Survey: 59% of American physicians now support UHC

Great Debates
61

[QUOTE=BrainGlutton]
No, I presume we need to learn all we can from their examples, good and bad – and the same WRT education, transportation, and a lot of other policy areas. America pays far, far too little attention to how other countries do things.
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Perhaps, but in looking at other nations’ health care systems, those who support single-payer in the U.S. pay far too little attention to the drawbacks of these systems.

Again, every system has both good points and bad points. It’s about trade-offs.

Perhaps, but since pretty much every nation (including the U.S.) has at the very least a quasi-socialist health care system and all are very, very flawed, it’s a very limited question.

Again, looking at how the government distorts the health care system supports the notion that more government will make things worse, not better.

62

[QUOTE=brazil84]
By the way, a few years ago, the same survey asked doctors if they favor a so-called “single payer” health care plan where health care is paid by the federal government.

26% favored such a plan; 60% opposed it. That’s a pretty wide margin – a bit wider than the margin trumpeted in the original post in this thread.
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Yes . . . as noted in the OP . . . The breaking news here is that they have changed their minds.

63

[QUOTE=BrainGlutton]
Yes . . . as noted in the OP . . . The breaking news here is that they have changed their minds.
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Ummm, no. The percentages in that article refer to a different question. A question that does not mention single payer plans.

The most recent question regarding single payer plans was responded to with a resounding negative by the self-selected sample of doctors in the survey.

64

[QUOTE=Renob]

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Medicaid, which is essentially a universal health care system for people of certain incomes. I know that many doctors don’t participate due to low reimbursement rates and complicated paperwork. What makes them think that any “universal health care” plan would be different?
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let us parse this

Medicaid – is government/taxpayer subsidized payment for health services
doctors don’t participate – accept patients who have Medicaid
Medicaid – denies payment for services
Medicaid – doctors clerical costs are not supported by doctors income
Medicaid – doctors risk of not being paid is to high

points:

  1. Medicaid is a form of national health insurance subsidized by the taxpayer
  2. All Hospitals and on staff doctors participate in Medicaid by law

conclusions
Supply of private practice doctors is reduced for constant demand increases price.

Healthcare problem #2
Medicaid is broken in 2 ways
a. does not stimulate competitiveness
b. Cost of clerical overhead in hospital and government regulators is passed on to taxpayer

Healthcare problem #1 (restated)
Doctor insurance company and lawyer relationships are broken in 3 ways
a. Doctors cannot satisfy the customer
b. Doctors practice is not controlled by doctor so
b. Higher than necessary Malpractice insurance costs are passed through to customer

65

Double post.

66

[QUOTE=DrCube]
Anything is better than what we have now. If the winds are blowing towards UHC, then we might as well give it a shot. That doesn’t mean I wouldn’t rather have the free market do its magic. But we have to do something.
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let us parse this]

Anything is better – Oh really: let’s subsidize shamans, faith healers, and snake oil salesmen.
the winds are blowing – your mouth is open
free market do its magic – The market has not been free for a long time

points:

  1. A free market was at a time when the old country doctor existed.
  2. The market is controlled by insurance co., lawyers, and government and therefore not free.

Conclusions:
Poster typifies why UHC is such has been a perennial issue.
Many of us if not a large majority decide our position regarding UHC based on how we feel!

Dope:
Doctors are the most unemotional people that I know.
If they debated why a person should live die they could not go on to the next patient.
In order to define what UHC looks like we must do it unemotionally.
Emotions cloud the rational mind.

Health care problem #3
Patients and taxpayers approach health care with emotion such as:
a. jealous that others appear to be receiving better treatment
b. fear of an ugly diagnosis and shamed by evidence of poor lifestyle choices
c. Anger that have a health care issue
d. Love for our fellow man.
e. Sadness that others might die
f. Happy all the medical breakthroughs might save them in the future.

67

[QUOTE=Renob]
I would disagree that “it’s much better” than what we have here. It has better aspects, I’ll agree, but it also has worse aspects. I may depart from some of my free market brethern here, but I don’t know if we can accurately say that one system is “better” than the other. They are different and do different things well. If you place more value on everyone being covered, then you go with Canada. If you place your value on more patient autonomy, you go with the U.S.
We have gotten worse results the more government has gotten involved in U.S. health care. Again, government has distorted the market to a huge extent producing significant problems. It makes no sense to me that we’d want more government when government has proven to be the problem in many instances.
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Well, if you place more value on longer life expectancies with less percentage of GNP spent on health care, you would also go with Canada. These seem to me to be the sort of things we should be placing value on. I’m interested in knowing why you perceive the US system as offering more “patient autonomy”. You do know that Canadians are free to receive care from any doctor they choose, right?

WRT the second paragraph, I don’t think it’s true that we are getting worse results than we were a couple decades ago, but the percentage of GNP devoted to health care is certainly rising at an unsustainable rate. And I would submit that this is due to the rising influence of HMOs; it’s not as though there has been any sweeping expansion of the role of government in health care since the introduction of Medicare and Medicaid; so why have things suddenly gotten worse in the recent past?

