# Vermont uses ACA to launch single-payer health care **URL:** \ **Category:** Great Debates\ **Created:** [November 25, 2013, 4:46pm UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762 "2013-11-25T16:46:00Z")\ **Posts on this page:** 13\ **Page:** 14
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [November 28, 2013, 12:42am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/261 "2013-11-28T00:42:39Z")
> [@elucidator](#): > > Because _freedom_! If they get control of our health care, they will turn our nation into a festering hell-hole like Sweden, or, **God forbid, _Canada_!** Holy crap! We would have to start being _polite_! ---
**Author:** ![Farin](https://avatars.discourse-cdn.com/v4/letter/f/e79b87/32.png) [@Farin](https://boards.straightdope.com/u/Farin)\ **Post date:** [November 28, 2013, 12:49am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/262 "2013-11-28T00:49:18Z")
> [@runner pat](#): > > Holy crap! We would have to start being _polite_! Oh, Anglophone Canada? That’s not so bad. The Francophones are rude as heck. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 28, 2013, 2:04am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/263 "2013-11-28T02:04:03Z")
> [@Mr.Duality](#): > > [Here’s a cite](http://economix.blogs.nytimes.com/2008/11/21/why-does-us-health-care-cost-so-much-part-ii-indefensible-administrative-costs/) saying medical administration overhead amounts to 21%. Apples and oranges. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [November 28, 2013, 2:10am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/264 "2013-11-28T02:10:19Z")
> [@runner pat](#): > > Holy crap! We would have to start being _polite_! We could try the crack-smoking drunken stupor thing, too. ---
**Author:** ![Mr.Duality](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mr.duality/32/4098_2.png) [@Mr.Duality](https://boards.straightdope.com/u/Mr.Duality)\ **Post date:** [November 28, 2013, 2:22am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/265 "2013-11-28T02:22:20Z")
> [@Terr](#): > > Apples and oranges. So you are one of _those people_ who think apples and oranges can not be compared. I suspected as much. I am seriously peeved by people who say that I can’t compare apples and oranges. They are both fruit, dammit. They both grow on trees. They have comparable contents (i.e. vitamins, carbohydrates, fiber, and so on) and grow to comparable sizes. So puh-leez don’t tell me that apples and oranges can’t be compared. They are prime candidates for comparison. Apples and oranges have in fact been subjected to rigorous scientific comparison [(cite)](http://www.improbable.com/airchives/paperair/volume1/v1i3/air-1-3-apples.html) and have been found to be quite similar. ---
**Author:** ![Mr.Duality](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mr.duality/32/4098_2.png) [@Mr.Duality](https://boards.straightdope.com/u/Mr.Duality)\ **Post date:** [November 28, 2013, 4:13pm UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/266 "2013-11-28T16:13:44Z")
To add a quote from my cite, “Thus, it would appear that the comparing apples and oranges defense should no longer be considered valid.” ---
**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:** [November 28, 2013, 9:32pm UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/267 "2013-11-28T21:32:25Z")
> [@Human\_Action](#): > > His point is a good one: Americans are already paying quite a bit for government healthcare, and paying yet more for private healthcare. And for what? The care isn’t any better, it just costs more. If everyone could be well covered for what we already pay in taxes, meaning that the bulk of what’s spent on private care could be used for other things, where’s the harm? Yes. That is my point. That and a little bit more. Take the British NHS as an example. In these discussions, people sometimes forget that the NHS isn’t something the British have that Americans totally lack. It is something the UK has **instead of** Medicare, Medicaid, IHA, VHA, etc. That grouping of health care providers together covers 28 % of the US population. The NHS covers 100 % of the UK population. Americas government health care programs costs 4000 per American per year. The NHS costs 2900 per citizen per year. $ 1100 less per citizen. That is not a small difference. That is an **enormous** difference. To the US, that difference represents 340 billion dollars per year. To add some scale, the US military budget is 680 billion. Anyone here ever thought the US was overspending on the miitary budget? The US spends the equivalent of half the military budget on government healthcare \*\*over and above \*\*what the UK spends on government healthcare. Per person. And UK government healthcare covers everyone. And over 70 % of Americans have to spend money on private healthcare in addition to that. And that is 4500 $ per person. Even **more** money. Its not that “everyone could be well covered for what we already pay in taxes” its that everyone could be well covered for\*\* a lot\*\* less\*\*. [Cite for the numbers.](http://www.oecd.org/unitedstates/Briefing-Note-USA-2013.pdf) ---
