The Morality of a Single Payer Health Care System

[JonNC]

Who’s getting their property confiscated?

You seem to be unwilling to understand that a single payer system is not the same thing as a state owned system. Put simply, it means everyone is covered under something like Medicare.

The doctor still owns their practice, the corporation that owns the hospital still owns the hospital.

That will have the same government restrictions as single payer. Government will still decide what gets covered , what doesn’t. Medicare is a government controlled healthcare model.

And if it isn’t , I should be allowed to get my "contributions " back with interest in order to seek out healthcare services on my own. If I can’t, then yes, my property was confiscated

 

[JonNC]

The head of Solidarity HealthShare is on the radio right now, discussing how that group can negotiate a 90% reduction on medical bills.

Bradley Hahn

844-313-4999

tomperna.org/2017/02/15/solidarity-healthshare-the-catholic-answer-to-the-healthcare-dilemma/

That’s one thing that could be done right now, perhaps even with an executive order, lift the limits on health sharing

 

[Rau]

And if it isn’t, I should be allowed to get my "contributions " back with interest in order to seek out healthcare services on my own. If I can’t, then yes, my property was confiscated

Not sure how elementary/secondary schooling works in the USA, but if you send your child to a private (Catholic, or other) school, or indeed home-school, do you get back the tax money you contributed that funded the public/government schools?

 

[JonNC]

Not sure how elementary/secondary schooling works in the USA, but if you send your child to a private (Catholic, or other) school, or indeed home-school, do you get back the tax money you contributed that funded the public/government schools?

No, though vouchers are available in some states, but you make my point: Medicare is not demonstrably different from a single payer plan. The government dictates who gets what care when, and who is denied it.

 

[o_mlly]

Medicare is not demonstrably different from a single payer plan. The government dictates who gets what care when, and who is denied it.

To the OP’s question on the morality of Single Payer/Decider, I am already forced to fund the murder of children in the Medicaid scheme. (See: abortionfunds.org/medicaid/)

Presently, we may only be able to mitigate the evils of abortion. Are the examples of other countries with nationalized health care instructive? I think so.
*But today, French law requires that prenatal tests be offered to all pregnant women. According to some academic studies, more than 90 percent of French children prenatally diagnosed with Down syndrome are aborted. And the French government has decided that the mere sight of children with Down syndrome on television is an unhappy intrusion on the national conscience. firstthings.com/web-exclusives/2017/08/shunning-the-disabled
*
On that basis alone – mitigating the evils of abortion (and euthanasia), today a single payer/decider must be postponed until tax-payer’s money is once again prohibited to fund the murder of the unborn (and the elderly).

 

[JonNC]

To the OP’s question on the morality of Single Payer/Decider, I am already forced to fund the murder of children in the Medicaid scheme. (See: abortionfunds.org/medicaid/)

Presently, we may only be able to mitigate the evils of abortion. Are the examples of other countries with nationalized health care instructive? I think so.
But today, French law requires that prenatal tests be offered to all pregnant women. According to some academic studies, more than 90 percent of French children prenatally diagnosed with Down syndrome are aborted. And the French government has decided that the mere sight of children with Down syndrome on television is an unhappy intrusion on the national conscience. firstthings.com/web-exclusives/2017/08/shunning-the-disabled

On that basis alone – mitigating the evils of abortion (and euthanasia), today a single payer/decider must be postponed until tax-payer’s money is once again prohibited to fund the murder of the unborn (and the elderly).

Incredibly well said. Abortion, euthanasia, denial of care because of age or severity of illness, all imposed on those who oppose them by government dictate makes it immoral

 

[Vonsalza]

That will have the same government restrictions as single payer. Government will still decide what gets covered , what doesn’t.

First of all, you stand the same risk with your private insurer. As a rule, they tend to deny coverage for expensive procedures the first time around for many folks as a rather evil cost saving measure. I had a echocardiogram done and just about had to have an attorney I’m pals with write them a letter to get it covered.

Secondly, in government insurance schemes usually the opposite problems arise. Dishonest doctors will double-bill Medicaid/Medicare or add-in procedures that were not performed, or perform additional procedures that are not medically necessary.

If anything, it’s too easy for doctors to get paid under government insurance, as it currently stands.

And if it isn’t , I should be allowed to get my "contributions " back with interest…

Does your current insurance company return your premiums if you didn’t go to the doctor much that year?
Does the government give you any of your tax money back on the basis that it wasn’t sufficiently used to your personal benefit?

