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Why Obama's Public Option Is Defective, and Why We Need Single-Payer
The Progressive ^ | July 22, 2009 | Drs. Steffie Woolhandler and David Himmelstein

Posted on 08/06/2009 5:35:11 PM PDT by Lorianne

Once Congress finishes mandating that we all buy private health insurance, it can move on to requiring Americans to purchase other defective products.

A Ford Pinto in every garage?

Lead-painted toys for every child?

Melamine-laced chow for every puppy?

Private health insurance doesn’t work.

Even middle-class families with supposedly good coverage are just one serious illness away from financial ruin.

Illness and medical bills contribute to 62 percent of personal bankruptcies — a 50 percent increase since 2001. And three-quarters of the medically bankrupt had insurance, at least when they first got sick.

Coverage that families bought in good faith failed to protect them. Some were bankrupted by co-payments, deductibles, and loopholes. Others got too sick to work, leaving them unemployed and uninsured.

Now Congress plans to make it a federal offence not to purchase such faulty insurance.

On top of that, it’s threatening to tax workers’ health benefits to meet the costs of simultaneously covering the poor and keeping private insurers in business.

President Obama's plan would finance reform by draining funds from hospitals that serve the neediest patients. His other funding plans aren’t harmful, just illusory. He’s gotten unenforceable pledges from hospitals, insurers and the American Medical Association to rein in costs, a replay of promises they made (and broke) to Presidents Nixon and Carter. And Obama trumpets savings from computerized medical records and better care management, savings the Congressional Budget Office has dismissed as wishful thinking.

The president’s health plan can’t make universal, comprehensive coverage affordable.

Only single-payer health reform — Medicare for All — can achieve that goal.

Single-payer national health care could realize about $400 billion in savings annually — enough to cover the uninsured and to upgrade coverage for all Americans. But the vast majority of these savings aren’t available unless we go all the way to single payer.

A public plan option might cut into private insurers’ profits. That’s why they hate it. But their profits — roughly $10 billion annually — are dwarfed by the money they waste in search of profit. They spend vast sums for marketing (to attract the healthy); demarketing (to avoid the sick); billing their ever-shifting roster of enrollees; fighting with providers over bills; and lobbying politicians. And doctors and hospitals spend billions more meeting insurers’ demands for documentation.

A single-payer plan would eliminate most insurance overhead, as well as these other paperwork expenses. Hospitals could be paid like a fire department, receiving a single monthly check for their entire budget. Physicians’ billing could be similarly simplified.

With a public insurance option, by contrast, hospitals and doctors would still need elaborate billing and cost-tracking systems. And overhead for even the most efficient competitive public option would be far higher than for traditional Medicare, which is efficient precisely because it doesn’t compete. It automatically enrolls seniors at 65 and deducts their premiums through the social security system, contracts with any willing provider, and does no marketing.

Health insurers compete by NOT paying for care: by seeking out the healthy and avoiding the sick; by denying payment and shifting costs onto patients; and by lobbying for unfair public subsidies (as under the Medicare HMO program). A kinder, gentler public plan that failed to emulate these behaviors would soon be saddled with the sickest, costliest patients and the highest payouts, driving premiums to uncompetitive levels. To compete successfully, a public plan would have to copy private plans.

Decades of experience teach that private insurers cannot control costs or provide families with the coverage they need. And a government-run clone of private insurers cannot fix these flaws.


TOPICS: Business/Economy; Government
KEYWORDS: bho44; bhohealthcare; obamacare; plantationhealthcare; publicoption; singlepayer
They make some good points about the defects in the current plan being proposed though they don't point out the pitfalls of single-payer.
1 posted on 08/06/2009 5:35:11 PM PDT by Lorianne
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To: Lorianne
Pitfalls of single payer? How about disasters beyond belief? A single payer health care will cost at least one trillion dollars a year, provides a very bad health care quality, and will absolutely bankrupt the country in few years.

No to single payer, no to public option, no to socialism.

2 posted on 08/06/2009 5:39:26 PM PDT by jveritas (God Bless our brave troops)
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To: Lorianne

Uhh...actually it’s one of the most obtuse and uninformative articles on the issue that I have read.


3 posted on 08/06/2009 5:41:46 PM PDT by Eagles6 ( Typical White Guy: Christian, Constitutionalist, Heterosexual, Redneck. (Let them eat arugula!))
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To: jveritas
And YES to getting the GOVERNMENT creeps in WASHINGTON DC as FAR AWAY from our MEDICAL SYSTEM as is possible.

JUST SAY NO!

Please DO NOT mess up the best MEDICAL CARE and INNOVATION and TECHNOLOGY in the WORLD. PLEASE do not make it so the best and brightest NO LONGER want to go into medicine. Please do not ALLOW anyone other than the FAMILY and the DOCTOR to make ANY MEDICAL DECISIONS. Period. The end.

WE do NOT HAVE A MEDICAL CRISIS UNLESS MEDICARE OR MEDICAID is in TROUBLE and we have not been told. If they are, they are GOVERNMENT RUN and this should tell ya all ya need to know!

4 posted on 08/06/2009 5:44:48 PM PDT by Republic
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To: Lorianne

STUPID IVORY TOWER DOCTORS.


