help me understand single payer / medicare

[sickmint79]

1. under the "single payer" plan, hospitals and care would still be privatized so proponents argue there would be no deminishment of quality.

2. i believe they also argue the plan is similar to medicare which is "doing well".

what are the arguments against these?

it sounds to me like the first still has the same effect whether hospitals are privately or government run, since the government will be regulating the costs of services instead of the market, and employees will be capped, and not rewarded for excellency anyway, or trivially rewarded? does it matter if they are private or not at this point? is medicare really doing all that great? thanks.

[DocGrimes]

Hospitals and such may retain their 'private' nature but with single payer system you would have one centralized payer deciding what forms of care can by given and how much can be paid.

So if you needed a form of care not supported by the single payer you may be out in the cold.

Also, with a single payer system there is a risk that folks would contract away their ability to seek care outside that system to some degree.

I have ran into this in my practice with Medicare. A Medicare beneficiary is not allowed to privately contract with me for care even if they desire to do so. All such care must be reported and go through the Medicare system even if Medicare will refuse to pay. This is not all the details but a simplified version.

And there is a great deal of effective and cost efficient care that Medicare for which Medicare will not pay. So we would be left paying more taxes for 'healthcare' coverage that doesn't cover, or that limits our options.

[fsk]

As far as I can tell, single payer health care means that the "free market" for health care has been completely eliminated.

Under a "single payer" system, attempting to purchase medical care in the free market is a crime.

[angelatc]

Any time you have a single buyer in the market, there really isn't a market. RIght now, if my insurance company refused to pay for a treatment, I have a couple of options. I pay myself, I get a new insurer, or I sue my insurer.

IF the government starts paying, all of those options disappear.

I think insurance itself is a scam. I can certainly justify having a major medical plan, but all the things that insurance covers these days is counter productive to a free market.

[DocGrimes]

Yep, I dislike insurance as well, especially as it now exists. The more I learn and experience the more I come to understand that insurance leads to price increases as folks try to get bigger and bigger pieces of the pie.

Docs and hospitals will charge rates to insurance companies probably would never had developed if the responsibility for payment stayed in the clients pocket.

And I think your right, single payer would likely kill the last vestiges we have of a 'free' health care market.