# Socialized Medicine and Single Payer Systems **URL:** \ **Category:** Great Debates\ **Created:** [August 6, 2012, 6:58pm UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644 "2012-08-06T18:58:33Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![amanset](https://avatars.discourse-cdn.com/v4/letter/a/8dc957/32.png) [@amanset](https://boards.straightdope.com/u/amanset)\ **Post date:** [August 9, 2012, 12:55pm UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/61 "2012-08-09T12:55:45Z")
> [@PrettyVacant](#): > > Sorry, 15 years ago … you saw a private dentist? I definitely had work done in the UK privately before I left to live in Sweden, which I did in November 1999, almost thirteen years ago. I remember needing fillings and being offered the cheap NHS amalgam and then a plethora of other options that I could have privately. I remember bonded amalgam (that I opted for), amalgam with a weird covering on top and white being three of the options. In other words, private dentistry in the UK fifteen years ago doesn’t sound weird to me. ---
**Author:** ![Patty\_O\_Furniture](https://avatars.discourse-cdn.com/v4/letter/p/96bed5/32.png) [@Patty\_O\_Furniture](https://boards.straightdope.com/u/Patty_O_Furniture)\ **Post date:** [August 9, 2012, 2:33pm UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/62 "2012-08-09T14:33:33Z")
This just in: [Romney campaign endorses the central idea of the Affordable Care Act](http://leanforward.msnbc.com/_news/2012/08/08/13186789-shrum-mitt-romney-just-endorsed-the-central-idea-of-the-affordable-care-act?lite). > [@](#): > > Earlier today, Romney campaign spokesperson Andrea Saul appeared on national television to offer an interesting response to a Priorities USA attack ad that features an Indiana man whose wife died of cancer a few years after Romney’s Bain Capital shut down his workplace, costing his family its health insurance plan. > > “If people had been in Massachusetts, under Governor Romney’s health care plan, they would have had health care,” said Saul, appearing to back the idea of bringing Romney’s health care plan nationwide. The Massachusetts law, of course, was a model for President Obama’s Affordable Care Act, which Romney has vowed to repeal. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [August 9, 2012, 3:30pm UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/63 "2012-08-09T15:30:04Z")
> [@amanset](#): > > In other words, private dentistry in the UK fifteen years ago doesn’t sound weird to me. I agree, it’s not unusual. Quartz’s was offering his example of how shit the NHS was for him and the best he could come up with was something that would cause 99.99% of people in the world to say ‘are you fucking sure?’. Some people don’t know they’re born. Plus, of course, it became a completely different service after 12 years of pretty relentless investment by New Labour that saw most waiting lists eradicated and historic levels of infrastructure investment. But Quartz wants to remind us of 1997. ---
**Author:** ![fumster](https://avatars.discourse-cdn.com/v4/letter/f/e9c0ed/32.png) [@fumster](https://boards.straightdope.com/u/fumster)\ **Post date:** [August 9, 2012, 4:02pm UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/64 "2012-08-09T16:02:50Z")
> [@PrettyVacant](#): > > I agree, it’s not unusual. > Quartz’s was offering his example of how shit the NHS was for him and the best he could come up with was something that would cause 99.99% of people in the world to say ‘are you fucking sure?’. Some people don’t know they’re born. > > Plus, of course, it became a completely different service after 12 years of pretty relentless investment by New Labour that saw most waiting lists eradicated and historic levels of infrastructure investment. > > But Quartz wants to remind us of 1997. I didn’t take it as a dig at NHS, just showing that some minor medical procedures could be delayed a bit and that he solved that by having supplemental insurance. Pretty good example of how things should work IMHO ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [August 10, 2012, 6:55am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/65 "2012-08-10T06:55:06Z")
> [@fumster](#): > > I didn’t take it as a dig at NHS, just showing that some minor medical procedures could be delayed a bit and that he solved that by having supplemental insurance. Pretty good example of how things should work IMHO Quartz didn’t mention supplemental insurance; I assumed he’d paid out of pocket. I don’t know about the UK, but in Spain, supplemental insurance schemes tend to be cons; every non-SS/Mutua procedure my family has ever had in Spain has been out of pocket (Mom’s varicose veins, which make SiL climb a hospital’s worth of walls because “Milady can’t wait one fucking month to have it done via SS and then she complains she doesn’t have any money”; her podologist, which she visits privately because doing it via SS would involve taking the bus to go to the hospital, oh the horror; my Lasik and Littlebro’s; dentistry, etc.). I only know a family in Spain who has supplemental insurance of the non-con type and all it does is pay for a private room if they get sent to a specific hospital (assuming there’s a private room available in that wing). ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 10, 2012, 7:54am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/66 "2012-08-10T07:54:22Z")
