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Dr. Crosby,

If your desire is for more people to have insurance coverage, then a single-payer system might achieve that goal. But if you want health care reform, it is not the answer. Corruption in the insurance industry is a big problem, but it is not the sole problem. It needs to be addressed. But there are many areas of wasteful spending (see http://www.pwc.com/extweb/pwcpublications.nsf/docid/73272CB152086C6385257425006BA2FC) that if addressed, will more properly overhaul the system.

As I’ve posted previously, medical tort reform is also important, as it will effectively decrease the $210 billion per year spent on defensive medicine. And getting the nation to realize the importance of preventive medicine will eventually dramatically decrease health care spending. As a pediatrician, how many morbidly obese children are you now seeing, who develop type II diabetes, hypertension, and hypercholesterolemia even as children? These kids, unless they make huge lifestyle changes, will eventually be placed on many expensive drugs to keep their problems in check. They will develop end-stage joint arthritis at young ages, and will need very expensive joint replacement surgeries. And because their joints will be replaced at relatively young ages, the replacements will likely wear out in their lifetime necessitating a second replacement surgery. They are also more likely to develop gallstones requiring surgery. They are also more likely to develop heart disease, leading to expensive procedures down the road. The list goes on and on. Most of this expense could be prevented if patients would take an active role in their health care.

How many patients are placed on expensive brand-name drugs when generics will perform the same?

As others have posted, how much money is wasted on end-of-life care? This is another preventive medicine issue: people need to have living wills and health care powers of attorney in place before they get sick. They need to discuss these issues with their primary care physicians.

Single-payer coverage is not the answer to our health care problem. It will create more problems than it helps. The quality of medical care will decrease, as the “best and brightest” minds seek professions outside of health care to avoid the red tape. You, as a physician, will lose even more autonomy under this system.

Dr. Crosby, I agree with most of your statement, but I'm not sure that "campaign finance reform" is the single answer to our health care system. And huck, I seriously doubt that "single-payer" will create more problems than it helps, and that "the quality of health care will decrease as the best and brightest minds will seek professions outside health care to avoid the red tape." This sounds like the usual right-wingnut, "special interest," hoopla to me!

truman, This sounds like the usual right-wingnut, "special interest," hoopla to me!

Everything that doesn't fall in line with your every thought "sounds right-wingnut to you.

However, I also don't see how campaign-finance reform would address the health care system.

huck, what you are suggesting in your 2nd paragraph is parental responsibility. How could you?

"...and that "the quality of health care will decrease as the best and brightest minds will seek professions outside health care to avoid the red tape." This sounds like the usual right-wingnut, "special interest," hoopla to me!"

http://www.medicalnewstoday.com/articles/85323.php

Dan,

Sorry to suggest that people need to take responsibility for themselves (and their children)! I’ll try not to do it again. Much easier to place blame on others for our problems…

Your link is interesting, but not very convincing for a change to Canada’s type of system. Only 13% of Canadian-trained doctors wanted to return there from the states. It’s been like that for as long as I can remember. My grandfather, who was a physician, left Canada many years ago for the states in search of better medicine, and he found it (in his opinion).

Apology accepted huck, just don't suggest people take responsibility for themselves and their children, that's the job of govt. in contemporary thought.

Glad you liked the link, but my point is the exact opposite. I agree with your statement that the best and brightest will seek other professions than (govt. run) health care. Either that or they will practice elsewhere. The Canada link proves that contention, as well as the example of your grand dad.

Sorry Dan - I misunderstood your post.

"However, I also don't see how campaign-finance reform would address the health care system."

It's pretty obvious.

Currently (and it happened gradually over the course of thirty years or more), our elected officials are bought and paid for by special interests. Among these special interests are the health insurance companies and pharmaceutical companies. These companies have a vested interest in preserving the status quo, and thus can dictate to those to whom they contribute how they will vote.

What is it that is unclear about that?

ghost, believe me, a few things that fall "within my line of thought" do not sound "right-wingnut!" But I must say, you're not one of those things!

"that or they will practice elsewhere. The Canada link proves that contention, as well as the example of your grand dad. "

It proves nothing, and for two, maybe three, reasons.

1. Our system will not be identical to Canada's, maybe not even similar.

2. Clearly, there will be nowhere else to go. Basically everyone else has some sort of universal system. Are they going to migrate to Mexico next? Doubt it. See? Crisis avoided.

3. The original contention was not that doctors would practice elsewhere, but that "the best and brightest minds will seek professions outside health care to avoid the red tape." Your link doesn't address that argument. In fact, these guys stayed Doctors. Now they were willing to move to make more dollars, but for some reason, I doubt that money is the only or primary motivation for becoming a doctor, not that it doesn't help.

rahrah, yes! You tell it like it is!

rahrah, yes! You tell it like it is!

1. Our system will not be identical to Canada's, maybe not even similar.

How do you know? Canadian health care started as a provincial system and has now morphed to where it is illegal to pay with one's own money for govt. covered services.

