shortages; who gets treatment? We are back at square one: I think it should be ordered by those who should pay. I trust dollars to be "fairer" than an opaque system, and would rather the coverage I can get be a known quantity than be at the mercy of the whims of a bureaucrat. My biggest question: why do you want to force those who can pay onto the same plan? That is a part of single-payer that makes no sense. Why not let those who like their existing coverage keep it, as most Americans still do? [0] There was an article that surfaced about an Indian hospital that had industrialized common health-care procedures. A four-year degree is not essential for these; why is it required? If we commoditize common and routine procedures via removal of barriers to entry, we can greatly increase the benefit without forcing those who like what they have to become worse off and without hurting more complicated situations. Lastly, the problem with socialized medicine is that it cannot afford to spend beyond a certain amount per-person on average. End-of-life care is enormously expensive in America, but is better than in other places. [1] Many of us may say it is foolish to spend upwards of a million dollars for a few more years of life, but having spoken to a few dying people, most say something to the effect of that they would give every thing they have for a few more weeks (the exception being those in exceptional pain, those with loss of senses, etc.). EDIT: Downvoters care to comment? [0] https://news.gallup.com/poll/245195/americans-rate-healthcare-quite-positively.aspx https://news.gallup.com/poll/245195/americans-rate-healthcar... [1] https://www.forbes.com/sites/cjarlotta/2016/01/19/end-of-life-care-costs-in-us-comparable-to-europe-and-canada/#350a2305ada3 https://www.forbes.com/sites/cjarlotta/2016/01/19/end-of-lif...

mises 7y ago

> freedom to pick any doctor Any doctor? Doctors can take so many patients. Though it may benefit a large number of people, some may end up worse. Those who have the best doctors currently (because they can pay) may no longer be able to have those doctors.

beat 7y ago
You realize that's a terrible argument, right?
- mises 7y ago
  Ok, why? I'm more than open to being convinced otherwise; I'd love to think no one would be harmed.
  - beat 7y ago
    First, it's unlikely that an influx of new patients due to opening networks and increasing coverage would lead to doctors dropping existing patients. On what grounds would that happen? Second, you're at best arguing that we shouldn't go to a fair system of rationing because it would hurt the beneficiaries of an unfair system of rationing. And to take this sideways... my favorite health care model is the Japanese system. It's actually quite similar to the American system (private employer-provided insurance, private providers), but with one key difference... a government commission fixes the prices for all medical goods and services. No more negotiating between providers and insurers. So no "networks". It leads directly to the situation you described. It also leads to costing half as much as the US, for universal coverage and better outcomes. I'll take that trade, thank you.
    - mises 7y ago
      > it's unlikely that an influx of new patients due to opening networks and increasing coverage would lead to doctors dropping existing patients. It wouldn't, but if I needed to get a doctor, I might no longer be able to get a very good one. Remember that cheaper prices for medical care means the smartest, best people may not become doctors. > you're at best arguing that we shouldn't go to a fair system of rationing because it would hurt the beneficiaries of an unfair system of rationing. I don't believe the current system is "unfair". Why is it? Most Americans like what they have; it is the bottom few percent who are unhappy. Is that "unfair"? At what percentage does that become the case? Must most of society change to accommodate a small, dissatisfied minority? Without government regulation, health care would be much cheaper. Why must I purchase coverage for a hysterectomy or for birth control as part of a plan? I will never need these services. Wasted money. What of experimental treatments? I know a person who is alive thanks to an experimental treatment that was reasonably priced. All it amounted to was an antibiotic regimen far outside the bounds of the CDC-recommended one, out-patient. The problem with single-payer is that I cannot do that, because there is a single payer - the feds. I may not pay for my own procedures (and my friend would not have been able to do so), even though this was quite affordable, because it was not on "the list". Fixing prices is a possibility (albeit not one of which I am as fond), though we would need to allow procedures to be done out side of that (for those which were not approved, or for those who could not get availability and could pay). It is basic economics that price ceilings create shortages; who gets treatment? We are back at square one: I think it should be ordered by those who should pay. I trust dollars to be "fairer" than an opaque system, and would rather the coverage I can get be a known quantity than be at the mercy of the whims of a bureaucrat. My biggest question: why do you want to force those who can pay onto the same plan? That is a part of single-payer that makes no sense. Why not let those who like their existing coverage keep it, as most Americans still do? [0] There was an article that surfaced about an Indian hospital that had industrialized common health-care procedures. A four-year degree is not essential for these; why is it required? If we commoditize common and routine procedures via removal of barriers to entry, we can greatly increase the benefit without forcing those who like what they have to become worse off and without hurting more complicated situations. Lastly, the problem with socialized medicine is that it cannot afford to spend beyond a certain amount per-person on average. End-of-life care is enormously expensive in America, but is better than in other places. [1] Many of us may say it is foolish to spend upwards of a million dollars for a few more years of life, but having spoken to a few dying people, most say something to the effect of that they would give every thing they have for a few more weeks (the exception being those in exceptional pain, those with loss of senses, etc.). EDIT: Downvoters care to comment? [0] https://news.gallup.com/poll/245195/americans-rate-healthcare-quite-positively.aspx https://news.gallup.com/poll/245195/americans-rate-healthcar... [1] https://www.forbes.com/sites/cjarlotta/2016/01/19/end-of-life-care-costs-in-us-comparable-to-europe-and-canada/#350a2305ada3 https://www.forbes.com/sites/cjarlotta/2016/01/19/end-of-lif...