If you want my initial reaction to the article you quoted it is this:

This "Doctor" may be good at "doctoring," but he doesn't understand the "business" side of healthcare very well, especially since exactly what he is "arguing for" has been staring him in the fact as a REALITY for a number of years, decades as a matter of fact. (Just one example: do you, or the author of the article, have any idea what the COST is to an employer for WORKERS COMPENSATION INSURANCE and UNEMPLOYMENT INSURANCE? GUESS who THAT insurance premium is PAID TO? To the government, not an insurance company, because it is MANDATED by the State.

I know it because I've been on "both sides" of the street, Mr. W.

I was a PROVIDER of services. I knew my costs and I sent the bills out.

I am an independent insurance agent so that *I* can find the best products and companies for my CLIENTS. I have a responsibility to the insurers to NOT commit fraud and "play by the rules" established by the STATES concerning insurance.

But I get the sense that all you want to do IS to argue and not discuss and evaluate a difficult subject. IF that is the case, I'd really rather you just said so, and I can save myself a LOT of time better spent on "other things," like the IDIOCY of the impending AEP (Nov. 15 to Dec. 31) for Medicare recipients (a large percentage of my client base), the ONLY time of the year that Medicare allows Medicare recipients (all the MILLIONS of them) to make changes in their plans, most of which changes REQUIRE Medicare to approve them AND offer NO protection for an agent or an insurance company.

To give you an idea of the "idiocy," consider this: during the 6 weeks provided for changes, a person COULD change their mind and change their plan choice EVERY DAY if they wanted to. Regardless of how many times they actually did, ONLY the "last choice" before the cut off date of Dec.31 would actually BE effective.

By the way, if you really want to see the idiocy of the government "running" healthcare, you should look at the implementation of Medicare Part D (for prescription drugs) when it first came out. I could tell you a number of "nightmare" stories from my clients when it became MANDATED that they had to take a Medicare Rx plan, and that there is a 1% percent PER MONTH PENALTY for every month that an eligible Medicare recipient chooses NOT to pay for an Rx plan. THAT penalty is "tacked onto" the cost for a plan when they DO choose to get one, and it stays tacked on for the rest of their lives. (in other words, Medicare "forces" someone to pay for Rx coverage that they don't need because they are healthy and penalizes them if they don't want to pay for something they aren't using or to pay so "someone else" can have the coverage).

Now, how many people pay a "retainer" or a contract with an attorney to PAY for their assistance REGARDLESS of outcome? In my business there is NO obligation to pay for anything any insurance agent does for a client. We are paid by the insurance company, and then ONLY if the client buys something. IF they later cancel their policy, the insurance company "takes back" the commission it paid to the agent. In other words, the agent is NOT paid a salary, and IS totally "on the hook" for performance on a "straight commission" basis. ALL of my "overhead," is MY problem, not the clients' and not the insurance company.

I carry "Errors and Omissions" insurance. Mr. W., imho, what you are doing right now is essentially an "omissions" offense where you are trying to focus the argument ONLY on the "who pays for it" side and not the total "problem" or issue. In the interest of "full disclosure," you need to begin to address the various component issues of the entire healthcare delivery system.

Here on MB, most of us are familiar with the "omissions" issue as being REAL and relevant to a "full picture" of what is really going on.

Here's an interesting video reflecting what is happening across the country.

Notice that it's not only this father that is impacted but his employer and all the other employees at his company as well.

Working man - son's desease


The website www.guaranteedhealthcare.org has many other video's depicting what is going on around the country that everyone should check out. Just because it's not you today...doesn't mean it won't be tomorrow.

Mr. Wondering

FH,

I've done a little research and I'll try to throw some numbers around a bit.

I can't begin to give sources for each and every number so I apologize up front if they are wrong or outdated as I'm not giving them to be exact numbers. The numbers are out there for any one to look up on their own off the links already provided or a simple google search.


In 1990...US Healthcare spending was 717 billion
In 2004...US Healthcare spending was 1,878 billion

I have seen the number +30% as the adminstrative, advertising and profits expense burden that the Health Insurance Industry places on top of the cost of the actual delivery of healthcare in the US; however, I have seen that number stated as 350 billion. Thus, I conclude that the 350 billion estimate must have been a prior year, like 2000 or 2000 as those are the years the US cost of healthcare crossed the 1 trillion dollar threshold.

I could be wrong...but this may mean that in 2004 the cost of the Health Care Industry was more like $563 billion.

On the other hand, maybe the $350 billion dollar estimatated savings some of the single payer healthcare website reference is the difference between the admistrative costs the government would incur versus the health insurance industry. For example, eliminating the Private Health Insurance Industry may save the entire system $563 billion but somebody has to administer it, and if the Government were to incur say a 10% cost, the savings computation would be $563 billion less $188 billion or $375 billion saved by eliminating the health insurance industry as the middleman.


Whatever...there is no denying that a single payer system WILL save billions of dollars. IMO, even a $100 billion would be big enough to consider it.


You have also argued for tort reform and argue lawyers are part or most of the problem. I find this to be a grossly inappropriate attempt to deflect attention away from the Health Insurance Industry cost on the system.

Again...these are just numbers I found out there on the internet. They could be off substantially....but even if they were it still would demonstrate the huge disparity between the burden of your industry versus the burden of malpractice attorneys on the Healthcare System in total.

