# 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:** 6
**Author:** ![Mdcastle](https://avatars.discourse-cdn.com/v4/letter/m/958977/32.png) [@Mdcastle](https://boards.straightdope.com/u/Mdcastle)\ **Post date:** [August 11, 2012, 1:24am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/101 "2012-08-11T01:24:06Z")
The bottom line is we can’t afford to give everyone unlimited healthcare. So there has to be some limitation, whether it be limited by the government, insurance companies, by how much you can pay, or some combination of above. ---
**Author:** ![fumster](https://avatars.discourse-cdn.com/v4/letter/f/e9c0ed/32.png) [@fumster](https://boards.straightdope.com/u/fumster)\ **Post date:** [August 11, 2012, 2:58am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/102 "2012-08-11T02:58:16Z")
> [@adaher](#): > > Unless your feelings are unanimous, the reduction in benefits for being a doctor will result in fewer doctors than there would otherwise be. So I guess that explains why the US ranks 52nd in doctors [per-capita](http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people). This is really sad, like watching a train wreck, as you pull one ridiculous statement after another out of your rectum. We get it: you are a Libertarian and you will never, ever accept the fact that UHC might work better than a market based model. This despite not 1, or 5, or 10, but dozens of existence proofs. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 11, 2012, 3:23am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/103 "2012-08-11T03:23:26Z")
Fewer doctors than there otherwise would be. That can be made up by importing doctors from the Third World, of course. The US doesn’t make it easy for foreign doctors to practice here. In addition, the AMA controls the supply of doctors. If we removed those controls and limits on foreign doctors to conform more with what EU countries have, we could have more doctors at lower cost. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 11, 2012, 3:24am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/104 "2012-08-11T03:24:41Z")
> [@Mdcastleman](#): > > The bottom line is we can’t afford to give everyone unlimited healthcare. So there has to be some limitation, whether it be limited by the government, insurance companies, by how much you can pay, or some combination of above. That is indeed the bottom line. Trying to deny the tradeoffs is childish and a product of dogmatic, ideological thinking. ---
**Author:** ![RickJay](https://avatars.discourse-cdn.com/v4/letter/r/bb73d2/32.png) [@RickJay](https://boards.straightdope.com/u/RickJay)\ **Post date:** [August 11, 2012, 4:37am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/105 "2012-08-11T04:37:52Z")
> [@Mdcastleman](#): > > The bottom line is we can’t afford to give everyone unlimited healthcare. But _nobody consumes unlimited health care._ The demand for health care is inherently limited by a person’s health and the non-monetary costs of accessing health care. ---
**Author:** ![medicated](https://avatars.discourse-cdn.com/v4/letter/m/7ab992/32.png) [@medicated](https://boards.straightdope.com/u/medicated)\ **Post date:** [August 11, 2012, 5:18am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/106 "2012-08-11T05:18:34Z")
> [@RickJay](#): > > Canada. Not really. For the most part, doctors are forbidden to bill the public and private systems at the same time. That does tend to heavily discourage private treatment of, say, broken legs or ulcers. It doesn’t touch various other areas that aren’t covered by the provincial systems. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 11, 2012, 5:43am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/107 "2012-08-11T05:43:26Z")
> [@RickJay](#): > > But _nobody consumes unlimited health care._ The demand for health care is inherently limited by a person’s health and the non-monetary costs of accessing health care. Demand can be nearly unlimited for chronic or terminal conditions. Medicare is a single payer system that doesn’t try to control costs except through negotiating prices. They do not limit access. and as we see with Medicare, you cannot save enough money by getting lower prices alone. At some point the government has to say no to 90-year olds wanting hip replacements. ---
**Author:** ![fumster](https://avatars.discourse-cdn.com/v4/letter/f/e9c0ed/32.png) [@fumster](https://boards.straightdope.com/u/fumster)\ **Post date:** [August 11, 2012, 6:23am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/108 "2012-08-11T06:23:00Z")
> [@adaher](#): > > Fewer doctors than there otherwise would be. That can be made up by importing doctors from the Third World, of course. The US doesn’t make it easy for foreign doctors to practice here. In addition, the AMA controls the supply of doctors. If we removed those controls and limits on foreign doctors to conform more with what EU countries have, we could have more doctors at lower cost. Do you have a point beyond your libertarian fanboyism? If the AMA is the limiting factor in the number of doctors, then the fact that some people are dissuaded from being doctors due to lower compensation does not matter, as there are other people willing to take those positions. You libertarians always sing the same tune: if we just let the market alone all would be good. If the market does not do a good job it’s because it wasn’t a \*true \*free market. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [August 11, 2012, 6:42am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/109 "2012-08-11T06:42:45Z")
> [@RickJay](#): > > If you’re saying UHC is a choice people express through their vote, then Americans are given that choice every two years. Anytime they want they could elect a slate of candidates to Congress who promised to implement real UHC. They keep choosing otherwise. I’m sure you know they population is propagandised to hell, and to the point very many vote against their own best interests - and even the best interests of their family. US healthcare is the longest, most successful con in the history of democracy. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [August 11, 2012, 6:44am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/110 "2012-08-11T06:44:51Z")
> [@Mdcastleman](#): > > The bottom line is we can’t afford to give everyone unlimited healthcare. So there has to be some limitation, whether it be limited by the government, insurance companies, by how much you can pay, or some combination of above. The USA can’t afford 10% of GDP to take care of the entire population, but it can afford 17% (and climbing) to take care of 80% of the population? ---
