You are forgetting that, unlike a private company, a government run plan can operate at a significant loss for quite some time…effectively putting private companies out of business. Also, once you reach single payer it is probably impossible to go back.
You are also forgetting about the taxpayers. Eventually, if taxes need to be increased to keep supporting the system, there will be a movement toward cutting taxes or at least not raising taxes. I think this sentiment is quite different from a person thinking their insurance company charges too much for too little and shops around (assuming, of course, that there is more competition in the private sector than there is now) or saying “screw it…I’ll take my chances without insurance” like many young people are doing right now.
What is the “cutting point”, where is the line drawn? How many people have to be affected before you consider it beneficial to society as a whole?
Quite simply, we don’t have the money for what is being proposed and we sure as shit wouldn’t have the money to cover everything for everyone.
The rationing is something that is going to happen. Exactly what aspects of the rationing is the debate, not the actual rationing itself.
For instance, if the rationing occurs as people die from not getting treatment due to government incompetence (can we all agree that is bad)?
If the rationing is of a sort that prohibits a certain small demographic from getting some testing done (which might kill a few people) (is that AS bad?)
Pricing is indeed rationing. There is no other way to put it. If the popularity of some item increases, and the demand outstrips supply, prices go up. This limits the number of people who can afford such luxuries. Pricing usually results in self-rationing…people will not buy a Lexus but, instead, buy a Chevy so they can afford the steaks for dinner.
Self-rationing is also at work in health care. People choose not to go to the doctor for every minor ailment because they think it better to spend their money on other things. When we remove self-rationing by giving equal access to things (i.e. government health care) the job of rationing falls to the government. I prefer self-rationing to government rationing.
Gonzomax is correct. The guidelines were changed as a practical matter. Why subject women at low risk to increased radiation. At some point the harm outweighs the good. The guidelines may mean that insurance will not cover the procedure for younger women (unless they have an increased risk of breast cancer) but you are still welcome to give your doctor cash for the procedure. My fear is that, in a government run system, the test simply will not be available to anyone below the suggested age regardless of the ability to pay
I don’t disagree with your philosophical point. I’m just saying that if, in any other context, you started telling people that (for example) baseball cards and blue jeans are “rationed,” they’d tell you that that’s not what the word means. As I said – by your definition, everything everywhere that does not have infinite supply is “rationed.” That’s not normal usage of the word.
I think that people confuse rationing by others with self-rationing. Everything that does not have an infinite supply IS rationed. Obviously the best system is to let us choose what we can do without.
Self rationing is fine as a decider between brands of car. For an appendectomy or chemotherapy, not so much. Cars are not a reasonable analogy to health care. People don’t get actual health care on an optional basis.
This whole meme that under UHC people are just going to go rushing off to the doctor for every broken fingernail, thus bankrupting the system, is just manufactured silliness. People don’t like going to the doctor, even when they are actually sick. To say nothing of the loss of work or other productive time, incidental expenses as for transportation, and general inconvenience of scheduling, there is the waiting about in rooms full of actual sick people. Nothing about the experience is at all attractive. The number of people who will actually contribute to some kind of health care waste will be miniscule.
Why? You don’t know what they will provide. I get emails from Medicare every year trying to get me to take screenings and preventative tests. I never got one from my insurance companies.
Really, the bottom line is that if you suddenly changed to a system like we have in Canada, where the wealthy cannot "buy their way’ up the waiting list… You will have pissed off pretty much all of the wealthy people. And these are people with power and influence.
Many people up here who bitch about waiting lists are the wealthy, who feel that their money should buy them whatever they want. They would complain if a poor person with a brain tumor got in the MRI line ahead of the scan for their sore knee. They really could not give a rat’s ass if the poor person dies.
I think there is more of an independent “do it yourself” attitude in the US, and less of a perceived need for a social safety net. This, combined with the fact that your systems are entrenched, and there is a billion dollar insurance industry with their own motivations means that you have quite a tough road to follow with regards to Universal Health Care. You might have had more success 30 -40 years ago… Now, not so much.