In a recent year the medical malpractice industry cost on healthcare was estimated at $6.7 billion. I think that number includes payouts, premiums, court adminstration, experts, etc.. $6.7 billion is not even comparable to $350 billion. $6.7 billion is less than 1% of the total $1,878 Billion cost of healthcare in the US. Most malpractice cases are handled on a contingent legal fee basis of around 33%, thus, the lawyers you like to complain about likely take home less than $2 billion total per year with approximately, say, $4 billion going to INJURED PERSONS. (which I presume you are OK with people injured being compensated to a large extent...remember, most settle) I read one study that estimated only 13% to 16% of all malpractice claims in the US represented claims absent true medical errors. That means that the burden of the shocking and supposed onerous fraudulent claims of malpractice only total about $1 billion. $1 billion only represents .053% of the total cost of Heathcare in the US. Disgusting sure...but not nearly disgusting as the 350 times greater burden/cost of Private Healthcare Insurance in comparison.

Even if these numbers are WAY off..they could never far enough off to justify the "blame the lawyers" rhetoric we so often here from the Medical Establishment.

That is not to say some Tort Reform wouldn't be helpful. We have caps in Michigan and although I think they are too low (and you would too if something happened to you), I do think they help both sides come to reasonable and timely settlements which substantially reduce the cost of the most expensive part of malpractice cases...neverending litigation. A reasonable cap removes the casino effect from the litigation system and would be advantageous. I think caps and rules also make the system less contentious and more accessable. A very low number of medical errors actual result in malpractice payouts.

I also wouldn't mind seeing Medical Tribunal's wherein payouts for all the true medical errors would be handled expediently and more people would be able to more easily seek redress. Less BIG payouts but the likely the same dollars spread out to more ACTUALLY injured persons.

I don't practice in the area...so I don't mind attorney's incurring a pay cut along with doctors, hospitals, etc. (healthcare doesn't need to represent over 15% of our GDP so costs must be contained) while we all work together to eliminate the private insurance industries do nothing burden on the system.


Mr. Wondering

p.s. - Once again...under the Single Payer Health System there would still be medical malpractice lawyers and lawsuits, however, a significant portion of the typical malpractice damages include the cost of medical care and future medical care for those plaintiffs disabled but not quite killed by the medical practitioner at fault.

Mr. W.

Please note, I don't disagree with you that our current system is somewhat broken.

That being said, I must disagree with the notion of our Government going into business on any level and that includes taking over/operating our auto manufacurers, taking over/owning stock in financial institutions, and taking over/operating the health insurance industry.

Our Government was never set up to PRODUCE products that would compete with the individual person.

Government of the people, by the people, for the people is not a business entity, nor should we be allowing or supporting it to become such.


Just wanted to make a quick comment in my busy day, I have been enjoying this thread.

Mr. W., I will be the first to say that healthcare premiums are too high and that there should be coverage, not denial of coverage, available for people with "health conditions." The "issue" is not that. It is HOW should that be best accomplished without destroying the very system that provides the best healthcare in the world? IT IS NOT "solely" a "money issue." There ARE "other ways" other than a government run socialized medicine system.

However, the effects of what you proposing are much more far reaching that just a "few dollars" or even a "lot of dollars" (be it 30% for the administrative costs of insurance companies or anything else). First, I don't accept for one "New York Minute" that the government would "save" that alleged 30% in administrative costs as the Government itself has no "profit motive" and has no "accountability" to anyone for what it does. It simply establishes beauracracy that is bloated and inefficient and arbitrarily assignes "payments" regardless of true COST to the providers.

Thus, the "administrative costs" will soar, not reduce, and the available providers WILL decline because they will choose to NOT provide the services at the rates "offered" (read mandated) by the government. The reimbursement rates, for example, for Medicare, are the same regardless of "where" in the country the service is performed. I guarantee you that the "cost" to provide the very same service is markedly different in different regions in the country, say between New York and Michigan and North Carolina and Mississippi.

Doctors are in "private practice." They are NOT members of a Union, such as the UAW.

The "average" UAW worker at Ford, GM, Chrysler, makes about $75.00 per hour by Union Contract. That is WAGES and does NOT include healthcare and pension benefits that the COMPANY must bear on their behalf (and "pass on" to the consumers in the form of higher car and truck prices).

$75.00 x 2080 (straight full time annual hours, not including any overtime) = $156,000 per year. EVEN IF benefits were included in that amount, $156,000 per year is a LOT of money to "afford" health insurance, which of course they DON'T have to do because they make the Automobile COMPANY provide it.

But guess what, NOW the automakers and union employees want YOU and ME and EVERYONE to pay for their "folly." ONLY the auto industry people will "benefit" from a bail out. It will do nothing to help the "average" non-auto industry person.

Why not sent the "bail out money" directly to TAXPAYERS and let THEM decide who to help with the cash?

THAT is always the "government response." "Throw YOUR money at problems" in the hope that it will "fix" the problem (Same thing we see with Education).All the "experts" aside, these "bail outs" WON'T work. NOTHING has changed in the base problem, which in the case of the auto industry IS the unions and management's capitulation to the Unions. It is TIME for them all to "face the music" and go out of business. LET the Union workers go find some other sort of employment. SAVE the taxpayer money and let the "Free Market System" work.