No, it’s not 1997, it’s 2011: > **[Sharp rise in NHS patients waiting more than 18 weeks for care](https://www.theguardian.com/society/2011/oct/13/nhs-waiting-times-rise-cuts)** > > Nearly 30,000 had to wait for treatment for longer than NHS target in August, a rise of 48% on previous year Just minor procedures, things like knee and hip operations and removal of cataracts. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [August 10, 2012, 7:59am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/67 "2012-08-10T07:59:27Z")
No one suggested it didn’t happen in 1997. Spending is related to GDP - GDP went up really very considerably for most of New Labour’s time in office so NHS spending increased similarily. You may have noticed growth, etc has evaporated since around 08/09. Ditto schools spending, military, welfare state, civil servants, etc. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 10, 2012, 8:24am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/68 "2012-08-10T08:24:47Z")
Exactly. I’m not trying to trash single payer so much as show its tradeoffs. Some are under the impression that single payer is a system where only unnecessary procedures are delayed. They also tend to miss the serious supply problems afflicting the system. the UK has as many doctors per 100,000 people as the US. Other universal health care systems have a lot more doctors. What happens is that patients still die from lack of access to medical care, a problem UHC is supposed to fix: > **[BBC News | Health | Doctor shortage 'is killing patients'](http://news.bbc.co.uk/2/hi/health/360152.stm)** > > Patients are more likely to die in an English hospital if it employs fewer doctors per hospital bed, according to "disgraceful" findings. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [August 10, 2012, 9:04am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/69 "2012-08-10T09:04:38Z")
Guess what? People die. You know what the great feature of UHC should be? Not going bankrupt because you get sick and die. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [August 10, 2012, 9:27am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/70 "2012-08-10T09:27:37Z")
> [@adaher](#): > > [http://news.bbc.co.uk/2/hi/health/360152.stm](http://news.bbc.co.uk/2/hi/health/360152.stm) 1999? Jesus, are you sure. Doctors per 100,000, 2000-2009: [http://www.oecd-ilibrary.org/sites/health\_glance-2011-en/03/02/g3-02-01.html?contentType=&itemId=/content/chapter/health\_glance-2011-21-en&containerItemId=/content/serial/19991312&accessItemIds=/content/book/health\_glance-2011-en&mimeType=text/html](http://www.oecd-ilibrary.org/sites/health_glance-2011-en/03/02/g3-02-01.html?contentType=&itemId=/content/chapter/health_glance-2011-21-en&containerItemId=/content/serial/19991312&accessItemIds=/content/book/health_glance-2011-en&mimeType=text/html) Life Expectancy - contrast 13th with 38th: > **[List of countries by life expectancy](https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy)** > > This list of countries and territories by life expectancy provides a comprehensive list of countries alongside their respective life expectancy figures. The data is differentiated by sex, presenting life expectancies for males, females, and a combined average. In addition to sovereign nations, the list encompasses several non-sovereign entities and territories. The figures serve as an indicator of the quality of healthcare in the respective countries and are influenced by various factors, inc... If you can find any data where UHC systems don’t perform better than the USA non-inclusive systme, it would be interesting. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [August 10, 2012, 10:11am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/71 "2012-08-10T10:11:52Z")
> [@adaher](#): > > What happens is that patients still die from lack of access to medical care, a problem UHC is supposed to fix: > > [BBC News | Health | Doctor shortage 'is killing patients'](http://news.bbc.co.uk/2/hi/health/360152.stm) You know that is a 1999 link don’t you? First and foremost, UHC is supposed to fix the problem of \*access \*to healthcare. (the clue is in the name). It is never going to completely solve the problem of people dying, It merely seeks to be better, fairer, cheaper and more inclusive than the alternatives. Let’s make sure that as many people as possible have access to fairly mundane, life saving and life enhancing treatments. and let’s make sure that we don’t bankrupt people in the process or otherwise restrict their life chances. I prefer to measure the success of a health care system by how it impacts on my life. If I broke my hip tomorrow would I get treated tomorrow? Yes. Would it cost me anything? No. Would I get follow up treatment if needed? Yes. Would it cost me anything? No. Do I know of anyone in this country who isn’t covered in exactly the same way? No. Can I change my job without worrying about health coverage? Yes. Can the same be said of the USA system? BTW, feel free to replace “Broken Hip” with any other ailment. Treatment time may vary according to medical priorities but it will get done (not the case in the USA) And in some UHC systems there are some moderate standard costs that are kept low and capped or waived. But the general principle is the same. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 10, 2012, 10:13am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/72 "2012-08-10T10:13:58Z")
