# UHC/Single Payer in the US...how would you do it? **URL:** \ **Category:** Great Debates\ **Created:** [July 3, 2017, 3:09pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433 "2017-07-03T15:09:46Z")\ **Posts on this page:** 11\ **Page:** 4
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [July 7, 2017, 2:25pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/61 "2017-07-07T14:25:27Z")
> [@Northern\_Piper](#): > > That’s an article from 24 years ago. With a greater awareness of identity thefts, Canadian governments have been amping up the security features on a lot of government-issued ID. I’d be curious to see if there is still an issue. Thing is, I don’t know of any more recent study. So it may well be a case of “its not an issue as long as no-one makes it an issue.” Physicians don’t like to tell people they can’t treat them,and there seems to be a lot of nod-and-wink in relation to Americans getting their perscriptions filled on the Canadain side of the border. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [July 7, 2017, 2:25pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/62 "2017-07-07T14:25:49Z")
> [@Tee](#): > > Using this as a starting point, I have every expectation that any federal program will be rejected by half of the country. Half the country? Or the politicians representing half the country? ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [July 7, 2017, 2:49pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/63 "2017-07-07T14:49:40Z")
> [@Grim\_Render](#): > > Thing is, I don’t know of any more recent study. > > So it may well be a case of “its not an issue as long as no-one makes it an issue.” Physicians don’t like to tell people they can’t treat them,and there seems to be a lot of nod-and-wink in relation to Americans getting their perscriptions filled on the Canadain side of the border. Coincidentally, that 24 year old article is from just before Ontario started switching to photo health cards. They never went whole hog to make everyone switch as initially intended so about 80% of the population has photo cards and the rest old style cards. [Ontario launches push to eliminate red and white health cards - Government pushing new photo health cards to help deter fraud](http://www.cbc.ca/beta/news/canada/toronto/ontario-launches-push-to-eliminate-red-and-white-health-cards-1.3205933) ---
**Author:** ![davida03801](https://avatars.discourse-cdn.com/v4/letter/d/b5e925/32.png) [@davida03801](https://boards.straightdope.com/u/davida03801)\ **Post date:** [July 7, 2017, 8:10pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/64 "2017-07-07T20:10:08Z")
> [@Ravenman](#): > > You are reading sources that tell you what you want to hear. Would not that be true on both sides ? Strong advocates for any subject generally ignore the negative aspects of the subject they promote. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [July 7, 2017, 8:28pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/65 "2017-07-07T20:28:33Z")
> [@davida03801](#): > > Would not that be true on both sides ? Strong advocates for any subject generally ignore the negative aspects of the subject they promote. Sometimes but if everything you’ve heard about the Canadian and UK system is negative you are definitely getting the wrong impression. There are problems, of course, but I showed you the Gallup poll that shows satisfaction with healthcare access in those countries is way higher. There’s numerous neutral accounting of the systems that show it’s cheaper per capita in those UHC countries with most health data as good or better than US numbers. I’m going to go out on a limb and say all the negatives you’ve read about Canadian healthcare were wait times and new procedures not covered so people had to go State-side to get it done. That is a valid concern in many cases but the Gallup poll shows, that’s a trade off that makes for happier citizens. I know this as a Canadian and I’ve heard it from Brits, as much as we’ll sometimes complain about it, UHC is a treasured part of our society and it would be political suicide to suggest getting rid of it. ---
**Author:** ![Tee](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@Tee](https://boards.straightdope.com/u/Tee)\ **Post date:** [July 7, 2017, 8:57pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/66 "2017-07-07T20:57:02Z")
> [@Quartz](#): > > Half the country? Or the politicians representing half the country? Half of the people in the country. There is a whole other school of thought here that believes the federal government involvement in health care led to the current problems, and/or that trying to fix the problems is overextending its power. Their solution is free markets. To be fair I think that argument has merit in our current system, but it’s usually part of a complete anti-liberalism package that wants to dismantle social programs altogether, because they’re immoral, expensive, job-killing or whatever. So, for example you can come here and find any number of people who are a) ill, b) on fixed incomes via Social Security, and c) covered by Medicare, who despise the government and want the ACA repealed yesterday. And again to be fair, they may or may not recognize their own situations but the complaints are like “my daughter has to pay more for her insurance than her mortgage,” or something to that effect. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [July 8, 2017, 1:28pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/67 "2017-07-08T13:28:36Z")