All the businesses that exist to support the Auto Industry can likewise "go under."

Let the government BUY everyone a car (probably Japanese or Korean) in exchange for their "Foreign Aid".


NO MORE TEA for the government to keep them "in office." Indict, impeach, and toss the "culprits" like Chris Dodd and Barney Frank OUT OF their malfeasance and irresponsibility as "Managers of the Government Corporation."

There is just so much to reply to in there I don't know where to begin.

I don't have much time, so a couple quick points.

1. UAW auto workers make around $23 or $24 per hour on average. You appear to be using some formula where someone has taken every single bottom line employee expense (including health benefits for active, retired and surviving spouses, administration costs, etc.) lumped it all together and divided it by the number of wage hours in a given year. $75/hour in no way reflects the take home pay of union employees today.

2. 1 in 10 jobs in this country depend on the viability of the auto industry.

3. US Automakers are at an every growing (especially as the cost of retiree health care soars) competitive disadvantage to foreign carmakers where the government subsidizes them. All their competitors are in countries with Universal Healthcare and don't have to provide the same benefits to their retirees. (this isn't even mentioning trade barriers and access to market restrictions)

4. Here's an article I found, which in the interest of fairness I thought I'd provide you. It supports your arguments.
Medicare administrative Costs versus Private Insurance

*Interesting paper. I haven't taken a skeptical eye to the entire piece yet as it was clearly written and massaged FOR the Private Health Insurance Industry. Figures lie and liars figure but it does give us some numbers with which to work. Look close and you'll see why the insurance industry would love to have less Employer Plans and more individual plans as McCain was advocating. Individual plans are a lot more profitable even though they cost much more to administer. Notice also there is one chart that projects a sharp decline in Medicare adminstrative costs as more and more people utilize the system. By 2025 their admin costs are projected to be at 1.6%. This is something the authors fail to address is the advantage of economies of scale. Administration costs of ONE national plan with "everyone in" a universal plan would be much cheaper than any other alternative per dollar...government waste and inefficiencies aside.

Mr. Wondering

This is off subject but an interesting article relative to the Auto industry bailout.

Should we bail out the auto industry

w

Mr.W, to the issue at hand of a "Single Payor" system that eliminates private healthcare insurance, the analysis article you cited is a very good starting point to dissuss the actual issues regarding the "premiums" (taxes or premiums, it doesn't matter what you 'call' them) and the COST of the healthcare service actually provided.

But before going to that discussion, let me just reply to your current post. If, after that, you really do want to have a discussion of the system, the facts and issues, without the "emotional" component or the appeal to "fairness," I would be willing to spend some time on that sort of discussion.




Actually, the wages are different depending upon factors such as "new hires" versus "time on the job." The actual MEDIAN wage is around $30.00 per hour (a search of GM wages, for example, will give the breakdowns, but ONLY on a "MEDIAN" basis, not actual wages).

In addition, there is a LARGE percentage of Retired Auto Workers(actually greater than the number of active employees) who retain lifetime pension and healthcare benefits that CONTINUE to be a burden on the companies overall. (i.e. people are NOT "dying off," and many are living post-retirement as long as, or almost as long as, their entire "working life.")

That "living longer," by the way, is PRECISELY the problem with both Medicare and Social Security. When they were set up, neither government system "expected" that people would "outlive" the available resources from the available workers.

Additionally, the "benefits package" of the working employees is also very large and IS NOT factored into the "wage" calculations, which ONLY address the "actual hourly wage."

Are you perhaps arguing that we should make the government (meaning us the taxpayers) responsible for those retirement benefits and NOT the company? Those workers CHOSE to work for the company, not the federal government. I, and I assume you too, had NO part in "negotiating" with the Unions for their "benefits." WHY should I be "on the hook" to PAY for their greed and refusal to work with the companies to keep the COMPANY viable? NOW, they are "negotiating" with the realization that the "golden goose" IS about to be cooked because the barbarians are coming. Once the company "Goes Under," they will LOSE their jobs, their pensions, their healthcare benefits, everything.

Trying to "ignore" the actual COST of business is typical of many arguments against private sector healthcare, but they are REAL and they would be born by the government, albiet as they play their typical "shell game" of NOT accounting for all the costs associated with actually providing the "payor system."

Now, if you want to take the "argument" out of the realm of the "religious component of the sanctity of life," for example, and just use "humanistic, evolutionary-type" reasoning, there is NO "inherent worth" in any person, and certainly no right to be a "burden" on others. Things like the video you presented earlier about the child with hemophilia ARE emotionally heartwrenching, but only if you THINK that "natural selection" might NOT be the "real answer." What "right" does that child have to live? I know that sounds harsh, but we cannot argue on the one hand that all life is precious and that healthcare is a "right" for all people AND argue on the other hand that there is NO creator and no created "inherent worth" of any individual (the basic premise of abortion supporters, for example).

IF "natural selection" IS the "way that it is" and that God is NOT "part of the equation," then it makes NO sense for anyone to have to pay for anyone's healthcare needs other than what they want to pay for their own needs, and maybe what they want to "Donate" to someone else that they might be "concerned about" in some way (as a relative, friend, or whatever).

