I am on your side about some things, just not specifically about universal health care. Most doctors who oppose universal healthcare are worried about their own pockets. It is easy to take a self-centered look at policy, but I prefer to look at what is best for everyone involved. Probably why I am a liberal.
p.s. I am so out of touch I had to look up that reference to Holiday Inn Express! Hahaha!
Regarding Michael Moore, I agree, one must always be wary of what are presented as facts from a very opinionated source. However, as a physician I simply saw my patients' stories in the film. I know that such stories are real, I see them every day. The idea of people suffering needlessly is painful to me. This is why I cannot reconcile the view that healthcare is not a human right. Is it really right to let people suffer, when we as a nation and as a community have the power to relieve that suffering? You may draw your own conclusions, but I feel that as a society we are at our best when we care for others, and at our worst when we ignore the unacceptable situations of poverty, disease, hunger, etc. that others may endure. I'll come back to this later.
1) Remove regulations that prohibit robust plan options. Citizens should have multiple choices concerning their health whether it be full coverage, catastrophic coverage, 80/20 plans, health savings accounts, or any additional plan that the American innovator can produce.
Sure, having affordable plans is key, but so too is requiring people to have a plan. Without universal healthcare the system is still broken. The people who will never decide to get insurance for themselves can still get cancer, get traumatic brain injuries, etc., and who pays the astronomical bills? They are absorbed by the hospital.
2) Remove employers from the equation of paying for health care.
Agreed! It just doesn't make sense.
3) Seek to phase out Medicare. Our politicians have done a poor job of anticipating the rise in Medicare costs and it is affecting our national budget. The inflated national budget provides a need for government officials to deny doctors full payment for care. The Medicare patient doesn't know this because the doctor is not allowed to bill the patient for the remaining total.
To me, it seems more logical to say, make the government pay actual costs of care. It doesn't make sense to say that since Medicare is not paying well, let's get rid of Medicare. Then who pays for these people's care? Either we still pay for it through jacked up prices because the patients themselves simply never pay the bills, or the patients will not seek care. And having people not seeking care when they need it ends up with catastrophic bills in a situation that has become too far gone to save (which people also can't afford), and it ends up with sick people who aren't being treated. That's unacceptable in our so called 'advanced society'.
If an individual cannot pay for the costs of health care during his/her retirement then they are not yet adequately prepared for retirement. Removing Medicare from the equation will cause citizens to plan accordingly as opposed to not considering the costs allowing the nation as a whole to foot the bill.
Sure, and if people plan right for their mortgages, they'll never go into foreclosure. If they plan their budgets right, they'll never go into credit card debt. Are any of these things ever going to happen? No. At least my plan has a chance of getting everyone covered and paid for! You say you don't trust the government to run any program without corruption and bureaucracy. Well, I don't trust people to plan for the costs of health care. Sure, maybe if the world was made up of GRS readers. But it isn't! There will always be a sizeable segment of 'non-planners'. The people who say "hey, I might die tomorrow, why save for retirement?" Your philosophy says if those people get sick, let them die, or let them suffer the consequences. Not in my book. Under my philosophy no one has to die without proper medical care.
4) Replace Medicaid with a 501(c)(3) non-profit corporation. Several posters seem to like the idea of helping out with medical costs for the poor. Well, how about a plan that does that and is tax deductible? Replacing Medicaid with a 501(c)(3) corporation will allow citizens to donate money into a system and receive a receipt for a tax deduction. Also, doctors will have the option of donating part of their time to the organization (they can even do so from their own office) and can deduct the cost of their time. The system will allow those who are poor to receive some of the same services as those who can easily afford insurance.
To me it is unacceptable to tell people who are sick or dying to try their luck with charities. Everyone should have access to the same medical care. Everyone. They should not have to rely on donations of time and money, which will never be enough to provide for the need. Doctors already donate their time to help care for the uninsured through free clinics nationwide that are 501(c)3 non profits. This system is obviously not caring for all the people who need help. I used to work at a free clinic. We never had time or resources to see everyone who needed care. We were not providing the standard of care to these people. We had to beg labs and testing facilities to donate services like blood tests and mammograms. Have you ever read anything by Paul Farmer? Probably not, but in his book Pathologies of Power, he makes a convincing argument that the poor deserve a higher standard of care, rather than the lower standard of care that they usually receive, because the poor are more at risk for disease.