**Author:** ![Kobal2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kobal2/32/20_2.png) [@Kobal2](https://boards.straightdope.com/u/Kobal2)\ **Post date:** [November 28, 2013, 10:10pm UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/268 "2013-11-28T22:10:18Z")
> [@Human\_Action](#): > > His point is a good one: Americans are already paying quite a bit for government healthcare, and paying yet more for private healthcare. And for what? The care isn’t any better, it just costs more. If everyone could be well covered for what we already pay in taxes, meaning that the bulk of what’s spent on private care could be used for other things, where’s the harm? Well, obviously the harm is to the checkbook of insurance execs, for-profit health organizations folks and their respective lobbyists. And surely you can’t wish to harm checkbooks, unless you’re a Red. So when did you start hating America, exactly ? [QUOTE=ElvisL1ves] We could try the crack-smoking drunken stupor thing, too. [/QUOTE] Well the thing is, the American health care system as it stands seems to me to have involved crack-smoking drunken stupor extensively already. ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [November 28, 2013, 10:17pm UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/269 "2013-11-28T22:17:34Z")
You know, if it wouldn’t be so annoying to all the people involved, I’d love to read/see more dialogue between American conservatives and countries with single payer/universal-type systems — to see how the former would express to the latter why they’re so oppressed and the American system (pre-ACA) is so superior, and how the latter would respond. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [November 28, 2013, 11:38pm UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/270 "2013-11-28T23:38:42Z")
They would gob-smack their foreheads and say “Shit! Why didn’t I see that!” and rush out to join the movement to repeal. Which they hadn’t done before because nobody told them how miserable they were. 'Cause, you know, our health care system is the envy of the world. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 29, 2013, 12:21am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/271 "2013-11-29T00:21:26Z")
US may soon lower the difference between average wait times to see specialists in the US and in Canada - by hiking up the US wait times. > **[Medicaid Growth Could Aggravate Doctor Shortage (Published 2013)](https://www.nytimes.com/2013/11/29/us/lack-of-doctors-may-worsen-as-millions-join-medicaid-rolls.html?partner=rss&emc=rss&smid=tw-nytimes)** > > Under the new health care law, a wave of additional Americans will soon be covered by Medicaid, a program that has struggled with a shortage of doctors willing to accept its low reimbursement rates and red tape. Obamacare tries to fake the doctors out by temporarily increasing Medicaid payments to lure them in. They must think physicians are stupid. ---
**Author:** ![Human\_Action](https://avatars.discourse-cdn.com/v4/letter/h/ac91a4/32.png) [@Human\_Action](https://boards.straightdope.com/u/Human_Action)\ **Post date:** [November 29, 2013, 1:32am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/272 "2013-11-29T01:32:16Z")
> [@Terr](#): > > US may soon lower the difference between average wait times to see specialists in the US and in Canada - by hiking up the US wait times. > > [http://www.nytimes.com/2013/11/29/us/lack-of-doctors-may-worsen-as-millions-join-medicaid-rolls.html?partner=rss&emc=rss&smid=tw-nytimes](http://www.nytimes.com/2013/11/29/us/lack-of-doctors-may-worsen-as-millions-join-medicaid-rolls.html?partner=rss&emc=rss&smid=tw-nytimes) > > Obamacare tries to fake the doctors out by temporarily increasing Medicaid payments to lure them in. They must think physicians are stupid. Well, here’s the problem: > [@](#): > > On top of that, only about 57 percent of doctors in California accept new Medicaid patients, according to a study published last year in the journal Health Affairs — the second-lowest rate in the nation after New Jersey. Payment rates for Medicaid, known in California as Medi-Cal, are also low here compared with most states, and are being cut by an additional 10 percent in some cases just as the expansion begins. Offer doctors peanuts for treating Medicaid patients, and of course they’ll balk. > [@](#): > > “Having been in the trenches with Medi-Cal patients who have serious eye problems,” he said, “I can tell you it’s very, very hard to get them in to see those specialists.” And for this, we pay over $4,000 per taxpayer? To hell with that. ---
**Author:** ![NiceGuyJack](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/niceguyjack/32/3069_2.png) [@NiceGuyJack](https://boards.straightdope.com/u/NiceGuyJack)\ **Post date:** [November 29, 2013, 9:10am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/273 "2013-11-29T09:10:41Z")
> [@Terr](#): > > Belarus’ and Belgium have the same number of doctors per capita. Do you their health systems’ quality is comparable? Egypt has more doctors per capita than the US. Do you think Egypt’s health system is on the same level as the US? Lebanon’s number of doctors per capita is the same as Italy’s. Do you think that correlates to the health system’s quality in those two countries? Belgium would likely have more advanced equipment and facilities. So, yes a richer country would tend to have better health care because they can afford to spend on it. Surprise surprise. The US does indeed have the advanced equipment and facilities, but not everyone has access to it. So, if you are rich and well off, the US health care is grade A. If you’re poor, not so good. Like accidentally cutting off two fingers, you can only afford to pay to save one, which finger to chose? In Belgium, you would keep both. By the way, I’d like to point out that some doctors could still continue private practices in Vermont for elective health care, such as plastic surgery, or so I would assume. Electives wouldn’t be covered under single payer. Correct me if I’m wrong. [Previous page](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762.md?page=13)