Call it rationing or some other word, but it still remains that access to a limited pool of medical resources is limited in the US by a person’s ability to pay (either directly or through expensive private insurance). In Canada, access to the limited pool is (mostly) limited by medical decisions, triage and necessity.
Correct…I do not know. But, unless everything is covered for everyone at every age (which I doubt), then guidelines like the breast cancer screening will be used to determine who is elegible to receive a test. In a single payer system you may simply not be allowed to take a test that is not indicated. Correct me if I am wrong but you would not be allowed to pay a physician or lab cash to take some test.
We don’t get actual food and water on an optional basis either yet their is self-rationing. Maybe some people can only afford catastrophic insurance coverage that would cover things like cancer or appendectomy. This would be the Ford as opposed to the so-called Cadillac plan. This is not to suggest that people who cannot afford ANY type of insurance or are unable to pay out of pocket should be left in the street but many insurance policies are very expensive because they are mandated to cover so much that people may not need.
I don’t believe this. This is one of the reasons that insurance companies charge a copay or a deductible of some type. They know that if a service is entirely free people will use more of it. This is basic economics and human nature. Having a deductible makes people think about whether their condition is serious enough to spend X amount of money to have it looked at by a professional.
Actually you will have pissed off the vast majority of Americans that like their current coverage and do not have to wait six months for an MRI or three years for some operation.
Possibly. I’d put this down to “me first” attitudes, and “if I have the money I should be able to buy it” attitude. It’s a matter of understanding what is important. I acknowledge that because access to healthcare is not infinite and there is a societal need, that is bigger than me, I can’t get whatever I want immediately.
If I am waiting 6 months for an MRI, it means that someone else needed it more. If I wait three years for an operation, it means that it was not that necessary for me to get it right away. If my health situation changes in those three years, I will inform my doctor, and not just sit around and bitch about waitlists. If I feel the waitlists are too long, I can go online and see what they typical wait times are for the entire Province for various procedures, and not just rely on hyperbolic anecdotes like “three years wait for an operation”. If I feel that these wait lists are too long and my health is being impacted, I can directly appeal to elected officials who are responsible for this situation, and are quite sensitive to pissed off constituents.
From what I have seen, around 16% of Americans have no coverage currently…
So of the 84% with coverage, to get up a 2/3 majority of Americans (sound good for vast majority?) you would need almost 80% of those covered to like their current coverage. Is that really the number who do? I know nobody outside of federal employees (which is a pretty large number given where I live I will admit) who actively likes their current coverage.
Especially for older people, going to the doctor may be the most interesting they do all day. I know overprotective mothers who want to take Johnny in for every sniffle.
As noted, insurance policies that have minimal copays – $5 and $10 – do so because they are trying to limit frivolous appointments. The paperwork needed to process a $5 deductible makes it barely worth collecting. It’d be easier on everyone to just raise the deductible a few bucks a year – unless those copays were done specifically to deter unnecessary visits.
I would contend that the wait has nothing to do with who needs it more. How many MRI machines are there in canada per million people? That’s why you wait.
How many surgeons are there in canada per million people? I don’t know but I DO know that many Canadian doctors come to the US to make more money.
So that means a significant percentage of the uncovered like their health care? I can see if it was 89% of the covered, but 89% is more than the covered percentage…
And my health care and coverage sucks donkey balls.
There is certainly some truth in your argument - but the fact there are fewer MRI machines does not mean that we do not have enough, nor does it mean that the wait for an MIR is necessarily deleterious to the health of the population.
There can be an argument that the US has TOO MANY MRI machines. They may just sit around uselessly, waiting for someone to make use of them or MRI’s could be used far too often (when they do not return a positive benefit to the patient) The same could be said of doctors salaries - there can be an argument that they are paid TOO MUCH in the United States, due to the structure of the “money buys what you want” health system.
This may be partly the cause of the US paying much more per capita for health care (with inferior outcomes) as compared with other countries.