Why should you care if the poor are more at risk for disease? They should just pull themselves up by their bootstraps and make sure they save more money so they stop being poor. I'll take care of myself, they can take care of themselves. Wrong! The poor being sick has implications for you and me, my friend. Do you want to live in a society riddled with tuberculosis, AIDS, hepatitis and other infectious diseases? Do you want to live amongst people infested with scabies, lice, typhoid? I don't think so. You, me, other wealthy folks, and the government all have a vested interest in having healthy citizens. Healthy citizens work harder and work better. Healthy citizens keep you and me healthy, too. And that is just a self-serving look at why keeping poor people healthy is good, for those who cannot be swayed by arguments about helping others because they just don't care about others.
5) Knowing the costs up front will allow you to determine how to pay for a procedure; consider any cost saving alternatives; or if possible delaying the procedure to raise the funds in full. We walk into stores (Best Buy, Kroger, Wal-Mart) everyday and buy items in which prices stay similar at a national level; the same can happen in the medical industry with the right incentive.
I agree that people should be able to find out the cost of their medical care. I have a very difficult time finding out what any given treatment is going to cost my patients, though I have a vague idea. But you can't have it both ways. If we had universal healthcare, we'd be more likely to standardize billing. Keeping various private insurance companies involved who all negotiate their own prices for every service is the problem with billing. But I don't suppose you'd be interested in the idea of not allowing the insurance companies to negotiate prices, because that would be anti-business.
I think this argument is a little bit silly though. Medical care is not like shopping at Kroger, or to use a more common example, like Burger King. You cannot 'have it your way'. Physicians should be incentivized to provide the most efficient possible care for their patients. We should not expect patients to make decisions on what care they want based on what they can afford. Everyone should get the highest quality care that is cost-effective. You don't place an order when you go to the doctor. The doctor tells you what you need, and you get it. To opt out of treatments or services against medical advice is not in anyone's best interest. Also recall that a lot of people in this country don't have many choices for 'shopping' for medical care. With the physician shortage, doctors are concentrated in areas like NYC and Boston. People should be able to go to the nearest hospital, or whatever doctor they like to see, and expect the highest level of care, and not have to worry about the cost. Why would people want to save money by avoiding recommended medical treatment? I hate that idea. When the fire department comes to your house to save your family from a burning building, you don't ask "hey, how much is this going to cost the town? Would a private fire department be able to rescue us more cheaply? Does the town budget have enough to cover rescuing all of us, or can it only afford to rescue 2 of the 4 of us?" No! The fire department saves the whole family.
6) Petition colleges to provide free education for doctors, nurses, and health care technicians for the next tens years. The health care problem is a national problem that faces every American and will only get worse if we do not start training more doctors and nurses immediately. The single payer solution does nothing to address this issue. Part of the escalation of costs amongst doctors is a lack of competition for services. The doctor can raise prices and get away with it because there are so few. Have you been to a specialist lately? Unless you are one of the first patients then you will be waiting in a crowded room full of people to see the same doctor. The doctor having to fund a full staff is willing to take on as many patients as possible which means less time with the doctor. I don’t believe I have ever been with a doctor for more than fifteen minutes in the past ten years!
To your general idea: yes! Yes ! YES! A resounding yes. As I stated before, I think this is crucial. We cannot institute universal healthcare or any improved healthcare without more healthcare professionals.
