Dear John
I’ll admit there are incredible inefficiencies in the current system. Of course. no denying it. and you might be able to treat the inefficiencies you mention in your email with a single payer system. Fine. but you’ll get new inefficiencies when you implement your single payer system that will far outweigh the specific benefits from a single payer system you can identify right now.
It is also misleading to say the “private system” isn’t working.
We don’t have a private system.
We have a public / private system that is massively corrupted by public subsidies and further strained by a failing fully public system for old and underprivileged called medicare and Medicaid.
John, you want to blame everything on a combination of demographics and greed. You predict an “ageism” problem. the problem isn’t ageism per se, it is a system that systematically shifts resources from the productive to the unproductive individuals that make up society. That is a game the government plays.
The GOVERNMENT creates such divisions as ageism by being in the game of choosing winners and losers. Old people wouldn’t be in conflict with young if the government hadn’t designed the system to pit one group against the other.
And old people would be a lot better off if we had a system where end payers paid health care costs directly and market pressures forced healthcare providers to keep prices low – FOR EVERYONE.
Obviously we would need an insurance component to the system, but the insurance would be for catastrophic needs only; not for day to day coverage and routine drug therapies.
The far right wing of GOP is responsible for end of life issues that keep old people alive when they are vegetables. I think you’ve mentioned in past that something like 80% of healthcare costs are used up in last 3 months of people’s lives. Let individuals decide when to pull the plug. Crazy elements of religious right throw law suits at families who want to pull the plug. Another example of GOP hypocrisy – if they want a free market for health care then let people make such decisions themselves.
Insurance companies are in the driver seat in current system not because insurance execs are greedy. Insurance companies are in the driver seat because the system we have subsidizes medical insurance (via tax breaks for company sponsored insurance) and thus puts insurance companies in a position of maximum power in the system. The government created the flawed system we have.
The flawed system we have now isn’t a “market failure” or a failure of the private sector. There is no such thing as a “private health care system” here in the US.
I agree the current public/private system we have is screwed up, but it is not screwed up because of any inherent flaws in a private market for health care. markets don’t “do” anything. Markets are flawed in many ways, but government can’t fix these flaws without creating other worse flaws. Any systemic flaws in the current system (i.e price inflation and fiscal unsustainability)is caused by government policy.
You won’t fix the current system by getting rid of the private part of the current system. You’ll fix the system if you get rid of the inefficiencies caused by public policy and crazy incentives injected in the system by public subsidies and Medicaid.
John, you want to give the government total control of the current system as if that will drive efficiency!! Please explain exactly how a government monopoly will drive efficiency. I know there are a laundry list of claimed efficiencies – like ending redundancies in payment system for all the diff insurance companies. But, from a macro perspective, do you really believe that a public monopoly will be able to drive efficiencies over anything but the immediate short term??
Seriously john. think about it. do you really believe a public monopoly can sustain efficiency gains if it is not forced to be efficient based on competitive market pressures?? Forget it. believing in public monopolies is a pie in the sky fantasy.
I know it sounds great to have one payer and you can envision all of these great “savings” but the problem with a one-payer system is the same as any utopian scheme. It can’t work in the real world because any efficiency gains from one payer system will more than be offset by inefficiencies bred by an inherently corrupt government monopoly.
Is that to say the market system will be perfect. no of course not. But first let’s disentangle the problems the market faces currently that are inherent flaws in the market and problems that are caused by public policy. and then lets admit that the public sector isn’t going to be able to fix inherent market flaws with enlightened mandates and monopoly powers. Anything the public sector does to fix one problem will trigger a train of unintended consequences that cause some other related set of problems … that will inevitably be blames on the so called market.
If one payer systems are so great, why don’t we have a one payer system for housing, finance, education, automobiles, etc, etc? one payer systems ultimately prove unsustainable fiscally because there is no incentive in the system for continued efficiency gains in the system as a whole.
All humans are greedy. And businessmen are going to be greedy and maximize their rent seeking activities when they have a government facilitated “monopoly” like private insurance execs have; John, what do you think will happen when we give the monopoly over to politicians??? All humans are greedy, and bureaucrats will be just as corrupt as private insurance execs. With a single payer system you will just exchange one set of corrupt execs for another set of corrupt bureaucrats.
The answer is competition. Greed isn’t the problem. the problem is government mandated monopolies that allow individuals to game the system without consequences. If a company is filled with crooked employees, eventually it will go out of business. If a government monopoly is filled with corrupt bureaucrats, which is will be eventually, because humans are greedy, then the system still stays in business and the tax payer gets screwed.
That is what has happened with public education. the unions (and Democratic party) hold the public education system hostage for their own selfish purposes. tax payers get screwed. The political elite and organized labor laugh all the way to the bank.
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