[anothercomment]

why would the money coming from one pocket incentivize economic optimal treatment? By what mechanism? Why wouldn't hospitals try to fleece the government (spoiler: they do, in the countries with public health care)?

[nicky0]

> Why wouldn't hospitals try to fleece the government

In the UK most hospitals are owned and run by the state.

[grey-area]

Compare the actual figures spent per capita on healthcare spend in single payer vs the us system and the outcomes and you'll find your assumptions are badly wrong.

Single payer works better, that's why almost all countries use it for basic healthcare.

[aianus]

Single payer may work better overall but I can confirm that in Canada they do fleece the single payer in exactly this way.

"Only one issue per visit" so they can charge for two visits. Making me visit to hear the negative results of a standard STD panel, again, just so they can charge for two visits. They charge for an extra visit just to renew prescriptions with no additional examination. Etc.

[grey-area]

There are other reasons for one issue one visit - it helps them avoid long sessions which inconvenience everyone else though as soon as insurance companies are involved there are perverse incentives.

Also there are different structures for payment, insurance and pay per visit are simply not necessary with single payer though some systems use an amalgam of public/private.

[madengr]

Same thing in the USA. Trying getting a problem looked at during a physical; they want a separate appointment. Though since my insurance pays for physicals, I can see why they do it. Probably required by insurance company since my deductible is $5000.

[pjc50]

> hospitals try to fleece the government (spoiler: they do, in the countries with public health care)?

(A) which countries do you mean here? Be specific

(B) Do you think hospitals aren't trying to fleece insurers and customers all the time? e.g. with opaque billing practices?

[anothercomment]

A) For example Germany (where I live). B) Why do the billing practices have to be opaque? In Germany, patients often don't even see the bills. It all goes directly to the insurance company. For public insurance, that is. For private insurance, the patient pays and then asks the insurance company for their money back.

[walshemj]

The NHS as the only major buyer of drugs etc can bargain for price reductions

[reactor4]

Regarding your last question: because the government gets to say how much its willing to pay for any procedure. It's the government that has leverage on what the price will be in a single payer system.

[anothercomment]

But the doctors decide what procedures are necessary.