However, I think you are attributing several problems to the wrong cause. Insurance companies themselves have a lot to do with patients only getting to see the doctor for 15 minutes, because they do not reimburse for having longer conversations. Also, the fees are set by what the insurance company will pay. As you pointed out before, a physician cannot just charge whatever fee they want, because insurance companies will only pay what they believe the service you provided should be worth, and you cannot charge the patient for the remainder. If you say "but that fee is not enough, I need to charge more than that", the insurance company can say "fine, but our customers will not be able to see you as part of our plan". I think there are a lot of other things escalating costs of healthcare, I don't think doctors raising prices due to lack of competition is one of them. This isn't really related to either single payer/universal healthcare or to private companies, because either way we need to pay for physicians to spend more time with patients and incentivize primary care rather than procedures. I also addressed this issue in my prior post.
See this article for more info:http://www.democratandchronicle.com/art ... /811110325
7) Allow doctors to charge a significant portion of the procedural cost upfront. The 501(c)(3) corporation would theoretically take care of all the costs for the disadvantaged so then why the need for this policy? The growing problem of illegal aliens drains the medical industry of time, energy, and income. The additional paying customers will keep costs low for everyone as organizations will not have to shift costs in order to turn profit.
Having additional paying customers is another argument for universal healthcare.
Remember though, it is not just illegal aliens who do not pay for healthcare. It is anyone uninsured! So unless you mandate that everyone must have health insurance, we will still have to absorb huge healthcare bills that people do not pay for, and hospitals will still be going bankrupt.
Also, anyone can "choose" not to pay for healthcare, just like you can choose not to pay for other things. This is why people should not be paying for healthcare out of their own pockets. If everyone was covered, then hospitals would always be able to bill for services.
8 ) Place a cap on all civil law suits. Increase the criminal penalty for negligent care. Frivolous law suits targeted toward medical professionals adds a significant cost to the industry.
I absolutely agree with you 100%.
You said "The single payer system considers the government first and doctor/patient care second. "
I think in any system the consideration is money first, doctor/patient care second. I'm not really sure what the above statement means.
Health care is not a right or a privilege but a responsibility to members of our society. Rights mapped out in the Declaration of Independence are free and because health care will never be free it must never be considered a right (http://www.bdt.com/pages/Peikoff.html
That is such a sad idea! I am so glad I don't live in a country that actually enforces those kinds of ideals. Now you really have to read Pathologies of Power. It is available free preview on Google Books! Just read. He writes better than I could argue.
http://books.google.com/books/ucpress?i ... =0#PPA5,M1
Even looking at it now I am getting sucked in to reading it all over again. I cannot say it enough. This is a great book.
Making health care a right forces society to pay for the health care all citizens and non-citizens alike along with forcing doctors to take a set wage provided to them by the system. Citizens are currently free to pay for insurance or to go without insurance if they do not deem it cost effective or have established different priorities. I chose myself at one time not to pay for insurance. A stupid move in hindsight but I chose that option and that free choice is removed with a compulsory single payer system.
Doctors are already forced to take the 'wage' that insurance companies are willing to pay. Remember, there is a difference between single payer and socialized medicine. You are blurring the distinction here. In single payer, the hospitals and medical offices are still run privately. In socialized medicine, the government actually runs the hospitals and medical offices and thus physicians are employees of the government.
When people make the 'free choice' to go without insurance, they infringe upon others by risking catastrophic injury or illness which they cannot afford to pay for. That choice is nowhere near free. It can come with a price tag in the hundreds of thousands! And as we've noted numerous times, the rest of us then have to bear the burden of the uninsured. Mr. Peikoff states in the link you provide that when you rely on others to pay for your actions, you make those other people your 'rightless serfs' or 'slaves'. So for the rest of us to keep our inalienable rights, mustn't we require everyone to have health insurance?
I should add that Dr. Peikoff's outlook is upsetting to me. He calls doctors 'traders' and states that universal healthcare will ruin physicians. Interesting idea. I thought doctors would advocate the idea of healthcare for everyone. Unless they are only concerned about financial gain. I don't want my personal doctor to think like Dr. Peikoff or like Ayn Rand. I want my doctor to be compassionate and to give me the best quality care I can get, not without concern for cost effectiveness, but without concern for what I can afford to pay.