To accept the premise of pro-abortion folks, there IS no "inherent right to life" of any person. The ONLY thing that they will "grant" is that in the "morality of the country we live in," the Constitution (the opinions of a group of people) presents the opinion that "all people are created equal and endowed by their creator with certain inalienable rights, among which are life, liberty, and the pursuit of happiness." They REJECT the fundamemtal foundation of a "creator," but "like" the idea of "life being a right, just so long as it is after birth or after survival of being left to die from a botched abortion attempt."

In other words, it's all "relative" just so long as it suits their "other purposes."




So what? That is capitalism.

Care to think how many jobs depend upon the insurance industry?

And by the way, how many "independent insurance agents" might there be out there, who try to find the "best" insurance for a given client REGARDLESS of who the insurance company might be? You DO realize that these agents, and even many who are "captive" to one company, are "independent contractors" who are ONLY paid on commission and who are reponsible for ALL of their own costs of business?

You should see the latest "ruling" from CMS (the Center for Medicare and Medicaid Services) regarding all Medicare Part C plans....specifically dictating and regulating what the private companies can pay insurance agents for signing up people to a Medicare Part C (and also Part D Prescription Drug Plans) plan.

If you are interested, I could post part of the 44 page document that CMS released this week and imposed on the industry.

Aside from the issue of "what right does the government have to set the "wages" of private sector people," there is also an admission by CMS that they don't have the manpower to "do the job right."

Essentially, what CMS mandated, with a "stroke of the pen," is all insurance agents selling Medicare Part C plans (known as Medicare Advantage Plans WILL have their income for 2009, at a minimum, and possibly forever, CUT IN HALF.

Now THERE's a way to ensure that people get help understanding what their options ARE under the Medicare system.

But then toss on top of that the CMS rule thay you cannot call someone on the Do Not Call list, you cannot call anyone to talk about Part C plans unless they FIRST call you, you cannot knock on anyone's door to see if they even want to talk about Part C plans....and you have the government "caring enough" about the people to vitually cut them off from most information sources and cast them "adrift" to figure out what might be the "best way" to deal with Medicare.

And I have not even talked about what Medicare REQUIRES Medicare recpients to pay for that Medicare WILL NOT pay for.

And why stop with health insurance? Why not have the government be the "single payor source" for all insurance needs. FEMA could run it, and very efficiently, right?




Uh huh. I suppose we could look at this issue too, assuming we could look at the tax burden on the people to support the government run healthcare system. When it comes to healthcare, Mr. W. there IS "no free lunch."




I appreciate your posting this link. It begins to address the "arguments" of this "efficiency of scale" and exposes it for what it really is....a "shell game." While there ARE some "efficiencies of scale," MOST of the "disaparity" between government and private sector is because the government "hides" the true costs to its system by NOT accounting for the services in ONE accounting area, whereas the private sector MUST account for all of their "costs of providing the service."

And that doesn't even "factor in" the segment of the industry that actually PROVIDES the healthcare. All the "dollars" in the world will NOT cure anyone if the SERVICE is not available or provided. And people DON'T provide services for free. Just look at your auto repair bill if you question that and look for the "Labor" line of the bill.

It (the paper) could provide a good basis for a discussion of key component parts of the argument FOR and AGAINST a single payor government run healthcare system, as it begins to address the "lie" that the government is "more efficient" and could run a healthcare payor system "better."

FH, I would agree!
I have linked a graph that supports the issue of access and an article that is interesting as well.

Link to graph US vs. Canada access to technology
http://www.mackinac.org/images.aspx?ID=2748#939


Link to the article where graph is used
http://www.mackinac.org/article.aspx?ID=2748




I am back to my first comment that government has no business entering into the health care business nor any other business regardless of efficiency levels. I am amazed that "we the people" continue to support traveling down this slippery slope.

It's the difference between being a socialist or a capitalist, a liberal versus a conservative, servants and masters.

Socialism has failed everywhere it has been tried, yet people are seduced (and continue to be seduced in some countries) by the idea that "someone else" can be responsible other than themselves. Socialism "sounds nice," but results in methods that ensure the continuance of the government as it seeks to "straddle the road" and NOT take definitive stances, to not say there IS "Right and Wrong," but the untruth that we can "all get along all of the time" if we put government ahead of the individual. Eventually, it becomes the "government is always right" and any disagreement with government is "always wrong."

From there to Marxism/Communism (all just one big "happy family" and just "citizens of the world") is a VERY SMALL step. But it also begins incrementally, just a frog in pot of water doesn't notice the fire underneath that is heating the water to boiling. Put the frog into a pot that is already boiling and he will try to jump right out. Bring him to boiling gradually and before too long he's "just right" for dinner.

But there is ALWAYS a cost for that sort of "transference of risk." And that cost is loss of individual freedom, and eventually loss of Freedom itself, incrementally, gradually, but inexorably. And THAT is why the Founders of this great experiment in Freedom WARNED, strongly WARNED, against too much power in the hands of Government, especially a government wherein the people making up that government have lost their "connection to" and "belief in" God.

tst - thanks for the article. I am posting the entire article here (permission given by the source) in case anyone has trouble accessing the link or would like to read it the context of the discussion, since the Canadian "system" is often offered up as a "model" of what liberals would like to see in the USA.

