Single-payer approach best health care option
Five years from retiring from teaching family medicine, I see a single-payer health system as the only means to repair a health care system that spends so much more than comparable nations (all with national health plans) yet falls below 20th position on most ratings of health outcomes.
Expect the middlemen, particularly the insurance and pharmaceutical organizations, to spend millions in propaganda to maintain a status quo that benefits them so handsomely.
Most of the money to fund insured health care for all of our citizens will come from them. A nebulous malpractice threat must also be replaced with a system that compensates those who were injured while working openly to prevent recurrence of the causative errors.
The malpractice threat and interferences by intermediaries (e.g., pre-authorizations for medical treatments) have produced a fragmentation of care that results in expensive over-testing and over-treating with increasingly poor results for patient health.
Wayne Hale
Greensboro
Comments (26)
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Amazing that people who have dealt with government inefficiency and incompetence from the dmv to filing for unemployment benefits to building permits wants the same entity in charge of their health care.
There is absolutely no track record that government run health care will be any different. Long on bureaucracy and short on efficiency, the hallmark of government 'services'.
But it looks like it will become a reality with enough people clamoring for someone else to pay their way in life and a willing socialist in the wh to pave the way.
Posted on May 6, 2009 6:36 AM
Let's look at this rationally. Suppose you, or a loved one, needs brain surgery. You have your choice of doctors. One comes from the private sector, well known as one of the best. He has a reputation to uphold if he wants to maintain his status. The other is distracted by his anger at what Obama has decided he should be paid for the operation, which the doctor considers to be too little for the time and money invested in his education. Which do you choose?
Look at the idiots running things in DC. This administration or the last, doesn't make much difference. I don't want those fools in charge of my car warranty, much less my brain surgery.
Posted on May 6, 2009 7:31 AM
Sawdust, I would NOT buy a Chrysler car specifically because govt. backs the warranty. Both the Feds and the state have not yet sent my tax refund and I filed 6 weeks ago. Imagine seeking medical treatment.
Obama is getting resistance from some D's regarding cap & trade. Hopefully some of them will see the light regarding govt. takeover of health care.
Posted on May 6, 2009 7:55 AM
It's a good thing that, under the Obama health care plan, Docs will still be autonomous...you know, not employed by the government. In fact the plan very closely resembles Mitt Romney's plan....
Posted on May 6, 2009 7:58 AM
neo-sawdust,
Let's look at the current reality. It doesn't work for millions of people now. You want to set up the straw man of "government bureaucracy" to scare people. In my experience, I don't see how one government bureaucracy is going to do any worse than the hodgepodge of private bureaucracies we have now.
We have about 50 million uninsured and probably another 50 million underinsured. That is one third of our nation that effectively does not have access to health care.
My wife and I are reasonably healthy people in our fifties. When we had health insurance, it cost $850 per month and didn't even cover basic preventative care, such as Pap smears and mammograms. So, exactly what did we get for $850 a month?
Forget about your hypothetical brain surgery, Sawdust. I will settle for some affordable basic medical care.
Posted on May 6, 2009 8:03 AM
miktay has a point....private bureaucracies...private bureaucracies with a vested interest in not paying for Sawdust's brain surgery....
Posted on May 6, 2009 8:10 AM
Sawdust, you nailed it on the brain surgery thing. I have a friend who will be having that done this summer and he's researched it for a year now. He'll be going to NY where one of the best brain doc's in the country will do the deed.
Posted on May 6, 2009 8:19 AM
Miktay, you stated " We have about 50 million uninsured and probably another 50 million underinsured. That is one third of our nation that effectively does not have access to health care."
Just because these people are uninsured or underinsured doesn't mean they do not have access to health care.
All I can say is "be careful what you wish for".
Posted on May 6, 2009 8:27 AM
Hey guys, don't worry about that brain surgery. You'll be on a long list, and will likely die before the former AMTRAK conductor, now your brain surgeon, can kill you!
How many Americans are pouring into Canada for medical care, and how many Canadians are walking across the bridge to the USA!
