I agree in principle. The implementation details escape me. If a parent is covered by an employer, is that same plan going to be forced to cover the kid? If not, are all insurance companies going to be forced to write a policy for him? Will the cost be roughly equivalent of the parent’s coverage, though of course the kid pays the company allotment. Are the insurance companies then not going to be allowed to refuse pre-existing conditions, or jack up individual rates for them? In other words, in the interests of portability, are you going to force a company to perhaps lose money on this kid?
A single payer system, of course, provides portability. One argument for it is that in today’s system some people who might want to leave their companies to start a new one might not be able to afford to because of healthcare. In a place with a single payer system they could, and I think that would increase the number of small businesses and thus the economy.
Reducing overhead in insurance companies should do something. But do you really want Congress micromanaging doctors and hospitals? And, as I said, any attempt to make the system face hard choices, like in end of life care, will bring screams of “death panels” from morons like Palin and her Fox friends.
This may be a question quickly answered by someone more familiar with Canada’s health care system, but I recall hearing that they pull it off by having higher taxes and by having more restrictions on picking doctors. Any truth to that?
I am reasonably familiar with both systems (my family is split between the US and Canada and includes doctors on both sides. American doctors, particularly specialists make a lot more than their Canadian counterparts, and a big part of this difference is due to the doctors in the US having the optionif dropping participation in health plans that do not pay them “enough” while in Ontario at least you would lose 99% of your patients if you dropped OHP.
But the Canadian doctors are happy to get paid more than their British and Australian colleagues.
But part of the reason that “enough” for the American doctors is two to five times what the Canadians find sufficient is that the US doctors have higher costs dealing with insurance. Part of those higher costs are in turn an attempt by the doctors to define what the do as the highest billable, and the insurance companies’ response is to dispute the coding. So you have the absurd case of a doctor who cannot run his practice billing $600 per hour, while in Canada the GP is living quite well billing $250.
With respect to end-of-life care, I don’t think it’ll reduce healthcare costs all that much. Although Medicare provisions do focus on cost containment, one of the very biggest elements of Medicare is beneficiary choice and transparency. My take is that the purpose of that particular provision is to give the patient more of a say in their own treatment, before they’re in a precarious situation where they or their family members may not make the best choices.
Most hospitals now offer a living will and medical power of attorney at the time of treatment if you don’t already have one (dependent on the treatment, of course - they wouldn’t offer one to stitch up a superficial cut probably). However, most people would agree that when you’re in a lot of pain and/or are very ill is not the appropriate time to be making life or death decisions.
Having a living will and/or medical power of attorney is just common sense. I was shocked with Republicans spun it the way they did. I mean, I knew they’d have a lot to say about the bill in general, but that was such an outright fabrication it made my head spin. Nowhere in that portion of the healthcare bill does it mention weighing the costs of staying alive versus the relative “worth” of the patient.
It shouldn’t have been that surprising. I guess I was just of the opinion that deliberately lying specifically to terrify an already-vulnerable population was considered off limits. I’m not saying that’s never happened before in politics - I just hadn’t seen it done so blatantly, probably because I’d never before had to read such a contentious piece of legislation while it was being debated. My reaction was mostly, readreadreadreadread, “Wait, what? Huh?”