**Author:** ![SanVito](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sanvito/32/2805_2.png) [@SanVito](https://boards.straightdope.com/u/SanVito)\ **Post date:** [August 11, 2012, 7:04am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/111 "2012-08-11T07:04:12Z")
> [@adaher](#): > > So let’s see if I understand this. Someone can be driven to malnutrition by housing costs that make up 50% of their income, but a tax burden of 50% can’t possibly be the culprit? Who has a tax burden of 50%? I’m a reasonably paid professional in the UK, and my income tax comes in at about 20%. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 11, 2012, 7:09am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/112 "2012-08-11T07:09:32Z")
> [@fumster](#): > > Do you have a point beyond your libertarian fanboyism? If the AMA is the limiting factor in the number of doctors, then the fact that some people are dissuaded from being doctors due to lower compensation does not matter, as there are other people willing to take those positions. > > . What if we just reduce doctor compensation without increasing supply? Would the public support making it easier for Third World doctors to practice in the US without going to US medical schools? Can the AMA lobby be beaten in Congress and more medical schools slots opened up? And in the short term, how would this be paid for? We already have a higher education bubble and that will have to be solved as well. The fact is, if providers take the hit without any other policies in place to increase doctor supply, we will have fewer doctors than we do now. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 11, 2012, 7:12am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/113 "2012-08-11T07:12:59Z")
> [@SanVito](#): > > Who has a tax burden of 50%? > > I’m a reasonably paid professional in the UK, and my income tax comes in at about 20%. There are other taxes. The UK’s revenue is 40.8% of GDP. [https://www.cia.gov/library/publications/the-world-factbook/geos/uk.html](https://www.cia.gov/library/publications/the-world-factbook/geos/uk.html) Spending is actually right under 50%, which is the real rate of taxation, since that money must be paid back at some point. There is just no way taking 50% of the income of the country’s earners is not going to push some people into financial trouble. ANY other expense that was that high would be blamed for a bankruptcy. ---
**Author:** ![Gleena](https://avatars.discourse-cdn.com/v4/letter/g/b3f665/32.png) [@Gleena](https://boards.straightdope.com/u/Gleena)\ **Post date:** [August 11, 2012, 7:23am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/114 "2012-08-11T07:23:27Z")
> [@adaher](#): > > There are other taxes. The UK’s revenue is 40.8% of GDP. > > [https://www.cia.gov/library/publications/the-world-factbook/geos/uk.html](https://www.cia.gov/library/publications/the-world-factbook/geos/uk.html) > > Spending is actually right under 50%, which is the real rate of taxation, since that money must be paid back at some point. > > There is just no way taking 50% of the income of the country’s earners is not going to push some people into financial trouble. ANY other expense that was that high would be blamed for a bankruptcy. That’s…weird thinking, dude. I’m a reasonably paid Australian professional with a tax rate of just about 25%. We have UHC and private cover like the UK. I don’t think you can argue ‘real rates of taxation’ when you’re arguing that individuals are put in the poorhouse by 50% rates of tax. That’s just weird. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 11, 2012, 7:28am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/115 "2012-08-11T07:28:40Z")
It’s only weird because you’ve been taught that taxes don’t count since it’s not really your money. You never had it in the first place, so you can’t complain that it’s making you poor. ---
**Author:** ![Gleena](https://avatars.discourse-cdn.com/v4/letter/g/b3f665/32.png) [@Gleena](https://boards.straightdope.com/u/Gleena)\ **Post date:** [August 11, 2012, 7:34am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/116 "2012-08-11T07:34:19Z")
> [@adaher](#): > > It’s only weird because you’ve been taught that taxes don’t count since it’s not really your money. You never had it in the first place, so you can’t complain that it’s making you poor. Yeah, no. I’m an American as well, so I’ve heard that argument. It’s not true, mind, but I’ve heard it. It’s the cost of living in a civilized society. It’s not making me poor at all. You claim a 50% tax rate, but you’re unable to show that for reasonably paid professional in the UK (or in AU, I’d say). When someone shows up and says they don’t pay that, you do a song and dance about effective tax rates. I get the just asking questions routine you’ve got going on here, but on this point your facts don’t stack up. Also, it remains sloppy thinking. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 11, 2012, 7:43am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/117 "2012-08-11T07:43:29Z")
the money comes from somewhere. you pay sales taxes, a VAT, property taxes, social insurance taxes, and income taxes, correct? What do you think that all adds up to? ---
**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 11, 2012, 8:03am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/118 "2012-08-11T08:03:18Z")
> [@adaher](#): > > the money comes from somewhere. you pay sales taxes, a VAT, property taxes, social insurance taxes, and income taxes, correct? What do you think that all adds up to? so do you think that if your taxes were reduced that relative disposable income would increase? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 11, 2012, 8:16am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/119 "2012-08-11T08:16:45Z")
Absolutely. How could that not be the case? Why are do Americans have so much more disposable income than everyone else? > **[Disposable household and per capita income](https://en.wikipedia.org/wiki/Household_income#Median_equivalized_disposable_household_income_.28PPP.29_.24)** > > Household income is a measure of the combined incomes of all people sharing a particular household or place of residence. It includes every form of income, e.g., salaries and wages, retirement income, near cash government transfers like food stamps, and investment gains. > Average household incomes need not map directly to measures of an individual's earnings such as per capita income as numbers of people sharing households and numbers of income earners per household can vary significantly between... ---
**Author:** ![Spoons](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spoons/32/3141_2.png) [@Spoons](https://boards.straightdope.com/u/Spoons)\ **Post date:** [August 11, 2012, 9:35am UTC](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644/120 "2012-08-11T09:35:36Z")
> [@adaher](#): > > Absolutely. How could that not be the case? Why **are do** Americans have so much more disposable income than everyone else? Because they don`t spend anything on grammar education? [Previous page](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644.md?page=5) [Next page](https://boards.straightdope.com/t/socialized-medicine-and-single-payer-systems/630644.md?page=7)