Posted on May 6, 2009 11:05 AM
"How many Americans are pouring into Canada for medical care, and how many Canadians are walking across the bridge to the USA!"
My guesses, 2 and 7 respectively. 2000+ and 7 respectively if including the number of Americans who get their scripts in Canada.
Posted on May 6, 2009 11:10 AM
Miktay; I don't know how old you are. I'm 61, and I can remember the days before we had a "health care crisis" in this country. Back in the days when government hadn't been meddling too long. Back before the government "fixed" health care. Just as they have done with education, they managed to screw it up, just like they always screw up things when the Constitution is ignored. The government can't find its ass with both hands, much less perform brain surgery. Or build cars.
Posted on May 6, 2009 6:04 PM
Sawdust, once Obama gets his sycophant congress, there will be on import tariffs so high that we'll have no choice but to buy a Government Motors car.
Posted on May 6, 2009 6:22 PM
"Miktay; I don't know how old you are. I'm 61, and I can remember the days before we had a "health care crisis" in this country. Back in the days when government hadn't been meddling too long. Back before the government "fixed" health care."
Kids today haven't a clue about how it used to be. All they know is that is was unjust and racist, which is what they have been teaching in schools for the past 25 years.
Posted on May 6, 2009 6:27 PM
I visited the National Corvette Museum in Bowling Green, KY this afternoon. Pretty cool. The manufacturing plant, they told me, is only open periodically and they only build Corvettes to customer order now, and not too many at that.
I don't think the brand will fit the plans of Obamamotors and the environmentalists so it may go under or be sold, probably to some foreigner. A guy there told me that GM has laid off most of the Corvette engineers and they think it's only a matter of time before production is ceased. The end of an era perhaps.
Posted on May 6, 2009 6:47 PM
Hugh's friend, and Sawdust's example, can only "[go] to NY" BECAUSE the rest of us are paying for "one of the best brain doc's in the country [to] do the deed."
This fabled private sector is merely another bureaucracy with a vested interest in maintaining it's power.
==
Yes there are idiots running things in DC - but the vast majority of folks that work for the government are just regular folks trying to earn a living. The ratio of lazy and rude bastards to genuinely productive people is determined by the local management - this is true for unioned shops, privately run business' large and small, as well as corporate monsters.
Most "Big" things suck because they are simply too big and some common denominator tends to drag things down - but if you get the local chapter to a size where everyone knows everyone else, good things can happen even within the GM's of the world.
Here's a true story: In my home state of Delaware there are two DMV's near my old home. The one I use to go to is a royal pain in the ass - One day I went to the other location and found it pleasant and productive. I mentioned this to one of the clerks, stating "Wow, you guys sure are a lot better than the DMV down in Stranton"
She replied, "We know".
Ditto the military. We all hear stories - or lived the experience - of incompetance - the acronym SNAFU captures it well ... but on the front line when it's just you and the soldiers around you - it's a different story - as determined by the local management.
Posted on May 7, 2009 2:48 AM
What you're really remembering, Dusty, was a time when Doctors worked out of their house and were content with earning a mere several times that of the average Joe, knowing that local prestige and the knowledge they were doing a good thing for the community made up for any-other lackings. It was a time when people actually died of old age. It was an era when Pharmacutical companies weren't advertising on TV. There are bygone days when suggesting a guy needed a pill to help him screw would have been considered an insult to his manhood.
btw - you talk about the government not "[finding] its ass with both hands, much less perform brain surgery. Or build cars" .. per Dan's Corvette story apparently the private sector can't do that either.
Posted on May 7, 2009 3:19 AM
And here's the real problem with most of these posts:
Dan tells us Corvette's may soon be gone - the end of an era like the local Dr. who had a medical office attached to his house - where he would install stitches and the like. But why is the Corvette about to be gone? It is because of Obamamotors !!! Yea .. that makes sense!
No it doesn't.
The generic blogger in this site - mostly pigheaded wanna-be ditto-heads if you ask me - are convinced the free market is really free, and it was them damm hippy environmentalists who have screwed up everything. Whatever.