> [@foolsguinea](#): > > Guess what? People die. You know what the great feature of UHC should be? Not going bankrupt because you get sick and die. Do people still experience privation due to heavy tax burdens? Or is that yet another promised problem UHC was supposed to fix but didn’t? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 10, 2012, 10:25am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/73 "2012-08-10T10:25:39Z")
If you have an emergency, yes, you’ll get seen today. THat’s exactly the same as the US system. What happens if you are merely in horrible pain? What happens if something might be wrong with you but you don’t know what? How long to wait for diagnostics? Actually, we know exactly what happens. Things like cancer get detected later and patients die: > **[Cancer Survival Rates Improving Across Europe, But Still Lagging Behind US](https://www.medscape.com/viewarticle/561737)** > > New EUROCARE reports analyzing cancer survival statistics suggest that gaps between the countries of Europe are narrowing and that cancer care is improving, but comparison with US statistics suggests that Europe still lagging behind. One of the reports compares the statistics from Europe with those from the United States and shows that for most solid tumors, survival rates were significantly higher in US patients than in European patients. This analysis, headed by Arduino Verdecchia, PhD, from the National Center for Epidemiology, Health Surveillance, and Promotion, in Rome, Italy, was based on the most recent data available. It involved about 6.7 million patients from 21 countries, who were diagnosed with cancer between 2000 and 2002. The age-adjusted 5-year survival rates for all cancers combined was 47.3% for men and 55.8% for women, which is significantly lower than the estimates of 66.3% for men and 62.9% for women from the US Surveillance, Epidemiology, and End Results (SEER) program ( P \< .001). “Understanding the reasons for these persistent (but diminishing) differences is important for the public health response to cancer in Europe,” Dr. Berrino and colleagues write. The EUROCARE approach to disentangling these possible determinants of survival includes high-resolution studies, which use information accessed from clinical records. So far, these studies suggest that most of the survival differences for breast and colorectal cancer are attributable to differences in disease stage at diagnosis, while survival differences for testicular cancers seem to be due mostly to differences in access to appropriate treatment. Britain does especially poorly: > **[BBC NEWS | Health | Huge gap in world cancer survival](http://news.bbc.co.uk/2/hi/health/7510121.stm)** > > There is a huge variation in cancer survival rates across the world, an in-depth global study shows. Spending on health care was a major factor, the study of 31 countries said. Researchers said higher spending often meant quicker access to tests and treatment As you can see, you do actually get what you pay for. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [August 10, 2012, 10:34am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/74 "2012-08-10T10:34:28Z")
> [@adaher](#): > > Britain does especially poorly: > [@](#): > > although the data is from the 1990s since when survival rates have risen Cheers. Really helpful - fighting ignorace 20 years after the fact. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 10, 2012, 10:56am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/75 "2012-08-10T10:56:49Z")
Any evidence that the gap has closed and Britain isn’t still way behind? Or are we just to assume the problem is solved. I notice there’s a lot of assumptions behind UHC, mostly involving unicorns and other pony-type creatures. ---
**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\ **Post date:** [August 10, 2012, 11:03am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/76 "2012-08-10T11:03:23Z")
> [@adaher](#): > > If you have an emergency, yes, you’ll get seen today. THat’s exactly the same as the US system. What happens if you are merely in horrible pain? What happens if something might be wrong with you but you don’t know what? How long to wait for diagnostics? > > Actually, we know exactly what happens. Things like cancer get detected later and patients die: …um, no. Random google links to password protected reports do not an argument make. A few years ago my dad went to see his GP for a check up, and the doctor, following a hunch sent him straight to hospital for more tests. They found that my dad had bowel cancer: and a few weeks later they were operating on him to get it removed. Today: my dad is fitter than ever. He’s 82 and the operation was a couple of years ago. He didn’t face rationing because of his age, he didn’t have to wait too long for diagnostics and he didn’t go bankrupt paying for it. The total out-of-pocket expenses for the family was about $40.00 for the initial consultation and car parking charges on the day. Taxes paid by our family over the last sixty years took care of the surgery. You obviously have no clue how things work in UHC which is fine because this board is about fighting ignorance. But don’t pretend to be some sort of expert on the basis of a few google searches. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 10, 2012, 11:13am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/77 "2012-08-10T11:13:32Z")