Thanks for the chuckle.

 

[Vonsalza]

Incredibly well said. Abortion, euthanasia, denial of care because of age or severity of illness, all imposed on those who oppose them by government dictate makes it immoral

You just kinda roll it all up into one thing, don’t you?

Has anyone ever been denied an operation by Medicaid/Medicare because they’re too old? From what I understand, in the US that’s currently illegal.

And it won’t be imposed by fascist government dictate. This is a democratic republic. It’ll get voted in by the representatives of The People.

 

[Rau]

No, though vouchers are available in some states, but you make my point: Medicare is not demonstrably different from a single payer plan. The government dictates who gets what care when, and who is denied it.

School education is pretty much the same though.

 

[tomarin]

Not sure how elementary/secondary schooling works in the USA, but if you send your child to a private (Catholic, or other) school, or indeed home-school, do you get back the tax money you contributed that funded the public/government schools?

Nope. And if you’re childless, you don’t get back the money you contribute in taxes to public education.

 

[JonNC]

=Vonsalza;14866275]First of all, you stand the same risk with your private insurer. As a rule, they tend to deny coverage for expensive procedures the first time around for many folks as a rather evil cost saving measure. I had a echocardiogram done and just about had to have an attorney I’m pals with write them a letter to get it covered.

But I have the power to dissolve the contractual arrangement, or sue for failure to perform if that procedure is covered. With government, neither is a possibility.

Secondly, in government insurance schemes usually the opposite problems arise. Dishonest doctors will double-bill Medicaid/Medicare or add-in procedures that were not performed, or perform additional procedures that are not medically necessary.

Another great reason to end government interference in healthcare. But you are right, the larger the government monopoly, the larger the problems. If government determines unilaterally what a doctor should be paid for a procedure, then one shouldn’t be surprised when unscrupulous doctors try to “pay” themselves more.

If anything, it’s too easy for doctors to get paid under government insurance, as it currently stands.

Good point.

Does your current insurance company return your premiums if you didn’t go to the doctor much that year?
Does the government give you any of your tax money back on the basis that it wasn’t sufficiently used to your personal benefit?

My insurance premiums to my private insurer are paid via contractual arrangement, and I can withdraw from it at will (except for authoritarian individual mandates).

But thanks for making my point. Medicare is essentially as dictatorial as any other government single payer plan.

 

[JimG]

Mary Helen Morrow MD runs a “cash practice,” the original type of direct primary care. She does have some problems with the way medicine is practiced today, especially medicine as influenced by bureaucracy. I came across her comments in the “Authentic Medicine” blog here.

 

[LeafByNiggle]

That’s one thing that could be done right now, perhaps even with an executive order, lift the limits on health sharing

That would amount to rescinding the individual mandate that everyone carry insurance, since heath sharing plans are not insurance.

 

[Viki63]

. And if you’re childless, you don’t get back the money you contribute in taxes to public education.

Nor should you. Educating the young of each generation is part of belonging to the human community.

.

 

[JonNC]

That would amount to rescinding the individual mandate that everyone carry insurance, since heath sharing plans are not insurance.

Another good reason to do it.

The fact is that it’s already allowed by some. Expand it under equal protection

 

[Vonsalza]

Another great reason to end government interference in healthcare.

Whoa whoa whoa. So which is it? It’s too easy to get care from the government -or- it’s too easy to get denied care by the government.

You seem to be speaking out of both sides of your mouth on this one.

But you are right, the larger the government monopoly, the larger the problems. If government determines unilaterally what a doctor should be paid for a procedure, then one shouldn’t be surprised when unscrupulous doctors try to “pay” themselves more.

Such is the case with all insurance fraud, it seems. Private included. Per the rule of marginal analysis, if the condition is present in both alternatives, it’s irrelevant.

But thanks for making my point. Medicare is essentially as dictatorial as any other government single payer plan.

I get it. You don’t like paying taxes (join the club). But you’re about as empowered to change that as you are empowered to change when the next full moon happens. What’s the saying? Taxes and death?

It think you’re an otherwise rational person who has irrationally convinced himself that government is inherently evil despite all the incredible things it’s done in the last century. That’s too bad.

A government by-and-for people with different values across the board becomes tremendously complex. The way a lot of otherwise smart people deal with complex situations is to demonize them and falsely simplify them.

So it goes…

 

[JonNC]

=Vonsalza;14868659]Whoa whoa whoa. So which is it? It’s too easy to get care from the government -or- it’s too easy to get denied care by the government.

