How will healthcare change when, not if, we switch to a European style single payer system?

I really believe we are moving in the direction of a single payer system and away from private health insurance. I’m thinking within 10 years.

When it does, how will things change?

Lots of possible discussion points but to name a few:

Will we be able to pick our own doctors or choose which hospitals to go to?
Will there be rationing?
Will medical professionals like doctors and nurses, become government employees like they are now when they work for the VA?

What are your thoughts?

It’s almost as if no one has ever pointed out to American’s that UHC isn’t some sort of Soviet breadline.

Oh, or that America rations healthcare as well. It’s just that instead of people needing to wait to receive treatment, some American’s just don’t get it at all.

UHC isn’t a mystery. Look into other countries that do it if you want to know how it works and what it looks like.

You say “European style single payer”, but each country has a different health care system. Several countries in Europe have multi-payer universal health care, including Germany.

Ask someone on Medicare.

Far from perfect but about as good as we can get given our politicians/lobbyists.

Do you agree or disagree with this statement:

“Today in the United States, sick people are routinely denied treatment for bureaucratic reasons.”

Ding ding ding

It’ll look a lot like Medicare at the moment. Could we come up with a better system? Possibly. But not within the confines of our current environment.

OK, I will play, though I might regret it. I will speak only for the NHS, which is probably the ‘purest’ form of universal healthcare, in that it does not incorporate insurance or any co-pay, merely taxation.

In the NHS system, you can choose your own GP or dentist, provided they are within your catchment area. I just did a quick search on the NHS site for GP practices in my area and came up with 235 (I was surprised too, I’m not sure how many are actually taking on new patients right now).

You don’t normally pick hospitals or specialist doctors - these would be by referral from your GP, who is your healthcare gatekeeper.

As opposed to an endless supply of doctors and facilities which are run at half strength at the taxpayers expense? As you can see, there will always be a balance of perceived demand with supply. Does this mean sometimes there are waiting lists for certain procedures? Of course. But serious, time sensitive conditions are pushed right through (eg cancer). Knee operations may have to wait.

However, private healthcare is still freely available to access for anyone, if you want to pay for it and have zero waiting, and private insurance is drastically lower than in the US.

Some are, and some aren’t. GP practices are private, and receive funding from the NHS per patient registered, so GPs are self employed, and the nurses in their practice would be employees of the practice owner (normally the senior GP). Same goes for dentists.

Hospital staff are normally employed directly by the NHS, but are also free to take on work privately - for nurses, this might be doing additional ‘agency’ work, for doctors, this may be taking on private clients on the side, for which they are often allowed to use NHS premises and equipment.

How it looks will depend on which system you pick. The European systems are very, very different from each other. And it will also depend a lot on how much influence you let the health insurance and medical industries have. And whether their goal is setting the new system up to fail or setting it up so they can profit maximally from it.

I think only 4 things are guaranteed:

  1. A lot of people will get worse healthcare.
  2. A lot of people will get better healthcare.
  3. Your health insurance premiums will go down (if you have any).
  4. Your taxes will go up.

That is all anyone knows.

Cite on number 1?

If you are talking about rich people you can be sure there will be premium options that they can pay for to get their VIP treatment.

Along with trying to compare to a single target that is actually a broad range of targets, there’s another issue. European style single payer may well change in response to US implementation.

The US is the world’s largest economy and third most populous nation. We are a major source of medical innovation. US pharmaceutical companies produce the majority of patents for new drugs. When we make major changes it’s likely that there will be worldwide ripple effects effects as global markets adjust.

It would almost certainly BE Medicare, with its eligibility expanded to people of all ages and with its tax revenue base expanded to fit it. The system is already in place, and already highly efficient, already well-accepted and embraced by the populace, and there’s just no reason to set up something else alongside it. The rest would be tinkering with what it does and does not cover, and regularly adjusting rates, but that’s what happens now. Sure, private insurance (Medicare Supplement policies and the like) could still exist, just like private insurance still exists in Britain, but they wouldn’t be able to set prices oligopolistically as they do now.

Getting health care costs under control is another matter, and one which it would have been nice to see ACA tackle, but that wasn’t a possibility then. However, with most Americans getting the best-value option for primary coverage, that system would have far more negotiating ability.

This would mean no more private health insurance, right? So all the private health insurance companies would be out of business, or at least they’d have to radically change their business model. And the people who work for private health insurance companies would be out of a job.

To me, this looks like it may be the biggest obstacle to moving away from private health insurance: the private health insurers are going to be fighting for their lives for this not to happen.

Good point. I don’t don’t have a cite. No doubt the rich will, but I am thinking more about people who have decent salary and workplace pays for a good chunk of pretty good healthcare (HC).

I am pretty sure my current HC it is better than what would be the standard “single payer system” HC. So if I wanted to maintain it, I would have to pay for private. But by the time I factored in all the extra taxes, I doubt I could afford paying for private completely by myself. I would probably have to settle for the single payer HC.

Not the end of the world (hopefully). I am not saying that I would be overall against Single payer HC. I am just saying that not everyone’s HC will improve.

No cite’s, just my opinion.

Most people that have good jobs with pretty good healthcare almost never have to actually use any of it, so I think this is more a perception thing than a reality thing.

Oh, I don’t doubt that at all. It might be superficially named something else to show the transition but it’s been clear for years that the easiest solution - and with maximal efficiency - is to extend Medicare coverage to everyone.

If it’s something at all identifiably different, I think it would still be called Medicare, just to limit silly, lying, grandstanding opposition like we saw with ACA.

Some will still be unreachable, of course - there will still be idiots saying “I don’t want government-run health care. I don’t want socialized medicine. And don’t touch my Medicare.”

Not necessarily. My employer is self-insured, which means my employer actually pays the claims. I do have an insurance company card- but that company merely administers the program for a set fee and doesn’t take any risks. Blue Cross similarly administers Medicare in many states.

Also, insurance companies are completely in charge of Medicare Parts C & D (Advantage and Drug plans). They also sell Medicare Supplemental (MediGap plans) that cover the 20% of costs not paid by Medicare.