(emphasis added to draw attention to key areas)



Socialized Medicine Leaves a Bad Taste in Patients' Mouths

Hospital food is rarely mistaken for gourmet cuisine anywhere, but at least in Michigan it is not an issue over which major political campaigns are waged. In Canada, however, it is—and the lesson it provides for American health care is profound.


Last fall, a colleague of mine visited the Canadian province of Manitoba. With just a few days left before the elections, political campaigning there was at a fever pitch. My friend was astonished to observe that the dominant issue was indeed hospital food.

The patients of Manitoba's hospitals had complained for months about the introduction of "re-thermalized food"—cut-rate meals prepared 1,300 miles away in Toronto, then frozen and shipped to Manitoba where they are nuked in microwaves and served. Peter Holle, president of the Frontier Centre for Public Policy in Winnipeg, explained that re-heating meals was a cost-saving "innovation" of government bureaucrats employed by regional health authorities. (Another example of "administrative costs being lower, but the quality of service suffers. "Innovative?" Bureaucratic is more like it, not compassionate and not "outcomes" oriented at all.)

"Never mind that they taste like cardboard," says Holle. "Never mind that individual tastes and circumstances might dictate decentralized food services. Re-heated meals became a symbol of efficiency for the supposedly compassionate do-gooders in government. Why pay hundreds of workers in dozens of Manitoba kitchens when we can just zap up frozen dinners from Toronto?" As it turned out, the incumbent government in Manitoba and many of its supporters went down to defeat. Vile victuals were a key reason.

According to a national poll, four out of five Canadians are unhappy with their socialized health care system. Doctors in Manitoba apparently agree: Almost half of them have left the province in the past decade alone.

How does hospital food become a political issue? The same way anything—from the important to the utterly inconsequential—becomes a political issue: socialize it. Take any matter that people normally resolve quickly, peacefully, and privately by their own choices, turn it over to government, and watch as factions arise, conflict ensues, and problems appear.

Minor problems become intractable because government decisions are financed by taxes and imposed with police power. Government coercion guarantees that somebody, if not everybody, will be unhappy. If people cannot escape the system because they are forced into it, then they will bicker and fight endless and often silly battles. Politics is simply no way to run a kitchen or a car factory or a whole lot of other things.

But hospital food is probably among the least of Manitoba patients' concerns. According to a national poll, four out of five Canadians are unhappy with their socialized health care system and believe it has worsened noticeably in just the past five years. Doctors in Manitoba apparently agree: Almost half of them—an astonishing 1,800—have left the province in the past decade alone.

David Gratzer, a Canadian health policy commentator, published a blockbuster book last year entitled Code Blue. Gratzer revealed that the quality of care Canada's system provides to ordinary citizens matters less to its apologists than the quality of care it denies to the so-called rich. The egalitarian impulse that drives Canada's "universal" health care system calls for treating everybody the same; all patients get "free" care in the public system and are generally denied the option of getting faster or better care for a fee in the private sector.

Gratzer asks, "With health care, is our true goal that Mr. Smith, who owns three cars, not be allowed to get a quick (private) cataract surgery? Or is it that Mr. Jones, who just makes rent every month, gets (publicly funded) heart surgery when he needs it? The way [the system's] advocates carry on, you'd think that it was fine that Mr. Jones suffered crushing chest pain after walking three steps just as long as Mr. Smith had to stumble around blindly for six months."

Thanks to this idiocy, an estimated 212,990 Canadians were on hospital waiting lists for surgical procedures in 1998. The average total waiting time of 13.3 weeks was up from 11.9 weeks in 1997 and up a shocking 43 percent since 1993. No wonder that when former Quebec Premier Bourassa was diagnosed with cancer, he avoided "free" care in his home country and instead sought treatment in Cleveland.

Advocates of socialized health care in America—including the Clinton administration and Michigan Congressman John Dingell—would like to move us toward the Canadian model one step at a time. Indeed, Dingell's bill, the National Health Insurance Act (H.R. 16), would take us more than just a few steps in that direction.

But if the sorry state of Canadian health care tells us anything, it is that politicians and their bureaucracies should not be trusted with the care hospitals provide any more than they should be trusted with the food hospitals serve.
#####

Lawrence W. Reed is president of the Mackinac Center for Public Policy, a research and educational institute headquartered in Midland, Michigan. More information on economics and health care can be found at www.mackinac.org. Permission to reprint in whole or in part is hereby granted, provided the author and his affiliation are cited.


Now, nationlized healthcare already exists for many in the USA. Take the VA system, for example. Try scheduling surgery or getting a bed in a VA hospital NOW!, NOT weeks or months from now. It's not very dissimilar to the Canadian system "experience."

Honestly, I found the op-ed article, on page 1 of this thread, by Warren Pease advocating the single-payer system to be very disturbing. He is simply writing a persuasive opinion article that rails against free market capitalism, and has decided that government takeover of an entire industry is the cure.

I would suggest that his understanding of economics is very weak at best.
He doesn’t understand that they have everything in common when held up to the rule of supply and demand.
He is using the same manipulative arguments that he claims only exacerbate the problem. His arguments are no more than portraying the Insurance Companies, Hospitals and Doctors as villains, “profiting from people’s misery.” When the truth is they are offering a solution called “relieving misery.” This is basic economics 101, supply and demand. This basic rule of economics will not change even if the government takes control of the entire industry.