You seem to be speaking out of both sides of your mouth on this one.

Not at all. Being coerced by government to buy a consumer product does not correlate to ease of getting service. In a free society, individuals should have the freedom to decide the type of plan they want, if they want a plan, without government telling them what must be on their plan. IOW, it is none of their darn business!!

Such is the case with all insurance fraud, it seems. Private included. Per the rule of marginal analysis, if the condition is present in both alternatives, it’s irrelevant.

Except for the volume, and the fact that in the case of government, it is never working with it’s own money. The bigger the bureaucracy, the less competent it is. We can see this with the VA. No matter how good the doctors and nurses are, the bureaucracy has cost people their lives. I know. My nephew was one of them.

I get it. You don’t like paying taxes (join the club). But you’re about as empowered to change that as you are empowered to change when the next full moon happens. What’s the saying? Taxes and death?

That’s not what I said. I do not mind paying my fair share of taxes, for government to do what it has enumerated power to do. To quote, Scalia, “[The constitution] says what it says, and and doesn’t say what it doesn’t say.” Charge me my fair share of taxes for the enumerated powers. At the state level, charge me taxes for the services state government has a mandate in the state constitution to do. Same with local taxes.

It think you’re an otherwise rational person who has irrationally convinced himself that government is inherently evil despite all the incredible things it’s done in the last century. That’s too bad.

It is actually a rational position held by the founders and framers.
The Constitution is not an instrument for the government to restrain the people, it is an instrument for the people to restrain the government — lest it come to dominate our lives and interests.
Patrick Henry

It is the duty of the patriot to protect his country from its government.
Thomas Paine

"Dependence begets subservience and venality, suffocates the germ of virtue, and prepares fit tools for the designs of ambition."
– Thomas Jefferson

"[G]overnment, even in its best state, is but a necessary evil; in its worst state an intolerable one; for when we suffer or are exposed to the same miseries by a government, which we might expect in a country without government, our calamity is heightened by reflecting that we furnish the means by which we suffer."
– Thomas Paine

"[G]overnment, even in its best state, is but a necessary evil; in its worst state an intolerable one; for when we suffer or are exposed to the same miseries by a government, which we might expect in a country without government, our calamity is heightened by reflecting that we furnish the means by which we suffer."
– Thomas Paine

"Our tenet ever was that Congress had not unlimited powers to provide for the general welfare, but were restrained to those specifically enumerated, and that, as it was never meant that they should provide for that welfare but by the exercise of the enumerated powers, so it could not have been meant they should raise money for purposes which the enumeration did not place under their action; consequently, that the specification of powers is a limitation of the purposes for which they may raise money. "
– Thomas Jefferson letter to Albert Gallatin, 1817

And others

Every step we take towards making the State our Caretaker of our lives, by that much we move toward making the State our Master.
Dwight D. Eisenhower

**“In this present crisis, government is not the solution to our problem; government is the problem.”
**Ronald Reagan

If the risk of defending my liberty and that of our country is the charge of irrationality, I accept that risk, for the sake of my children and grandchildren.

So it goes.

And so it goes.

 

[Theo520]

Who’s getting their property confiscated?

You seem to be unwilling to understand that a single payer system is not the same thing as a state owned system. Put simply, it means everyone is covered under something like Medicare.

The doctor still owns their practice, the corporation that owns the hospital still owns the hospital.

You just have to look at most other countries with Universal Coverage. The doctors may or may not be private, but must of the infrastructure, the hospitals and major clinics end up being run by the Govt.

Private hospitals and clinics will only operate in the most ideal locations, where they can turn a profit in the prescribed fees. This results in a significant increase in Govt payroll for healthcare delivery.

Reducing unnecessary regulations may help to the extent such regs are costly. Government regulating businesses that directly affect human life – food, drugs, health care, etc. – are necessary and expected by citizens in a free-market economy. Paradoxically, increasing some regulations such as tort reform to limit jury awards would lower health costs.

Increasing competition only reduces costs if the present providers either enjoy excess profits or use more resources than necessary. In an industry where future revenues are most likely seen to be falling and existing providers are already exiting is not an industry likely to attract new entries.

Innovation, like reducing fraud and waste, is always a possible cost cutter but cannot be predicted and, therefore, is a poor planning tool. Efforts to innovate in themselves add costs now in which hard pressed providers with thin margins are unlikely to invest in the hope of lowering costs in the future. For instance, the mandated digitizing of health records did not go as planned. See chicagotribune.com/news/opinion/commentary/ct-obama-doctors-ehr-records-medicare-perspec-0529-20150528-story.html.

