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Access to the best doctors isn't a function of how they're paid for now, unless you're saying the current system is giving them slack in their schedules by keep

by beat 7y ago

Access to the best doctors isn't a function of how they're paid for now, unless you're saying the current system is giving them slack in their schedules by keeping patients away. Meanwhile, people are being denied access to good doctors with capacity now, because of a lack of insurance, or in-network restrictions. I've seen friends choose between life-threatening illness and bankruptcy due to networks, many times. As for the "smartest, best" people becoming doctors... I don't think medicine is a path chosen simply because it's lucrative, in most cases. It's chosen because it's challenging (or sometimes, because it's expected). And those in it for the money are in paths of lucrative-but-socially-useless things like cosmetic surgery. High pay is incidental here. Why pay coverage for things you'll never use? Same reason I'm paying for your broken arm. That's how insurance works. Spreading the risk. Single payer systems - like Medicare, for example - are quite capable of covering experimental treatments. Why are you saying they can't? You're ignoring plain facts here. And it's possible that your experimental coverage might not be covered by your private insurer, either. I've been in that boat myself. Fixed pricing is a far, far more transparent system than the current system of negotiating prices for the same things between different providers/insurers, so the same hospital charges $1.10 for aspirin here and $1.25 there. It also solves the problem of localized monopolies, such as rural hospitals, that can charge whatever they want because insurers have no alternative. Why force people onto the same plan? Single payer doesn't do that, necessarily. Again, Medicare. There's a HUGE market for Medicare supplemental insurance (I work in that market). Wealthier people can afford additional coverage above and beyond single player. The single payer provides a guaranteed baseline, and covers basics so private insurers can focus on corner cases, extremes, and luxuries. "End of life care is enormously expensive in America, but it is better than other places." Yeah, Medicare is single payer, right?

mises 7y ago
> Why pay coverage for things you'll never use? Same reason I'm paying for your broken arm. That's how insurance works. Spreading the risk. Insurance is supposed to hedge against risk. You might need a broken arm; I will never need a hysterectomy or birth control (especially not the type covered by insurance). > localized monopolies, such as rural hospitals, that can charge whatever they want because insurers have no alternative. And if the rural hospitals then shut down due to not being able to cover costs? > Why force people onto the same plan? Single payer doesn't do that, necessarily. Again, Medicare. There's a HUGE market for Medicare supplemental insurance The definition of single-payer is in the name - there is a single entity which pays for insurance. A single payer. That means, definitionally, no private/supplemental insurance, no cash payments, no nothing. Experimental treatment may not be covered by private insurance, but at least it can be purchased with cash. A single-payer system definitionally precludes a cash option. > Yeah, Medicare is single payer, right? Wrong; see above. Medicare is also subsidized in no small part by higher-paying patients; because it often reimburses at below-market rates, private coverage is necessary to pick up the slack.
- beat 7y ago
  I take it, then, that you're totally ok with Medicare for All as a plan, as it's not single payer? I'm guessing not, actually. The point is, you're using such a narrowly defined, pedantic definition of "single payer" as to make what you're railing against a total strawman. Not even the most socialist systems in the world, (Norway, Medicare, etc) come anywhere close to your extreme.
  - mises 7y ago
    > I take it, then, that you're totally ok with Medicare for All as a plan, as it's not single payer? Nope. I am also not okay with Medicare, Medicaid, Obamacare, and any sort of transfer payment from the feds. > I'm guessing not, actually. How remarkably prescient of you. > you're using such a narrowly defined, pedantic definition of "single payer" as to make what you're railing against a total strawman. Not even the most socialist systems in the world, (Norway, Medicare, etc) come anywhere close to your extreme. Gee whiz, I interpreted "single-payer" as meaning there was a single payer in the medical system? What sophistry! I believe it was Senator Harris that recently said that "Medicare for All" included abolishing all private health insurance, and this has seemed to get traction among the far left. Senator Sanders has similar ideas; he would allow a small amount of private insurance, but only in addition to mandatory enrollment in his plan. Reason Magazine corroborates the general definition: https://reason.com/2019/01/24/new-poll-shows-medicare-for-all-is-popul/ https://reason.com/2019/01/24/new-poll-shows-medicare-for-al... Show me the part of the constitution where it says the government may sell health care. Show me the part that justifies transfer payments of any kind. I proposed something of a solution above: remove the onerous regulations and allow industrialization of common procedures. This would cut out the bulk of health-care expense. And how would you pay for such a plan? Even doubling taxes wouldn't do it: https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay-for-medicare-for-all-1533163559 https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay... We're in a hole, financially speaking. America has about ninety-five trillion dollars in about household value; the "one percent" hold about forty percent of that. Seizing all the money they have, thirty-eight trillion dollars, would just about cover the costs of this "medicare for all" thing for a decade. What do you do then? We're spending too much, not taking too little.