> [@davida03801](#): > > Really. What I read about the UK and Canadian systems is quite negative. Please provide the cites with the glowing reviews of either. **Muffin** provided an interesting set of stats over in the “What is Canada” thread in IMHO, which I’ll just re-post here: > [@So just what is the 'meaning' of Canada?](https://boards.straightdope.com/t/so-just-what-is-the-meaning-of-canada/790340/54): > > Canadians live longer than Americans: > 79.3 years = Canadian life expectancy (2001) > 77.0 years = American life expectancy (2001) > > Canadians enjoy better health longer than Americans: > 69.9 years = Canadian healthy life expectancy (2001) > 67.4 = American healthy life expectancy (2001) > > Canadian individuals and insurers do not pay as much as American individuals and insurers: > 28 = Canadian private expenditure on health as % of total expenditure on health (2000) > 55.7 = American private expenditure on health as % of total expenditure on health (2000) > > Canadian taxpayers do not pay as much for health care as the American taxpayers: > $1826 = Canadian per capita government expenditure on health in international dollars (2000) > $1992 = American per capita government expenditure on health in international dollars (2000) > > Less of Canada’s GDP is spent on health than the USA’s: > 9.1 = Canadian total expenditure on health as % of GDP (2000) > 13 = American total expenditure on health as % of GDP (2000) > > World Health Organization stats: [http://www.who.int/whr/2002/annex/en/](http://www.who.int/whr/2002/annex/en/) So, Canadians pay less public money for UHC than Americans do for non-UHC, and get better results. ---
**Author:** ![Urbanredneck](https://avatars.discourse-cdn.com/v4/letter/u/ea5d25/32.png) [@Urbanredneck](https://boards.straightdope.com/u/Urbanredneck)\ **Post date:** [July 9, 2017, 10:11pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/68 "2017-07-09T22:11:11Z")
Question: in Canada and the UK are hospital workers and doctors actually government employees? Like civil servants? I hear they are in France. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [July 9, 2017, 11:14pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/69 "2017-07-09T23:14:08Z")
> [@Urbanredneck](#): > > Question: in Canada and the UK are hospital workers and doctors actually government employees? Like civil servants? I hear they are in France. IIRC, in Canada and the U.K., physician groups contract with the government but run their own practices or work for a government funded hospital. They are not civil servants like a DMV clerk. (Here in the states, my physician is employed by University of Washington Medicine, so I guess she is a government employee in a sense.) Your information about France is [wrong](https://en.m.wikipedia.org/wiki/Health_care_in_France). > [@](#): > > Most general physicians are in private practice but draw their income from the public insurance funds. > \ > There are public hospitals, non-profit independent hospitals (which are linked to the public system), as well as private for-profit hospitals. ---
**Author:** ![Evan\_Drake](https://avatars.discourse-cdn.com/v4/letter/e/b487fb/32.png) [@Evan\_Drake](https://boards.straightdope.com/u/Evan_Drake)\ **Post date:** [July 9, 2017, 11:34pm UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/70 "2017-07-09T23:34:25Z")
> [@Velocity](#): > > Not quite the answer you’re looking for, but for an example of the “compassion” of the \*\*\*ACA \*\*\*itself, I went to an ER three years ago. The only procedures that were performed were a blood test and some other examinations. Cost: $1,400. > As others have said, the Affordable Care Act isn’t very affordable. > [@davida03801](#): > > Really. What I read about the UK and Canadian systems is quite negative. Please provide the cites with the glowing reviews of either. Well, as said in another thread: A few months ago I came off a ladder and smashed up my right arm. I cleaned myself up with one arm dangling and grating, dialled 999 and awaited a disgustingly long time in the front garden for an ambulance who hadn’t been instructed my case was, as I thought, urgent. They examined me etc. and took me to hospital where I was stretchered in, given morphine and all that necessary stuff: in the morning I had a 3-hour operation, wherein they deliberately broke my elbow to reset it with a lot of wire, had a cast, had more drugs, stayed another night and discharged myself the next day. Follow-up care included 2 more casts and lots and lots of X-Rays, courtesy of Dr. Röntgen’s marvellous invention. I was charged nothing for the ambulance ride, for the operation, or for the hospital stay. £0.00. Nor for physio after, in a separate NHS doctors centre. If I had private insurance, which everyone can take out, it would only have got me a better hospital room. You may see why Britons are rather terrified of American system’s supplanting the NHS; however I think **personally** change in _America_ is impossible and will not happen due to capitalist inculcation since childhood that brainwashes the populace for the service of the regime. It cannot happen and all that can be attempted is petty amelioration and some, probably doomed, half-hearted cost-cutting. As with gun-control, no need to keep losing votes on issues that are unwinnable. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [July 10, 2017, 12:57am UTC](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433/71 "2017-07-10T00:57:27Z")
> [@Urbanredneck](#): > > Question: in Canada and the UK are hospital workers and doctors actually government employees? Like civil servants? I hear they are in France. In Canada, the great majority are private, self-employed physicians. They run their own clinics and bill the Medicare system of their province or territory for payment. They’re responsible for all the business decisions about their clinics, just like any other private business. In running their clinics, they do have to comply with health care regulations (e.g. cleanliness, keeping meds secure, and so on), but that’s similar to any other regulated business, like the food prep standards at restaurants; doesn’t mean that they’re government employees. The hospitals are publicly run, with the administrative structure varying with each province. The hospitals will employ some doctors, but the majority of the doctors in a hospital are private doctors who run their own clinics, and have “admitting privileges” at the local hospitals in their area. Again, admitting privileges doesn’t make them government employees. It means that they have the power to send a patient to the hospital for treatment, and to treat their patients in the hospital. [Previous page](https://boards.straightdope.com/t/uhc-single-payer-in-the-us-how-would-you-do-it/790433.md?page=3)