The plural of anecdote is not data. And the google searches are only to find cites, which are required here. But I’m used to the waving away of inconvenient truths from the proponents of UHC. It’s practically a matter of religious faith. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [August 10, 2012, 11:20am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/78 "2012-08-10T11:20:54Z")
> [@adaher](#): > > If you have an emergency, yes, you’ll get seen today. THat’s exactly the same as the US system. Exactly the same as the US system? unless I’m woefully misinformed wouldn’t they chase you with a big bill in the US? > [@](#): > > What happens if you are merely in horrible pain? you’d get seen according to medical priority (no charge) given pain relief (no charge) and diagnostics test scheduled according to a preliminary assessment (no charge) > [@](#): > > What happens if something might be wrong with you but you don’t know what? How long to wait for diagnostics? you’ll get seen according to medical priority (no charge). Diagnosis may be today, tomorrow, next week or next month according to individual situations _but it will happen regardless of who you are or how much money you have._ Of course if you are concerned by the wait then, just as in the USA, you are free to pay a little extra (cheaper than the US) and get it done immediately. Having UHC actually just expands your choices as well as protecting you against financial disaster. And remember, this is all cheaper than the US system. > [@](#): > > Actually, we know exactly what happens. Things like cancer get detected later and patients die: You don’t think cancer detection and treatment statistics are skewed by your system? Just think of all those USA citizens who never get their cancers detected and treated because they can’t afford it and are denied treatment at all. Obviously you can only look at the outcomes for cancer detection and treatment for those people who are undergoing detection and treatment. i.e. those that can afford it. And no-one is denying the fact that the USA medical infrastructure is brilliant…_IF_ you can afford it. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 10, 2012, 11:24am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/79 "2012-08-10T11:24:02Z")
[http://www.telegraph.co.uk/health/healthnews/8171165/British-cancer-survival-rates-still-lagging.html](http://www.telegraph.co.uk/health/healthnews/8171165/British-cancer-survival-rates-still-lagging.html) Survival rates have improved, but UK still lags. Here’s the advantages to UHC: 1. Certainty. You know you have health care, regardless of income and job status. There won’t be any anxiety about what is and is not covered, because everyone is treated the same. 2. Equality. Everyone gets the same basic level of care. And that’s pretty much it. Anything else is simply made up pap to try to sell the middle class something they mostly already have. Those are enormous advantages, don’t get me wrong. YOu could probably get people to support it even in the US without trying to sell it as the awesomest thing since the Iphone. But trying to tell some of these union guys with the cozy gold-plated plans that they’d be better off if that was taken away and they were dumped into the same pool as everyone else won’t fly. ---
**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\ **Post date:** [August 10, 2012, 11:29am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/80 "2012-08-10T11:29:08Z")
> [@adaher](#): > > The plural of anecdote is not data. And the google searches are only to find cites, which are required here. > > But I’m used to the waving away of inconvenient truths from the proponents of UHC. It’s practically a matter of religious faith. …I’m sorry: did you think you were citing data? You linked to BBC articles written years ago citing statistics from decades ago. You linked to a report that noone else can read and what you didn’t cite was how the US figures were collected as opposed to how the European ones were collected. You ignored the ample cites earlier in the thread that went against your opinion. Here’s the thing though. My anecdote is typical of UHC here in New Zealand. Its simply how it works. Its not an aberration. Its not abnormal. And if you had a basic understanding of how UHC actually worked you would know this. But you don’t. My “anecdote” was about as anecdotal as a guy going for a walk outside. The anecdote I told you is how UHC works. You don’t believe it. You can’t believe it. You make reference to “ponies and unicorns” because you can’t wrap your head around the fact that UHC works incredibly well. The bad stories you hear are the abberations, not the norm, and those are the ones that need the cite. [Previous page](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644.md?page=3) [Next page](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644.md?page=5)