I greatly disagree with Mr. Pease that adopting a single payer health care system, like Canada provides, should ever be considered as a solution. Canada made it ILLEGAL to have “private health care” that offers or covers anything the Government already offers or covers . They made it ILLEGAL to have competition in the market place. (Why the leaders of the freest country on earth would even consider this is beyond my comprehension) Canada has ignored the law of supply and demand by creating a system that will continue down the path that eventually leads to a “black market” style supply for those that demand and can afford better services.

I have quoted a basic definition to support my thoughts;
“Supply and demand is perhaps one of the most fundamental concepts of economics and it is the backbone of a market economy. Demand refers to how much (quantity) of a product or service is desired by buyers. The quantity demanded is the amount of a product people are willing to buy at a certain price; the relationship between price and quantity demanded is known as the demand relationship. Supply represents how much the market can offer. The quantity supplied refers to the amount of a certain good producers are willing to supply when receiving a certain price. The correlation between price and how much of a good or service is supplied to the market is known as the supply relationship. Price, therefore, is a reflection of supply and demand.

The relationship between demand and supply underlie the forces behind the allocation of resources. In market economy theories, demand and supply theory will allocate resources in the most efficient way possible.”

The reality that Mr. Pease is ignoring throughout his entire op-ed is that when price for a service is artificially suppressed, quality, innovation and supply will suffer as a result. Just look at the Soviet Union or Cuba for a better understanding of why this will not work in the long run. You can only hide from the basic law of supply and demand for a short period of time before the entire artificial suppression of the system implodes.

I find comments such as this next quote almost insulting to my intelligence;
And replaces them with bureaucrats from the government. I mean come on Mr. Pease, how stupid do you expect the reader to be?

And another; I mean come on, FREEEEE.

He has never heard the expression adopted by the American people during the Great Depression of the 1930’s era, “TANSTAAFL” which translated means; “There Ain’t No Such Thing As A Free Lunch”. Someone ALWAYS pays. And in this case it’s the tax payer that actually earns an income.


And this...He calls THIS “galling” compared to the working class taxpayer shouldering 100% of EVERONE’S costs. How is shoulder 100% less “galling”?


This next particular thought should appall any American that actually has a job and expects to profit from his educational investment, or his entrepreneurial spirit; AS THEY ALWAYS HAVE, geeze, you used to make money and now you don't? Not my definition of the same!
This is again the artificial suppression and price controls that I mentioned earlier. A violation of economics 101.

I know our system is somewhat broken, but IMHO the “Single-Payer” idea is not a long term viable solution for the USA.

THAT is what I've been saying from the beginning.

CIRCUMSTANCES (i.e., people living longer WITH problems due to advances in Medicines and Medical Care) have changed since many things, like Medicare and Social Security) were set up.

They never envisioned that we would be "outliving" the resources, but we ARE.

Therefore, we need to be thinking "outside of the box" for ways to improve the availability, accessability, and affordability of healthcare needs.

IF anyone doubts that "living longer" is a real issue, then all I can say is the Life Insurance tables that I have already project "life expectancy" out to 121 years of age.

IF THAT becomes the "norm," then think of what it means in relation to anyone's "working life" (approximately 45-55 years) to someone's "retired and on Medicare" life of however long they might live beyond age 65.

Look at the statistics of how many "workers" it took on average to "support" one Social Security retiree recipient compared to what it takes TODAY. All because we ARE living longer than the government, in all its wisdom, projected when they set up the system. Does THAT instill any faith and trust that the government would "get it right" if they took over ALL of healthcare?

Very good article Medc.


Since there has been some discussion about "Administrative Costs" being a "bad thing," I thought I'd copy one part of that article to sort of "set the record straight" on at least one area that some folks seem to be opposed to .... paying agents commissions for enrolling someone in a plan.


The "typical" commission rate for an agent is about 18% of the 1st year premium.

The "renewal" commission is typically about 1-2% for subsequent renewal years.

A "typical" family policy, let's say $400.00 per month in premium, or $4,800.00 per year, would result in a 1st year commission to the agent of $864.00 (at 18%, the most common rate).

Years 2 through ? would result in a commission of $96.00 for the year (at the "high" end of 2%, or $8.00 per month) PER policy. If you spend TIME servicing those clients, consider the $8.00 per MONTH is all you will be paid for your time. (I wonder how many attorneys make $100.00 per hour or more, even if they DON'T help their clients?)

The reality, however, is that few clients keep their policies beyond 1-3 years because they "price shop" their coverage and tend to switch to a policy that will have a lower premium.

Regardless, the agent cannot "count on renewals" and is essentially operating on an "all new business" basis in order to make any money (remember, ALL of the agents costs of his/her business are paid BY the agent as they are "independent contractors" and not employees (i.e. NO benefits of any kind).

They PAY all taxes as well as both "sides" of the FICA tax.

IF they can sell 60 policies per year (5 per month), they can "make" $51,840.00 for the year. However, they are paid "as earned," which means that that they only get a full twelve months of commission IF a client remains on the policy for the entire year AND if they sign up in January of each year.

They will get paid, but NOT all in the "year of sale" unless the client signs up for an effective date of January.

In addition, some companies will "advance" some of the 1st year commissions (never on the year 2+) to help the agent with Cash Flow. However, the typical "advance on commissions is typically 6-8 months, and the remainder of the year is paid 'as earned'. "As Earned" means that the client paid their monthly premium.