The old “doctor plumber” joke may come true.
*A pipe burst in a doctor’s house. He called a plumber. The plumber arrived, unpacked his tools, did mysterious plumber-type things for a while, and handed the doctor a bill for $600.

The doctor exclaimed, “This is ridiculous! I don’t even make that much as a doctor!.”

The plumber quietly answered, “Neither did I when I was a doctor.”*

Not suggesting we do away with regulations, but they must be reasonable and designed with compliance in mind. If we are spending more on regulation than on procedures, idiots were left in charge of setting up the regulations.

Probably one of the best ways to spur innovation would be transparency in the pricing, so customers could shop around and compare prices. It’s virtually impossible for someone to compare costs and performance/satisfaction/outcomes across service providers. And aspirin shouldn’t be billed at $10 each

Where there is real competition, there is innovation. Just look at how the cost of lasik eye surgery and other ‘out of pocket’ procedures have dropped. Innovation needs to happen with the providers, it doesn’t really work when it’s mandated by the idiots in charge of the bureaucracy.

 

[Vonsalza]

I know. My nephew was one of them.

I’m sorry to hear it.

Obviously, we don’t have to walk to far to find examples in the private market as well. Again, rule of marginal analysis…

That’s not what I said. I do not mind paying my fair share of taxes, for government to do what it has enumerated power to do.

Me too. And one of those enumerated powers seems to be the ability to create new programs, like the Interstate Highway System or the soon-coming U.S. Single-Payer Healthcare System.

It is actually a rational position held by the founders and framers.

Those are dead men. While we owe them gratitude for shaping our government’s origin, we owe them no obligation to let them shape its development.
As reading current attitudes into past events is anachronism, so too is trying to read past attitudes into current events.

If the risk of defending my liberty and that of our country is the charge of irrationality, I accept that risk, for the sake of my children and grandchildren.

I obviously do as well, seeing as the rhetoric flies both ways. Thus why I campaign whenever I can that all Americans should be able to get access to good care, regardless of their income. Such a system is the only system for followers of Christ.

 

[Vonsalza]

You just have to look at most other countries with Universal Coverage.

Keep in mind that among developed countries, this represents all of them except the US.

The doctors may or may not be private, but must of the infrastructure, the hospitals and major clinics end up being run by the Govt.

That’s genuinely not true.

Private hospitals and clinics will only operate in the most ideal locations, where they can turn a profit in the prescribed fees. This results in a significant increase in Govt payroll for healthcare delivery.

I live in a rural area where the great majority are on Medicaid and Medicare. Like around three-quarters of the people (I’ve forgotten the most recent number). A new hospital was built less than 10 years ago, complete with a million-dollar reflecting pool built purely for aesthetics.
The privates have figured out how to make single-payer “work” already.

If we are spending more on regulation than on procedures, idiots were left in charge of setting up the regulations.

No worries, as that would be a very hard target to hit. What was the admin percentage of the most recent Medicare budget. 2%? I know most people refuse to believe it’s that low, but feel free to look at the budget.

Probably one of the best ways to spur innovation would be transparency in the pricing…

The healthcare industry isn’t a price-sensitive as you’d think. When you get a bad flu or break your arm or have a heart attack, do you generally do a cost-benefit analysis before going to a doctor?

When you get cancer and are told that chemo is your best shot, are you shopping around for the cheapest oncologist that provides nuclear medicine?

Where there is real competition, there is innovation.

In a single payer system, the doctors are still competing among themselves for your business. That simply doesn’t change.

But keep in mind, the healthcare system isn’t competitive in the face of acute illness. You’re not going to compare cardiologists or orthopedic doctors when you have a heart attack or break your hip. You’re going to get to the one that’s the most immediately available.

Just look at how the cost of lasik eye surgery and other ‘out of pocket’ procedures have dropped. Innovation needs to happen with the providers, it doesn’t really work when it’s mandated by the idiots in charge of the bureaucracy.

I play golf with a guy that got rich doing lasik in the 90s when it was still kinda rare. Innovation didn’t make it cheaper. The surgery now is procedurally about the same as it was 20 years ago. He doesn’t much do it anymore (sorta like Rand Paul).

Saturation made it cheaper. Kids graduating from med-school saw it as an easy and lucrative specialization. 20 years later, there’s 3 that do it in every semi-rural town.