68

[QUOTE=Renob]
At the bottom is Medicaid, a government single-payer system that produced horrible care.

You appear not to understand what “single payer” means. It means that, for EVERYONE in the country, there is only one agency in charge of paying for health care. Medicaid is just one of the multiplicity of payers in the US system. It covers people who could not otherwise afford to purchase insurance. There are definite issues with access to care, since many doctors choose not to accept Medicaid’s low reimbursement rates (contrary to what some have claimed above, I have not heard that the paperwork burden or failure to pay valid claims is a major obstacle to doctors accepting Medicaid – I can certainly tell you from personal experience that these are major hassles in dealing with private insurance companies). However, as I stated above, there are obvious political reasons why a system which benefits ONLY the poor has trouble getting adequate funding from a government elected largely by the non-poor. And I am eager to hear what your proposed alternative to Medicaid would be – these people should just have no insurance coverage at all and depend on those doctors who are willing to work entirely for free? Do you really think they would then be better off?

69

[QUOTE=Thing Fish]
You appear not to understand what “single payer” means. It means that, for EVERYONE in the country, there is only one agency in charge of paying for health care. Medicaid is just one of the multiplicity of payers in the US system. It covers people who could not otherwise afford to purchase insurance.
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Exactly, it is a single-payer system for poor (and not-so-poor) people. And it pays for crappy service.

Please show me years Medicaid funding (at the state or federal level) decreases.

I’m actually not opposed to Medicaid for the poorest of the poor. I think it’s a pretty horrible system, though, and I wouldn’t wish it on anyone. I certainly wouldn’t wish it on those who have the resources to pay for their own medical care but are prevented from doing so by the government (as is the case in many single-payer nations).

Longer life expectancy may or may not have anything to do with quality of health care. There are a lot of things that end life early that cannot be remedied by the best health care systems in the world. If I get shot in the face, for instance, my family could rush me to the Mayo Clinic and I’d probably be dead.

And that care may or may not take a long time. And they may be denied care. And they cannot choose to pay for private care. Is that how you define freedom?

There is excellent evidence that the introduction of Medicare caused much of the health care spending inflation.

70

[QUOTE=Renob]
I would disagree that “it’s much better” than what we have here. It has better aspects, I’ll agree, but it also has worse aspects. I may depart from some of my free market brethern here, but I don’t know if we can accurately say that one system is “better” than the other. They are different and do different things well. If you place more value on everyone being covered, then you go with Canada. If you place your value on more patient autonomy, you go with the U.S.

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People have posted links to life expectancies and dollars per capita spent on healthcare in othe countries innumerable times. The results show their system is better. If you place more importance on your free market faith rather than having people living longer for less money, so be it.

My daughter is going to study in Germany next year. If my insurance won’t cover her there, she has to buy health insurance. For a whole 59 Euros a month. But we have the freedom not to buy it, so we’re better, huh?

71

[QUOTE=Voyager]
People have posted links to life expectancies and dollars per capita spent on healthcare in othe countries innumerable times. The results show their system is better. If you place more importance on your free market faith rather than having people living longer for less money, so be it.
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Again, trying to tie life expectancy to health care is a tricky proposition. There is a lot that effects life expectancy (genetics, for one, and lifestyle) that has nothing to do with health care. There are also things, as I pointed out above, that will kill you no matter what health care system you have. The US has a very high rate of gun fatalities compared to other nations. Are you saying that doctors in Canada know some secret to cure gun shots that doctors here don’t have? Are you saying that there’s some secret cure for diabetes in Canada? Are you saying the Canadia health care system causes people to eat healthier and smoke less?

72

Life expectancy, as Renob says, is a lousy measure of a country’s health care. The U.S. has many, many more fatal transportation accidents than other countries. The U.S. homicide rate is 10 times England’s, 8 times France’s and 5 times Canada’s. Are these good things? No, of course not. But they are not health issues, and wouldn’t change if every citizen was put on the health plan that Congress gets. If you want to get a true picture of life expectancy WRT health care, adjust for these “fatal injury” rates. When you do that U.S. life expectancy is actually higher than in nearly every other industrialized nation.

73

[QUOTE=Weirddave]
Yea there is. America, 30 years ago.
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How was the American health system in 1978 any (1) more free-market and (2) better than it is now?

