This issue is the one that’s most likely to sway an American practitioner over to the idea of single payer universal. Here are the different situations for doctors as it was explained to me once by a Canadian physician:
U.S.: Pay 1-3 full-time staff whose main job is to negotiate with 10+ for-profit insurers (each with their own plans and coding) in the hopes of collecting 50-cents on the dollar for a claim.
Canada: Pay one contractor for 8 hours of work a month to get the billing in order and submit claims to the government, collecting 100-cents on the dollar without negotiations.
For doctors whose primary goal is to practise medicine the choice between these systems would seem like a no-brainer, except that in the U.S. conservatives and Libertarians have spent decades scaring them with the boogeyman of “soshalism.” The Canadian doc told me that when he explains this in speeches to American doctors he can almost see the lights go on in their heads.
It’s not outside the realm of possibility for a right-wing populist to institute a universal social welfare programme like health care. The trick for the savvy fascist is to make sure that “universal” excludes anyone except his voting base and to make sure that “social welfare” doesn’t do anything that makes Jeebus cry (e.g. empower women).
Also, that cartoon. Wow. I thought it was satire a la The Onion’s “Stan Kelly” until I looked Ben Garrison up.
Note how Garrison also completely leaves poor Steve Bannon on his own, as if Gorka, Flynn, Conway, Spicer, Page, DeVos, etc. (not to mention Putin himself) aren’t doing their part for the alt-right in the tug-o-war with Da Joooos (including the late and unlamented Roy Cohn?!).
That’s what breaks when you think about healthcare. Car insurance is a pool of risk, health insurance is kind of a combination of a risk pool and a buyer’s club – you know you will need healthcare at some time, and a reasonable amount of preventative care has a cost as well. So, how do you price that? And how do you balance things so that you aren’t rationing care to keep that price reasonable?
My problem with government involvement is that I don’t trust them with my private medical data, and that I don’t want them policing my lifestyle. In practice, you have a government that discourages smoking while subsidizing tobacco and cheap corn syrup. My experience with Medicare in my family is that it’s very wasteful in some areas and stingy in other important ones.
There’s a lot of broken stuff that needs to be fixed all around.
My mom had a bad ovary - one miscarriage by her first husband (that’s a story there!), and five with my dad. They were married in '51, and she had three more before my brother was born in '57. Her last one was when she was more than just spotting and didn’t know she was pregnant and they put her on the Pill - BIG MISTAKE!
Nah, we’re tail-end Boomers; we’re not gonna get hated on for another ten years or so.
There are a few managed care organizations (Kaiser Permanente comes first to mind) that free physicians up from running a business and let them focus on patients. No hassling with the insurance company when you already work for them. Not always great for the patient, but there’s a reason why KP has such great physician satisfaction scores.
My ex was the first child in Germany to be fitted with a pacemaker at age 4. It was open heart surgery and there were 4 specialists in attendance. The family was ready to put together the money to get them there from Switzerland and the US but the government insurance said that if the doctors would agree to come then they would pay for it. Pacemakers for kids used to have to be replaced every 5 years because the batteries gave out. How many surgeries have there been? I don’t know. How much has it cost the country of Germany? I don’t know and no one is asking because that would be like asking, " how much is a person worth?"