Posted on May 7, 2009 3:26 AM
A point not previously covered regarding Sawdust's example is his lack of knowledge regarding the conduct of health care professionals. Yes, doctors are human and respond inappropriately at times. And skill does vary greatly (as in any profession). However, to suggest a doctor would let his anger at anything interfere with doing his best on a patient is silly and ludicrous. Their integrity would prevent retaliation against a patient, not to mention their fear of a lawsuit.
I have strong negative feeling regarding the government doling out monies for the health care of illegals. But I have never mistreated an illegal patient (or any other patient) based on personal anger or upset. I did not go into nursing and stay in nursing for almost 30 years to add pain and suffering to anyone’s condition. I became a nurse to improve their lives in whatever small way I could.
I resent the cavalier implication that health care professionals are subject to taking their anger out on their patients. I find this suggestion to be NOT true of anyone I have ever worked with.
Posted on May 7, 2009 6:20 AM
"...and it was them damm hippy environmentalists who have screwed up everything."
You could say that:
http://www.cnn.com/2009/POLITICS/01/26/obama.emissions/index.html
"Environmentalists and many state officials said they hope that Obama would endorse tough tailpipe emissions standards proposed by California."
http://www.washingtonpost.com/wp-dyn/content/article/2009/01/26/AR2009012602028.html
Environmentalists are pushing Obama for a "vehicle mileage tax". Luckily he hasn't conceded to that....yet.
http://crosscut.com/2009/03/05/transportation/18893/
http://www.greenpeace.org/usa/campaigns/global-warming-and-energy/break-the-addiction
http://features.csmonitor.com/environment/2009/01/26/under-obama%E2%80%99s-energy-plan-cars-would-be-cleaner-but-costlier/
And Bushmotors was no better:
http://www.timesonline.co.uk/tol/news/environment/article3076119.ece
"Government leaders such as Nancy Pelosi have already voiced the opinion that Americans should drive smaller, more efficient vehicles."
And this one says it all:
Disappearing Cars
"In a move largely seen as giving in to Washington, General Motors recently closed it High Performance Vehicles division. The HPV team was largely responsible for GM's most exciting cars including the Cadillac CTS-V and the Chevrolet Corvette ZR1.
Bureaucrats have little use for performance-oriented V-8 powered cars, so don't expect cars like the Chevy Corvette, Dodge Viper, Chevrolet Camaro SS, or Dodge Challenger R/T to survive long term. Their survival is no longer tied to customer demand, but to the demands of the government that now controls the product portfolios and development dollars at GM and Chrysler. "
http://autos.aol.com/article/car-news/corvette-demise/20090429001
Yes JDR, the hippy tree huggers have power, even more now. Take your head out of the sand. Can you imagine an auto manufacturer having to build different versions of cars depending upon the state where it is destined?
Maybe there will be a Nancy Pelosi approved hybrid Corvette with a two cylinder 20 hp Briggs and Stratton engine like my lawnmower.
Posted on May 7, 2009 7:44 AM
So, Yvonne, I guess you opt for the government doctor. As you say, doctors are human, subject to distractions. When it comes to brain surgery, a little bit of distraction can go a long way.
Me, I'll take the private sector doctor any day. And I believe that anyone with half a brain would do the same. JDR may have other opinions, naturally.
Posted on May 7, 2009 1:19 PM
I'd much rather take the surgeon that I've met more than once after a few severe headaches, discussed a treatment plan with, gotten second or third opinions on, and asked every question that's even remotely relevant than I would taking whichever surgeon is on call at the local hospital the night the aneurysm that I didn't know I had explodes and half my body becomes paralyzed.
But maybe that's just me.
Posted on May 7, 2009 5:15 PM
Dan: If the government “controls the product portfolios and development dollars at GM and Chrysler” … it is because the "free marketers” at GM and Chrysler could not by themselves produce cars people wanted – meaning (at least to me) cars that lasted. I currently own three Toyotas and one Lexus because previous Toyotas have achieved over 250,000 miles without breathing hard.