5 posted on 08/06/2009 5:45:17 PM PDT by vpintheak (Like a muddied spring or a polluted well is a righteous man who gives way to the wicked. Prov. 25:26)
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To: Eagles6

“Uhh...actually it’s one of the most obtuse and uninformative articles on the issue that I have read.”

That’s because you don’t understand “progressive” (aka marxist) economics.


6 posted on 08/06/2009 5:46:13 PM PDT by aquila48
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To: Lorianne
I'll give the author credit for openly supporting this, rather than the neck-snapping double-speak coming from the Dems and Obama. I wish more liberals were honest about their intentions.

That said, it's still your typical liberal utopian fantasy. The author should take some basic economics. When you subsidize something or when it's "free", people are going to use more of it. And the author never mentions how single-payer is going to be funded.

7 posted on 08/06/2009 5:48:29 PM PDT by Extremely Extreme Extremist ("It (Gov't) can't make you happier, healthier, wealthier, and wise" - Sarah Palin 07/26)
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To: jveritas

Single payer is not going to happen.
But it might happen eventually if they pass this ‘public option’ plan. Therefore, we should concentrate on the pitfalls of the publc option plan, which this article clearly illustrates will not work.


8 posted on 08/06/2009 5:53:48 PM PDT by Lorianne
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To: Lorianne
Hospitals could be paid like a fire department, receiving a single monthly check for their entire budget.

It's truly sad that any sentient being could write that line, completely convinced that it would be a good thing for every hospital in America to direct its efforts being sure no extra month left over when the money is gone. "Here's your monthly check, Weenie Hut General. Make sure it lasts."

9 posted on 08/06/2009 5:54:01 PM PDT by Minn (Here is a realistic picture of the prophet: ----> ([: {()
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To: Extremely Extreme Extremist

“And the author never mentions how single-payer is going to be funded.”

Right. That’s because it can’t be financially sustainable (as other countries’ experience and our own Medicare system clearly show ... they are going broke). However, it is my contention that the current plan being proposed is even LESS financially sound.


10 posted on 08/06/2009 5:57:39 PM PDT by Lorianne
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To: Lorianne

Medicare for all. Let me see, the program will start losing money in 2017 because the politicians who legislate its benefits promise their voters more than the program income can support. Young people who pay for the system who know that they will not be able to use it when they get old because it will be financially broke cannot quit the system. Talk about consumer protection for a defective product, under the current government programs of Medicare/medicaid and social security, it does not exist. Private insurers may not be perfect, but if my insurance company starts to have financial problems or start screwing their customers with technical BS, I can replace them with another competitor. Under a one payer government run system, if the system goes bad, the payer has nowhere to go.


11 posted on 08/06/2009 5:59:17 PM PDT by Fee (Peace, prosperity, jobs and common sense)
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To: Republic

Amen.


12 posted on 08/06/2009 6:19:01 PM PDT by jveritas (God Bless our brave troops)
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To: vpintheak

Their names say it all.....


13 posted on 08/06/2009 6:22:42 PM PDT by elcid1970 ("O Muslim! My bullets are dipped in pig grease!")
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To: Fee
FY2009 Medicare budget is 408 billions dollars.

Number of people enrolled in Medicare are 43 millions.

Based on the above each person enrolled in Medicare cost $ 9,488.

Now if 300 millions people enroll in single-payer socialized health care and each will cost $ 9,488 then the total cost would be 2.846 TRILLION DOLLARS.

14 posted on 08/06/2009 6:31:05 PM PDT by jveritas (God Bless our brave troops)
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To: jveritas
Now imagine that we cut the cost by 2/3 i.e. provide the worst quality health care system, pay the docotor much lower salaries (including the two doctors who authored this article), and pay the hospitals much less money, then the single payer socialized health care will still cost 900 BILLION DOLLARS A YEAR
15 posted on 08/06/2009 6:35:38 PM PDT by jveritas (God Bless our brave troops)
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To: jveritas
Sorry make it 948 BILLION DOLLARS A YEAR not 900 BILLIONS
16 posted on 08/06/2009 6:37:22 PM PDT by jveritas (God Bless our brave troops)
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To: Lorianne
It automatically enrolls seniors at 65 and deducts their premiums through the social security system, contracts with any willing provider, and does no marketing.

Since they "automatically" grab up the over 65 crowd and they "automatically" deduct their premiums from the miserable pittance that SS represents, they have no NEED for marketing as their clients do not have a say in the matter. As to the "contracts with any willing provider", every year that passes see the government cut back further on what they offer to providers. I've had doctors bluntly tell me that they can not afford to accept Medicare as they would run in the red. Without tort reform and some serious malpractice protection for providers that situation will not change because of a single payer system. Meanwhile,as the cutbacks continue from year to year the number of "willing providers" continues to shrink.

What is the ultimate end of a "single payer" system, make all health care providers government employees?

Regards,
GtG

17 posted on 08/06/2009 7:25:30 PM PDT by Gandalf_The_Gray (I live in my own little world, I like it 'cuz they know me here.)
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To: aquila48

I’m just a mobster donchaknow.


18 posted on 08/07/2009 5:04:27 PM PDT by Eagles6 ( Typical White Guy: Christian, Constitutionalist, Heterosexual, Redneck. (Let them eat arugula!))
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