The Bad…

Single-payer health care is “socialized medicine”

That’s not true, but what if it were???  Why must “socialized” be a bad word? We have socialized fire and police and other vital public services. Why not also health care as they have in France and Germany, two of the highest ranked systems in the world? Are we so hung up on ideology that we must sacrifice pragmatism?

Our own VA and armed forces systems are “socialized,” though the VA has been significantly overloaded with Iraq veterans and Bush underfunded it over the last 8 years. But were it made a public option it would certainly be bolstered or it wouldn’t be used.

Medicare is a government-funded system, with its administration contracted to a private company that pays the private hospitals and private physicians. The system is not perfect and needs reform itself, but it is better than the private insurance industry that has a financial incentive to deny care.

But the government will stand between you and your doctor!

Wow! If I have my choice between having the government between me and my doctor, versus an insurance CEO whose salary and bonus is determined by the amount of patient care he can deny, I’ll take the government any day. One can be unelected, the other can’t be.

Remember the 17-year-old girl in California that died because she was denied a transplant? That was a private health care insurer in search of profits, not the Medicare system.  

That said, if there are things not covered by Medicare they can be purchased directly; you know, the old-fashioned free-market “conservative” way. What’s not to like about that?

But as well, a Medicare-for-all system also means the politicians would be included, so it’s not likely they’ll let it degrade.

The government should not be treating patients

Of course they shouldn’t, and they aren’t now with Medicare and they won’t be with a single-payer system. But opponents will stop at nothing to present “the sky is falling” scenarios.

Strangely, the one group that would benefit the most — businesses — has been duped by their insurance friends to lobby against their own best interests. Strange bedfellows.

Government care will be degraded

That’s simply hogwash. Medicare is the same service as any private plan, and the malpractice attorneys will keep it that way. Besides, who really thinks that for-profit care won’t deteriorate, specifically to increase profit margins? 

Doctors are quitting out of Medicare

Some doctors are opting out of Medicare because … drum roll please … they can!!!  They’ve built their practices to the point that they can avoid Medicare and go only with private insurers which often over-pay for testing (sometimes 4x Medicare rates).

But having spent 25 years as a health care provider I argue that Medicare rates are generally fair. They’ve established their fee schedule based on actual costs (labor, technology and locality). But some privates are still reimbursing “reasonable and customary,” which in lay terms is “whatever you can get away with.” And the insurers pay it because they don’t want to alienate the physician community at this point in time, and they pass the increased costs on to the employers.

And often the over-payments are necessary for physicians to offset their costs for charity care and bankruptcies and bad debt. But with the HR676 single payer system those losses are zero. Every bill is paid by the government system.

GPs and FPs will abandon medicine if not fairly paid

Clearly Medicare must increase its formula for paying GPs and FPs. But it must also allow nurse practitioners to treat minor illnesses and move minor care to retail clinics like those in Walgreens and other pharmacies. And with everyone now having health care the ERs will be freed for emergency care.

There is no Constitutional right to health care

Well of course not. But the taxpayers pay for thousands of things because they have been determined to be a “common good.” And in this case it saves taxpayer dollars by eliminating the inefficiencies common with free market services.

Now Kennedy is proposing “insurance mandates”

So think about it. The insurance bureaucracy is our main problem and is currently draining 31% of health care costs, and now Sen. Ted Kennedy wants to mandate insurance for the remaining 45 million of people that are currently uninsured! 

Wow. I wish I had more insurance stock, and indeed wish the government had mandated that 100% of Americans own my product when I was in business.

But this is a direct reflection of the $46 million in campaign contributions from the insurance industry. Aren’t politicians just great? You’d have thought they’d learn from the failed Massachusetts model, but they didn’t. The insurance industry just loves Mitt Romney, the Governor that signed it into law.

So now we have to add more expenses for investigative and legal costs to ensure that everyone buys an insurance plan whether they can afford to or not!

