Convince me to support single-payer (US)

[Northern_Piper]

@Ann_Hedonia

This is the elephant in the room and I think it needs to be addressed before we commit out tax dollars to universal coverage. I don’t really see the insurance companies as the bad guys, I think the providers are out to bilk the insurers. And I think any universal coverage needs to be accompanied by reforms that will be regarded as rationing by a lot of people, the people that actually want an unnecessary MRI and 10 unnecessary occupational therapy visits for a sprained wrist.
But inefficiencies and price-gouging in the medical industry has been my pet peeve for a long time now and my rants haven’t gained any traction. I’ve done the best I can, which was to opt myself out of this system.

This issue was raised in another thread recently: Medicare for All: What to be done to reduce fraud?

Here’s how I responded:

@Northern_Piper

Based on news stories I’ve seen occasionally, that’s exactly how [del]fraud[/del] over-billing is caught in the Canadian process.

Since there’s only one payer, and it’s all computerised, the Medicare officials find auditing very easy: «Computer! Give us all the bills filed in Town X for ear-wax cleaning in 2019!»

Je he computer spits out the info, and Dr Jones is off the charts for ear-wax cleaning. No other doctor in Town X has such a high rate.

So the bean-counters say «Computer! Give us all the bills filed by all Doctors in the Province for ear-wax cleaning!»

And Dr Jones is again off the charts.

So Dr Jones will get a visit from the auditors. Maybe it turns out that Dr Jones has invented a new marvellous technique for ear-wax cleaning, and is getting tonnes of referrals from other doctors, of patients with stubborn ear-wax blockages.

Or maybe Dr Jones is cheating the system.

Either way, the auditors for a single-payer system have a strong advantage over auditors in a private insurance system.

And that drives down rates of fraud (not Bryan Eckers´s theory about nice Canadians - sorry, Bryan. )

Criminologists have long been telling us that one of the best factors driving down criminal behaviour isn’t the severity of the punishment, but the chance of getting caught. If single-payer gives auditors better tools for catching fraudsters, then that drives down fraudulent behaviour.

Note that in this approach, it’s purely an issue between the medicare agency and the doctor. Even if the doctor has been found to be over-billing, it doesn’t affect that doctor’s patients. The medicare agency sues the doctor to recover the over-billed amounts. It might be your doctor who has over-billed, but you’re not involved, and the medicare agency doesn’t come after you for re-payment. It’s just between the agency and the doctor.