I agree we won't adopt a Canadian style system in one fell swoop, but neither you nor I know what US govt. health care will end up being over a period of decades.

2. Clearly, there will be nowhere else to go. Basically everyone else has some sort of universal system. Are they going to migrate to Mexico next? Doubt it.

Really? Ever heard of medical tourism? Just make the arrangements and hop on a plane:

http://medicaltourismguide.org/

http://www.medretreat.com/

http://www.medicaltourism.com/

Medical tourism has become popular from a cost savings standpoint. After govt. health care it will become more popular from an availability standpoint.

Looks like the Canadians are already doing that:

"The overall goal of Surgical Tourism Canada is to provide Canadians a quicker solution to enable them a pain free life, and for many, an earlier return to work."

Notice the words "quicker solution"?

http://www.surgicaltourism.ca/about.htm

3. The original contention was not that doctors would practice elsewhere, but that "the best and brightest minds will seek professions outside health care to avoid the red tape."

Reread my 10:23 post:

"I agree with your statement that the best and brightest will seek other professions than (govt. run) health care. Either that or they will practice elsewhere."

My link was an example of practicing elsewhere true, but some may choose other professions. I mentioned both.

My nephew is an example, a bright kid who has one more year left in his undergrad and wants to be a doctor. He is concerned about the eventual role of govt. in health care and how it may affect his earnings after investing so much time and money in med school and may seek another profession.

Just one example of course, but I would imagine there are others with the same concerns.

"I doubt that money is the only or primary motivation for becoming a doctor."

Depends upon the person, who knows? Look at the link again, the primary reason doctors trained in Canada moved here was money. Also the primary reason they would consider going back to Canada was money.

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rahrah, yes! You tell it like it is! Times 2.

rahrah will you please throw truman a bone before he wets the carpet? He's begging and panting for your approval as he does from all the libs on the blog, yet gets ignored. Just an attaboy and a pat on the head will do the trick.

As Dan notes, why would a "bright kid" go through 12-15 years of rigorous training beyond high school when he/she could make more money with far less training, and not have to practice at the mercy of the government? Most doctors (hopefully) go into medicine because they love to help people, but the pay ain't bad either. Take away the income and make the practice environment a lot less friendly, and see what happens to the quality of doctors in this country.

"but neither you nor I know what US govt. health care will end up being over a period of decades."

Hell, why all the arguments then? Let's just shut up then and see what happens.

Or, we can pay attention, make ourselves heard, and get a robust and fair system with fewer problems than most. No system will be perfect and to lower costs it's assured that someone will have to take less money. Personally, I'd rather see insurance companies take that hit or see the government pursue more of the benefits of its health research dollars invested directly and indirectly in pharmaceuticals.

Now, there are all these letters saying that Congress should consider a single payer system, and they should. It has pros and cons like any other solution. All I know for certain is that a system of payment for medical services based on profit is predicated on the fact that not everyone can be covered. We should weigh ALL options equally, even one like neo and JDR bicker about, but we need to figure out what our goals are.

I want a system with affordable and equal access for all, and I think most Americans do. To these ends, our current system fails and it is more than obvious that mild tinkering won't suffice. The problems are too numerous and require a robust and wide-reaching solution.

"Hell, why all the arguments then? Let's just shut up then and see what happens."

Using history as an example, govt. health care will likely emulate other massive govt. programs with the intention to "make things better", such as the war on poverty and resultant welfare state.

A Danish friend that we have not seen in several years dropped by yesterday for the afternoon.

When I asked him about taxes, he naturally complaining about taxes in Denmark as it is one of the most, if not the most, high tax countries in the world.

Get this, he owns a vacation home over there and pays taxes on the potential rental income of this home even though he never rents it!! Doesn't matter to the Danish govt., he could "potentially" make money from renting therefore he must pay rental income taxes!!

I asked him about health care costs and he mentioned "it's free". It may sound amazing, but people with govt. health care are so conditioned to it that they perceive it as being free. I countered that it is not free, that his "rental income" and other taxes pay for it. He agreed, but mentioned again he doesn't have to pay money out of pocket for a doctor visit, therefore the perception that it's free.

Well now, I see that dan (who is not the sharpest tool in the shed) continues to whine re taxes and health care, day in and day out, and night-time doesn't slow him down! And his whining is, of course, always blistering dumb! Yes, he and the other right-wingnuts that post on this site can move that 21% approval rating into the teens without trying!

I think Denmark does have the highest taxes in the world .. Tell your friend love it or leave it, Dan ..

On another topic - by many accounts Germany has a good system - a split of private and public programs that has develop over a very very long time .. and their taxes are a little higher but generaly comparable to ours:

Country - Corp - Indiv - VAT

Germany - 30% to 33% - 15% to 45% - 19%
U.S.A. - 15% to 35% - 15% to 35% - 0%

He did JDR, lives in Brazil for the last 15 years, one reason is lower taxes.