(no subject)

[violachic]

Can someone explain single payer health care, and its pros and cons, as if I were eight years old? Everyone seems all excited about this, but I'm still skeptical. Maybe I'm missing something.

Comments

[madresal.livejournal.com]

I also am skeptical.

[sabotabby]

A proposed American plan, or single-payer health like we have here? I can explain the Canadian system a bit, as we've made a lot of use of it lately.

[violachic.livejournal.com]

Well, I've never actually been entirely clear of the details of the Canadian system, so if you can explain, I'd be obliged.

[sabotabby]

Disclaimer: I am not an insurance expert, I just played one at my old job.

Tax dollars go to the government. The government (in my case, Ontario) basically has one big insurance fund, called OHIP (Ontario Health Insurance Plan). This is our insurer for most medical expenses, but instead of paying them directly, you're paying them through the government. Accordingly, it's free to go to almost any doctor. (Prescription drugs, eye care, dental care, etc. aren't covered, but they could be if the plan were better. That's why the definition of a good job here still involves having benefits.)

There are several clear advantages to this. First, the way any insurance company works is that the more people buying into a plan, the cheaper the rates. Since everyone in the province buys into the plan (through their tax dollars), we get a better deal than we would through a private insurer.

Most relevant to people with serious health problems, like my step-dad, is that it removes much of the profit motive from frontline healthcare. He's had to undergo all sorts of experimental treatments that not even the best insurer in the U.S. would have covered, and that would have bankrupted our family several times over.

Next, you don't need to pay up front. Everyone gets a health card (and even if you lose it, it's not like they're going to deny you treatment), and you just show that and you're in. It's not like you foot the bill and then they pay you back, because a hell of a lot of people wouldn't have the money to front, and thus would avoid seeking medical help when they need it.

Finally, health care ends up being cheaper in the long run. For one thing, because of the sheer number of people involved, the insurance payments are decreased. But more importantly, there's not a situation where someone is too poor to go to a doctor, and then they get worse, requiring more expensive treatment. There are all kinds of cool alternatives too, from remote healthcare to phone lines where you can call in, to some doctors in Toronto who have started making house calls again (seriously, this was so awesome; one time my housemate and I got bronchitis and we felt too shitty to go to the hospital, so we called this number and a doctor came to our apartment).

I'm not saying it's perfect by any means—there are waiting lists (though not really where I live, and not for life-threatening things), and it still does cost more than it needs to. Also they really need to cover more things—I've had to bail people out to buy antibiotics and stuff. But the solutions all point to making it more socialized, not less.

The important thing is that we don't have people dying or going into lifelong debt because they were unlucky enough to get sick. I never bitch about our system anymore because I know my step-dad would have died years ago if he still lived in the States.

[divineaspect.livejournal.com]

The Government pays for all basic health care, emergency, and preventative.

Think Medicare (Thats even what most other countries systems are called) for everyone, where only 8 cents a dollar are spent for administative costs, vs Private Insurance where only 11 cents a dollar are spent on health care the rest being pocketed by the insurance companies.

That's why the AMA and other big lobbying groups for the Health Insurance Industry are trying desperately to kill it. It would cut their profits by a huge amount.

The idea is that this gives the government tremendous shopping power when demanding economies of scale. Theres the whole social justice thing, as well as the fact that healthy people are more productive. And people who know they have health coverage are more comfortable taking the kind of risks which could help the economy without worrying about their families losing their corporate health care plan.

Single payer, doesn't actually prohibit anyone from having private insurance if they want it.

Any clarification needed?

[violachic.livejournal.com]

No, that's great, thanks. I'm all for universal health care.

[grahamwest.livejournal.com]

It means everybody pays the same amount and it all goes into a giant pool of money and that money is used to pay everybody like doctors and hospitals and pharmacies.

If you're poor you don't have to pay anything, if you're rich you usually have to pay more - it's normally done by payroll taxes.

When you see a doctor, or go to the hospital, or get a prescription filled, you don't have to pay anything. In Britain there's a fixed fee for prescriptions, it doesn't matter what you're getting or how many different things, it's just for getting _something_.

The advantage is it's hassle free. You make your appointments, show up and get treated. It cuts down on the paperwork you have to do, too.

The disadvantages are that you have less options. The system is paying, not you, so you can't override your doctor and go see a different specialist, for example. Also that one giant pot of money is all there is to fund the whole system so if there's more to do than the money can afford there are delays with appointments and treatment and so on. Hospitals can get run down because there isn't spare money to paint them or provide new furniture and so on. Money can be wasted because being efficient isn't a natural outcome of this system; they try to be careful but patients don't have to care about wasting money and neither do doctors because they know they'll be paid.

In Britain, and I would imagine everywhere else too, you can still buy private medical insurance. There are private doctors, private hospitals and so on that you can either pay out of pocket or use private insurance for; sometimes the government program pays for treatment at those places. My Dad's girlfriend had treatment last year and her private insurance covered it; she said it was like a hotel - the quality is definitely higher than the government system.

Given that you can supplement your options with private insurance and that there's no worrying about financial ruin if you have something rare or your insurance has lapsed because you're not working, I think it's a good system.

[violachic.livejournal.com]

Thanks, that's a very clear explanation.

Can you speak to the critics of Britain's NHS?

[sabotabby]

The system is paying, not you, so you can't override your doctor and go see a different specialist, for example

You totally can here. I mean, you might have to do some shouting, but it's not impossible. I don't think it's feature of the system.

[themiddlestates.livejournal.com]

I "voted" on something on FB, and then read the comments. Reading the comments made me want to vomit.

It seems like there's so much misinformation out there, it's hard to know up from down.

[sabotabby]

There's a lot of money in making America's health care system inefficient and sadistic. You guys have probably the nastiest system in the industrialized world, but it's very profitable for a few, so quite a bit of cash goes into disinformation.

[anansi133.livejournal.com]

The Entry on Wikipedia is pretty informative, and it links to a lot more good background stuff.

I had thought that "single payer" meant only one financial entity was footing the bill, but it seems to have more to do with only one pool of consumers. The industry wants to divide us up into how expensive our claims are more likely to be- that's how the profit motive is maintained. If we're all a single pool of insurance buyers, then the profit motive goes out the window.

The plan being touted now, "public option" still has the government in competition with private insurers, keeping the rates high and delivered service low. The issue isn't going to get resolved until we decide that medical coverage should not have a profit motive.