74

[QUOTE=Thing Fish]
Well, if you place more value on longer life expectancies with less percentage of GNP spent on health care, you would also go with Canada. These seem to me to be the sort of things we should be placing value on. I’m interested in knowing why you perceive the US system as offering more “patient autonomy”. You do know that Canadians are free to receive care from any doctor they choose, right?
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I read your paragraph to my Canadian wife. She laughed and said “Sure, if you can find one”. “What do you mean?” I asked. “There’s a shortage of doctors” she said. “Ahh. But you can go to any doctor you want, right?”. “Oh ya, any GP, if you can find one taking new patients. If you want to see a OB/Gyn something you have to get a referral.” I found this exchange interesting, especially in light of your next paragraph:

[QUOTE=Thing Fish]
WRT the second paragraph, I don’t think it’s true that we are getting worse results than we were a couple decades ago, but the percentage of GNP devoted to health care is certainly rising at an unsustainable rate. And I would submit that this is due to the rising influence of HMOs;
[/quote]

Even if this is the case (And I give it a “maybe”), the health care system in Canada that you are lauding so much, in fact, the health care system in every other western nation that has socialized medicine, is run the same as an HMO. Limited access. Primary care physicians. Referrals needed for everything. Any government run system has to be run along these lines because there is only a finite amount of care available. So, I ask you, if HMOs are the problem, why do you think instituting one giant HMO run by the government is the solution?

[QUOTE=Thing Fish]
it’s not as though there has been any sweeping expansion of the role of government in health care since the introduction of Medicare and Medicaid; so why have things suddenly gotten worse in the recent past?
[/QUOTE]

Actually, there has been a tremendous increase in Government interference in the delivery of health care in the last few decades, HIPAA (The Health Insurance Portability and Accountability Act of 1996) alone has cost doctors, hospitals and insurance companies hundreds of billions of dollars in compliance costs; each new person inserted in the chain to ensure that the ever increasing number of Byzantine rules are followed adds more cost, more paperwork and more bureaucracy to a system that is already overburdened. The solution isn’t to put more government in, it’s to get the government we already have clogging up the system out.

75

Oh, and an interesting aside: Many other countries, you know, the ones that the Socialists like to tout? They are starting to move back towards free market health care, at least to some extent.

76

[QUOTE=BrainGlutton]
Well, I’m sure they’re not thinking of a British-style National Health Service. Maybe a Canadian-style singler-payer system, but that is not “a tax funded health rationing system.”
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From what Brazil84 cited in post 42 it appears that doctors do not support a tax-funded care system but the title of this thread implies that they do. I would think it a no-brainer that most doctors want their patients to have health insurance.

I would welcome a government mandate for health insurance just as we now mandate car insurance. I realize prices have risen over the years but the onus to take financial responsibility for anything in this country is on the decline.

77

Lol. Why are we debating single payer systems? The most recent survey by the same folks who did the survey from the OP asked doctors about this issue. The doctors were against a single payer system by a wide margin. That’s highly persuasive isn’t it? Isn’t it?

78

[QUOTE=Magiver]
From what Brazil84 cited in post 42 it appears that doctors do not support a tax-funded care system but the title of this thread implies that they do.
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How does it imply that? The cite said, “Only 26% of all physicians supported a national health insurance plan in which all health care is paid for by the federal government.” A UHC system can be one in which only some of it is paid for by the government, like the Clinton “managed care” plan in 1993, which would have left the health insurance companies in existence and in the system; as does the plan on which HRC is currently running, though whether that one is really UHC is debatable.

79

[QUOTE=Weirddave]
If you want to get a true picture of life expectancy WRT health care, adjust for these “fatal injury” rates. When you do that U.S. life expectancy is actually higher than in nearly every other industrialized nation.
[/QUOTE]
Sorry to have to resort to this but … cite please.

Cause while I don’t have the cite handy I seem to recall figures looking only at “avoidable deaths” which was defined as deaths that would have been avoidable with health care, not including things like murder, that showed that countries with universal healthcare are improving whereas the US is stuck and falling farther behind.

80

[QUOTE=DSeid]

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Believe it or not many docs actually did go into the field because we care about the health of our populous.
Yes, I take (a limited amount of) Medicaid patients. And I limit for exactly those reasons.
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Most people having some sort of insurance that at least covers the basics and that gives people the option of dealing with things before they are ER catastrophes - that we like.
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let us parse this

we care about the health of our populous – Doctors are motivated and fulfilled to provide service
Yes, I take (a limited amount of) Medicaid patients – But service only at price and terms doctors set.
ER catastrophes - that we like – liked because of challenges and extra monetary compensation.

Conclusions:

Doctors typically abide by th Declaration of Geneva. AKA Hippocratic Oath .
Doctors are capitalist and participate in a market economy.
Doctors are somewhat altruistic “I solemnly pledge myself to consecrate my life to the service of humanity”

Health care problem #4
The Hippocratic Oath is not immutable.
as in
“The amendments to the Declaration have been criticised as “imping[ing] on the inviolability of human life” because, for example, the original made “health and life” the doctor’s “first consideration” whereas the amended version removes the words “and life”, and the original required respect for human life “from the time of its conception” which was changed to “from its beginning” in 1984 and deleted in 2005.[5] These changes have been criticised as straying from the Hippocratic tradition and as a deviation from the post Nuremberg concern of lack of respect for human life “ see Declaration of Geneva - Wikipedia