No, we need zero waste, not more of the same.

And here’s a business owner that can’t afford his mandated insurance and Sen. Max Baucus doing his best to convince us that single-payer is bad. This guy should be unemployed at the earliest opportunity.

Isn’t it funny that we can reject paying higher taxes for an efficient health care system, but do not reject charging the public for an inefficient insurance bureaucracy?

Just like in Canada, we’ll have wait times and rationing

We won’t be like Canada. Their problem is inadequate funding; ours is systemic waste. We spend 16.5% of GDP versus their 10%. If they increased funding by just 10%, to 11% of GDP, they’d not have wait times either. Or alternatively they could remove one person out of every six from their system, as we do here in the U.S., and they’d eliminate their wait times too.

And rationing? Nothing could be worse than the rationing we do here in the U.S. by eliminating 45 million people from the system altogether. 15% of our people are going without health insurance. Now that is rationing!

Or they use the process of rescission, cancelling the policy based on some minor omission on the application, even if they cancel after you’ve scheduled an expensive, life-saving surgery.

Or alternatively we can look at rationing as the patient care that is denied to people who have insurance, like the 17 year old girl in California that died when she was denied a needed transplant by her private insurer.

No, this country should not be talking about rationing. We are deep into it already.

Any government plan will kill true competition

First, there is no such thing as competition in health care. Few mothers will seek out the lowest bidder to care for their family. In fact, those facilities with higher prices will be perceived as providing higher quality, though nothing could be further from the truth.

A national patient database could provide competition on quality, and the VA’s VistA system is the best. It’s open-source and free for the asking, but our politicians prefer the hundreds of private IT companies instead. Follow the money. Politicians will always prefer private companies to public entities because one can give campaign contributions and the other can’t.

And listen, if “private” really is more efficient than “public,” the insurance industry should be ecstatic about competing with Medicare. But it’s not, and they are so frightened that only $46 million in campaign contributions will soothe their fear.

Medicare and Medicaid are already breaking the budget

Well Yea, Medicare and Medicaid are running in the Red. We know that. What else would you expect after the 2003 $780 billion drug giveaway?

But we can reform the drug plan by taking away the windfall subsidy by the government, and the public supports a tax increase to pay for health care. That solves its deficit problem! We spend it here or we spend it there. If we transfer it from privatized to public funding we can save $400 billion in the process. Don’t reduce physician fees, eliminate the waste.

Why are we waiting? Mandating even more insurance bureaucracy is not the answer.

Think about it! $46 million!

That money came from profits on healthcare premiums that you or your employer contributed. And it’s going into our politician’s campaign funds. Insurance is one profitable business, and it’s well worth the $46 million in political bribes that are necessary to keep the inefficient bureaucracy in the loop. It’s money that need not be given for politicians to do the right thing, only the wrong thing. They do the right thing for free, but to do the wrong thing they must spend $46 million. Aren’t our politicians great?

What will happen if we keep what we have?

Nobody is going to like this outcome. The employers are simply not going to roll over to the insurers’ constant increases. They’ll start bringing health care in-house. Motorola and Kohls and other companies already do this, and contract directly with physicians and hospitals.

Sometimes they will be very good at it, and sometimes not. They are almost always at the whims of the CEO, and if he doesn’t believe in certain things (like stem cell treatments) that could be a problem. If it becomes a drain on profits or renders the company uncompetitive, more problems.

Physicians and hospitals will not like the downward pressure on price and ultimate corporate control. And the insurers raking in today’s profits will no more. They’ll be on the outside looking in. That might be the only positive.

Like it or not, Medicare or a VA-type of system will be the best for everybody. Especially the patients, if they count at all. Both Medicare and the VA should be opened up to the general public. 

But fear not. Winston Churchill once said “America will always do the right thing, but only after everything else fails.”

We will eventually get it right. It just depends on how long the public is willing to leave it in the hands of the conflicted politicians.


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