IF an advance was paid to the agent, and the client drops the policy before the 6-8 months of premiums are actually collected, the insurance company "charges back" the unearned commissions to the agent and the agent must pay the insurance company back.

Now let's assume that an agent DOES make the example of $51,840 for the entire year. $51,840 minus the approximate rate of 30% in taxes owed will net the agent $36,288 for the year.

Renewal commissions are virtually non-existant, and all expenses (including annual fees for Mandatory Continuing Education and fees to be appointed to sell a given company's products), including their own health care policy, must be paid by the agent, further lowering the "net profit" if you want to look at it as "profit" instead of "wages for a service performed."

AND THAT assumes the the agent sells ONLY family policies and NOT individual person policies.

And did I mention the COST of obtaining potential prospect leads or the restrictions on contacting people (like the Do Not Call list that places an $11,000 fine PER violation on the agent, and can result in revocation of the agent's license to sell insurance)?

I wonder how many attorneys would provide a service to their clients for that sort of "wage potential," since they are also paid on a "commission" basis?


Then there's the UAW with its hand out for ANOTHER 32 BILLION dollar bail out for the Auto Companies. I heard the President of the UAW this morning, and he will NOT "budge an inch" with respect to the benefits paid to Retired Auto Workers. It's time for Chapter 11 reorganization, imho. And I wonder how many of those "benefit rich" retirees could also utilize Medicare if they no longer had the company provided healthcare benefit (there are more retirees than workers in the Auto Manufacturers industry who are paid for no work for as long as they live)?

The US Auto Workers in the UAW are paid an average of $71.00 per hour (including benefits) compared to an average of $45.00 per hour for non-union auto manufacturers. WHO is ripping off who here? $32 BILLION to support this? From you and me, the taxpayers? Why?

Not surprisingly a little research yields the large underlying bias of the quoted article...

not only is it out of date...but it propogates unfounded myths about the Canadian Healthcare system.

MYTH: Canadian doctors are leaving for the US in droves

A list of Publications by the Canad...cy and services management alternatives.




It, the "Mackinac Center" is also substantially supported by and funded by conservative radical Richard (D i c k) DeVos and his right-wing fanatical groups. His brother-in-law, Erik, used the family wealth to start a military mercenary army. The company that it operates under, Blackwater USA, started in 1997 and quickly started getting contracts when George Bush became president. Blackwater...is scary stuff and a real threat to democracy (unlike Obama's Peace Corp and Americorp initiatives). These guys LIKE privatizing everything so THEY can control it be it the military or healthcare.

Mackinac Center is hardly unbiased.





I'm sorry I've not had time to respond further lately. I'll try to catch up soon. The 4 out of 5 Canadian's are unhappy with their socialized medicine is a lie or a bastardization of the response given. I've seen it written that the US Healthcare system enables some lucky individuals with enough money and not so chronically ill they can't work or to not old to obtain grade A healthcare but everyone else gets grade D and E/F healthcare whereas Canada achieves a Grade B level for nearly everybody that wants it. Thus...maybe 4 out of 5 Canadians are unhappy about their healthcare system (since it's not perfect) however, that is not the same as saying they would trade their system for our failing inefficient ineffective and unfair system.

$40,000 for Dialysis is NOT effecient or fair or relative to cost whatsoever. The system is busted. I'm open for alternatives that don't include "for profit" executives determining what I can get and not get.

Mr. Wondering

I'm sorry Mr. W., I must have missed the part where "bias" automatically renders facts irrelevant.

I thought YOU were arguing from a "biased" position too, as are we all who stand "on one side of an issue or another."


That you don't like the "political Right" we have already understood. So what? We all have "biases" on that score too. I detest the "liberal Left," the issue is still what happens to the SYSTEM of healthcare IF the government takes over all of healthcare AND the providers say "up yours!, I am NOT working for THAT pay!" ACCESS to healthcare, when and where, someone thinks they need help, IS the primary issue, not the "dollars and cents" even though the PAYING for the care IS an essential component in the delivery of healthcare.



Mr. Wondering, again you show an emotional response without a basis in FACT. Here is the FACT.

NO ONE is denied dialysis if they need it, regardless of "ability to pay."

COSTS of delivery, as well as the "profits" needed to PAY the staff and buy the supplies ARE NOT FREE. "Volunteers" do NOT staff the dialysis centers and do not work for free.

NO profits, NO care delivered.

But beyond that, dialysis patients are ALREADY RECEIVING SINGLE PAYOR SOURCE HEALTHCARE. They are ALL eligible for Social Security Disability AND for Medicare, no matter how old they are. I have dialysis clients who are in their 30's as well as those who are older than 65.

But here is the "catch" to your Single Payor system that already exists.

$1024 Part A deductible, potentially several times each year because it is based on a "benefit period" rather than a "calendar year."

20% of the Part B bill (which is where MOST dialysis treatment falls) that is UNCAPPED and UNLIMITED. Therefore, if you use as an example $1000.00 day COST for service, the patient (the person WITH the Single Payor Source of Medicare) is responsible BY MEDICARE LAW for 20%, or $200.00 PER TREATMENT DAY. They are dialyzed (assuming hemodialysis) 3 days per week. That equates to $600 per week x 52 weeks per year = $31,200.00 per year that the LAW says the patient is responsible for and NOT the "taxpayers who pay into the system."