Today a vendor took me to lunch. His 2005 Chevy Trailblazer (?) has a broken speedometer, gas gauge and one other gage – all at just over 60,000 miles and just out of warrantee.
Posted on May 7, 2009 6:32 PM
Sawdust:
I'm not arguing "the private sector doctor" is never better than "the government doctor". Think deeper, please.
Posted on May 7, 2009 6:35 PM
Speaking of thinking deeper - let's look at Dan's links.
His first one: “Obama to let states set auto emission rules.”
So Obama wants to let local populations determine their policy .. and you are complaining? What kind of conservative are you, wanting federal intervention? Opps, I forgot, you are a closet liberal (and this just shows it).
btw - Voinovich, R-Ohio has it exactly backwards: The federal government is not “piling on an industry” – the Obama proposal would pull the federal government OUT. Do you think Voinovich – from Ohio – might have some constituents to protect?
==
In the second link, Dan skips the very next sentence after his posted quote: “Automakers, meanwhile, want the administration to establish uniform nationwide mileage standards while moving to ease the cost by providing assistance and incentives for car buyers.”
Restated: Automakers WANT Federal Intervention – establishing mileage standards.
Restated: Automakers WANT Federal Money “to ease the cost by providing assistance and incentives for car buyers.”.
Restated: WAIT .. Now I see … Automakers are the Hippy Environmentalists.
==
The third link argues for a USER Tax – the more miles one drives the more one pays – presumably a flat rate whether you drive Hybrid or a Challenger. What’s wrong with that? Don’t like the tax, don’t drive. Easy.
==
Dan personally took the fourth link’s advice by purchasing a high-mpg vehicle. So he takes the advise and then disses it? What gives?
=
The fifth link repeats the above.
=
The last link is best addressed by its comments section:
“The few hundred or so ZR-1's that would be produced would not make a dent in GM's overall value … the new CAFE standards are going to hit domestic automakers very hard because they sell a higher proportion of trucks than import brands."
Frankly that sounds like Free Market.
Continuing: "As they make all their money on these trucks, they are going to be faced with having to either abandon the truck market, which would be suicide, or sell a significantly more fuel efficient fleet of cars than the import brands, which is impossible. What they really wanted was higher gas taxes and no CAFE, but that is politically impossible at the moment” John, Fairfax, VA US
Are CAFÉ standards bad? I dunno – they are a federal policy. Are seat-belts bad? They are a federal policy too. If there were no CAFÉ standards the cost of fuel might be $5 / gallon – based on presumed lower mpg’s and therefore a much higher demand. Would you be whining then? If we burned all the easy fuel – which is what happened anyway – would you be OK with no more ZR-1's .. only electric FIT’s ?
Posted on May 7, 2009 6:43 PM
I'm finally back from the KY/TN trip. There is a fancy Italian sports car in the baggage claim area at GSO. The sticker has a $1500 "gas guzzler tax" added to the total price.
Get your head out of the sand JDR. Certain people are insisting that all of us drive small cars and/or use public transport.
There is a simple reason I oppose each state having it's own emissions standards, think about the cost of cars when they have to be built to the specific standards of various states.
A simple example: Spokane, WA banned dishwasher detergent containing phosphates to "save the environment". Problem was the "green" detergents didn't work. Now residents are driving to Idaho and smuggling Electrasol back into Washington.
Imagine NC having much stricter emissions standards than VA. Cars sold in NC cost a few thousand more, so NC residents flock to VA to buy cheaper cars. Will that be illegal?
What happens when someone buys a car in Texas, with lesser emissions standards, and moves to California with their car?
Dozens of standards for something like cars would be disastrous. Think about it.
Posted on May 8, 2009 12:46 AM
I do not disagree, Dan .. my point was EVERY Federal intervention is not evil .. just as EVERY Free Market action is not perfection.
The trick is to find the correct balance .. an action which is near impossible with the divisive rhetoric here-in and elsewhere .. and even more difficult because one man's Federal intervention is another Free Market.
Posted on May 8, 2009 6:23 AM