by beat 7y ago

mises 7y ago

> Why pay coverage for things you'll never use? Same reason I'm paying for your broken arm. That's how insurance works. Spreading the risk. Insurance is supposed to hedge against risk. You might need a broken arm; I will never need a hysterectomy or birth control (especially not the type covered by insurance). > localized monopolies, such as rural hospitals, that can charge whatever they want because insurers have no alternative. And if the rural hospitals then shut down due to not being able to cover costs? > Why force people onto the same plan? Single payer doesn't do that, necessarily. Again, Medicare. There's a HUGE market for Medicare supplemental insurance The definition of single-payer is in the name - there is a single entity which pays for insurance. A single payer. That means, definitionally, no private/supplemental insurance, no cash payments, no nothing. Experimental treatment may not be covered by private insurance, but at least it can be purchased with cash. A single-payer system definitionally precludes a cash option. > Yeah, Medicare is single payer, right? Wrong; see above. Medicare is also subsidized in no small part by higher-paying patients; because it often reimburses at below-market rates, private coverage is necessary to pick up the slack.

beat 7y ago
I take it, then, that you're totally ok with Medicare for All as a plan, as it's not single payer? I'm guessing not, actually. The point is, you're using such a narrowly defined, pedantic definition of "single payer" as to make what you're railing against a total strawman. Not even the most socialist systems in the world, (Norway, Medicare, etc) come anywhere close to your extreme.
- mises 7y ago
  > I take it, then, that you're totally ok with Medicare for All as a plan, as it's not single payer? Nope. I am also not okay with Medicare, Medicaid, Obamacare, and any sort of transfer payment from the feds. > I'm guessing not, actually. How remarkably prescient of you. > you're using such a narrowly defined, pedantic definition of "single payer" as to make what you're railing against a total strawman. Not even the most socialist systems in the world, (Norway, Medicare, etc) come anywhere close to your extreme. Gee whiz, I interpreted "single-payer" as meaning there was a single payer in the medical system? What sophistry! I believe it was Senator Harris that recently said that "Medicare for All" included abolishing all private health insurance, and this has seemed to get traction among the far left. Senator Sanders has similar ideas; he would allow a small amount of private insurance, but only in addition to mandatory enrollment in his plan. Reason Magazine corroborates the general definition: https://reason.com/2019/01/24/new-poll-shows-medicare-for-all-is-popul/ https://reason.com/2019/01/24/new-poll-shows-medicare-for-al... Show me the part of the constitution where it says the government may sell health care. Show me the part that justifies transfer payments of any kind. I proposed something of a solution above: remove the onerous regulations and allow industrialization of common procedures. This would cut out the bulk of health-care expense. And how would you pay for such a plan? Even doubling taxes wouldn't do it: https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay-for-medicare-for-all-1533163559 https://www.wsj.com/articles/even-doubling-taxes-wouldnt-pay... We're in a hole, financially speaking. America has about ninety-five trillion dollars in about household value; the "one percent" hold about forty percent of that. Seizing all the money they have, thirty-eight trillion dollars, would just about cover the costs of this "medicare for all" thing for a decade. What do you do then? We're spending too much, not taking too little.