THAT is also why dialysis WILL take everything most people own.

Next up on the "list" is Long Term Care. The government WILL NOT provide Long Term Care coverage beyond 100 days, and will NOT provide even that unless it is ACUTE care. Intermediate and Custodial levels of care are PROHIBITED for payment BY the Single Payor Source of Medicare.

At an "average" annual cost of $60,000, anyone who DOES NOT have their own Long Term Care policy WILL lose everything they own if they need Long Term Care and don't have REALLY deep financial pockets of their own.

Another issue, IMO, that bears consideration in this discussion is the scale of populations.

The countries that are experimenting with government takeover single-payer systems have a much smaller population and economy.

Something else to consider is availability of services. Just because single-payer gives everyone the right to coverage, it cannot provide equal/fair access for everyone. The geographical challenges alone are an obstacle to fair and equal unless we advocate building and supporting facilities everywhere someone is located.



Mr. W.
I'm surprised that you would advocate an "entitlement program". Though I do agree with your concerns for humanity as a whole, I’m not sure I would agree with allowing an "attitude of entitlement", to drive the decision making process on this issue.

I hope you understand that I'm not opposed to reform of the insurance industry. I believe an overhaul of The McCarran-Ferguson Act would be a great place to start, along with the insurance industry Anti-Trust exemptions.
You might even look at AIG as a valid case study to support this overhaul. (A major insurance company, due to recent changes in this act, that entered into the banking business, which I would suggest has led to there current demise).
Also, in case you wonder, I would consider myself very centrist in my views.
However, even with my disgust toward the insurance industry as a whole, I could never support government takeover of any industry. Anyone can find another name for it, but YES it would be government takeover and ownership of an entire industry.
What a slippery slope that would be.


FH, I do not consider the agent’s role in the current system to be at fault for any of the problems that exist. Without agents/brokers, the system would be more dysfunctional than currently exists.

Mr.W, would you be so kind as to post the link to the article you quoted. I'd very much like to read the entire article as well as do a little research into the author of the article.

The Mackinac Center is something that I would encourge and recommend everyone access and read for themselves, draw their own conclusions, etc.


But you failed to address the arguments previously presented, resorting to "attack the Mackinac Center" rather than addressing the FACTS and the PROBLEMS.

Give enough time, I may just have to present some of those facts, as presented in your links to a government sponsored and funded "mouthpiece" for the "government's positions," while attempting to disguise their "bias" and "interpretations of the DATA and the FACTS."

Having read through several of the articles posted by that organization, it is NOT HARD to read through the editorial slant and see the REAL problems that they try to "gloss over" and "minimize" so as to continue promoting the government "line" of National Health Care is "best."


And you can begin by wondering why this organization chose the pejorative word "Myth" to title their propaganda machine. The "Why" seems simple enough, they want to begin by giving everyone the idea that ANY idea contrary to "Their Opinion and Interpretation of the Facts" is automatically WRONG.

The really DO think that the "people" ARE a bunch of non-thinking, uncritical, dolts who will "buy" anything they say and not be able to evaluate the Actual Conditions for themselves.

Basically, they ARE a "academia" model of elitists grounded in the idea of perpetuating the "system" and maintaining their own source of funding, which is the government itself and other "like-minded academic" sources.

Of course, that's MY opinion, formed AFTER reading many of their pdf posted articles, as is my opinion of the Mackinac Center, also formed AFTER reading several of their articles, the preponderance of which deal with Michigan the "state of affairs" in Michigan (see MESSA as just one example). Others can form their own conclusions by doing some similar reading for themselves.

http://www.chsrf.ca/mythbusters/html/myth29_e.php

Myth: Canadian doctors are leaving for the United States in droves

Myth Busted June 2001

Busted Again! September 2005

Yet Again! March 2008



Isn't it interesting that there is even "an argument," or even "a possibility" that the USA healthcare system MIGHT be more "attractive" to even some physicians, regardless of the attempt to belittle the "how many" question?



Yep, they are "at best" holding their levels and NOT increasing the availability of PROVIDERS, but they are still showing a NET LOSS, regardless of how they want to "massage" the numbers.


Well now, "a serious public policy problem"???

Ya think!?!

Oh shoot, here's the "quick government fix" for THAT problem….SEND all the foreign Doctors HOME! But then a 22% LOSS of Canadian Doctors MIGHT just cause even BIGGER delays in getting needed care.

Problems, problems.



Strategies? You mean like "free enterprise" and the legalization of private healthcare that just MIGHT "incentivise" (i.e. the "UGLY word": profit) the "retention of Doctors IN Canada?"

Nope, it couldn’t be that because Canada wants ALL of their Doctors to be EXCLUSIVELY in the Socialized Medicine, State run, Healthcare system and are afraid (legitimately I might agree) that the Doctors might, "horror of horrors," SPLIT their time between private and State run public Hospitals (they, the Doctors, just might LIKE being able to make more income from a private system.)

Regardless, the PROBLEM in the current "state of affairs" runs much deeper and there ARE huge DELAYS in getting needed treatment in Canada. And THAT IS a direct result of Nationalizing Healthcare, just as the "Obamaites" are pushing for in the USA.