I will have a longer post shortly on a “model” that single-payer health system advocates put out supposedly showing big savings, etc. from moving the US to a single, government-run payment system. In the meantime, one of the primary advocates for this, David Cutler, has published yet another of his delusional op-eds full of misleading information and outright lies. I would think that the experience of other countries with this system would be enough to show that they don’t save money, unless care is rationed and denied, or you can adopt the Canadian approach, which is to simply kill citizens with high health care needs. No one gets better care than an American with a private health plan, no one has better outcomes for a specific disease. Everywhere else care is limited, some treatments aren’t even available.
Among the idiotic claims Cutler makes is that administrative costs would be lower with a single-payer system. The federal government spends an incredible amount of money administering Medicare, Medicaid and other health programs and they don’t even do most of the basic administrative work, like processing claims. Private plans do that. He says people would get more preventative care, but the research shows that fee-for-service, government-run Medicaid and Medicare do a much worse job at that than do the contracted health plans for the same programs. And so on. But at least he has become more realistic, as he notes that from a budget perspective this is impossible. He might also have taken a lesson from Obama’s disastrous Un-affordable Care Act, which has driven costs up for everyone. (JAMA Article)
The JAMA article makes the following statement – “In 1993, President Bill Clinton’s proposed health care reform plan did not pass. When Republicans took control of both the House and Senate in 1994”
AKA “HillaryCare”
A few reminders regarding “HillaryCare ”
Hillary’s task force tried to model the program after the Canadian system with the limitations associated with retaining private & employer provided insurance. Under the Canadian system doctors used various methods to circumvent the restrictions imposed under their system. Under “hillarycare” , attempts by doctors to circumvent those restriction had proposed criminal sanctions.
Under “hillaryCare ” one method to control costs was the restrictions on various medical services deemed “ineffective” . One of those restrictions written into the plan was a ban on mammograms prior to age 50. 20 years ago, I had an employee at age 33 that had a very aggressive form of breast cancer that would have killed her in 2-3 years. Under “HillaryCare ” she would be dead at age 35-36. She is no longer an employee, but still a good friend and alive today.
Very few countries actually have single payer systems; most have hybrid public-private systems. For example, when I worked in Canada, my employer had a private plan to help with all the stuff the government plan did not cover. The main example of true single payer is the UK system. That is a warning. What advocates call “Medicare for all” would actually end up being “VA for all”.
Almost every western country permits some form of private insurance, usually supplemental, including England. And people can self-pay, but obviously only the pretty well off can afford that. England has a government-run health system as well, and that is the real disaster, enormously inefficient, long wait times, often poor outcomes. I do find it interesting that these overwhelmed national systems are increasingly turning to encouraging people to end their lives, often in questionable circumstances.
The use of private “supplemental” insurance in England is so normalized that it was mentioned on “The Marlow Murder Club” shown in the US on PBS. A character didn’t have the money for supplemental insurance to be able to see a specialist sooner (she was a lawyer, by the way) and so turned to theft. It was mentioned very matter of fact in the show.
yes, for those who can afford it, it is the only way to get decent access to care in England
I spent a fair amount of time visiting insurance companies throughout Asia, Europe and Mexico that were all tasked with creating a private health insurance product to supplement the failing government coverage, or in some cases, outright replace the Government coverage altogether. It is basic demographics. Aging population requires more healthcare services and pays little or no taxes = Aged dependency. Small percentage of population actually paying the taxes that support the government scheme. In many Asian countries there is barely just over 1 worker for each retired person. The options are raise taxes on those that are earning which impact other aspects of the economy (housing) or reduce the services that are covered by the Government scheme.