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by toomuchtodo 3264 days ago
America spends more per capita than any other first world country for worse outcomes [1]. Healthcare is expensive because of the profit motive. Single payer isn't implemented for (mostly) the same reason.

60% of Americans want single payer [2].

"A majority of Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage. And a growing share now supports a “single payer” approach to health insurance, according to a new national survey by Pew Research Center.

Currently, 60% say the federal government is responsible for ensuring health care coverage for all Americans, while 39% say this is not the government’s responsibility. These views are unchanged from January, but the share saying health coverage is a government responsibility remains at its highest level in nearly a decade.

Among those who see a government responsibility to provide health coverage for all, more now say it should be provided through a single health insurance system run by the government, rather than through a mix of private companies and government programs. Overall, 33% of the public now favors such a “single payer” approach to health insurance, up 5 percentage points since January and 12 points since 2014. Democrats – especially liberal Democrats – are much more supportive of this approach than they were even at the start of this year.

Even among those who say the federal government is not responsible for ensuring Americans have health care coverage, there is little public appetite for government withdrawing entirely from involvement in health care coverage. Among the public, 33% say that health care coverage is not the government’s responsibility, but that programs like Medicare and Medicaid should be continued; just 5% of Americans say the government should not be involved at all in providing health insurance."

Emphasis mine.

[1] http://www.npr.org/sections/goatsandsoda/2017/04/20/52477419...

[2] http://www.pewresearch.org/fact-tank/2017/06/23/public-suppo...

3 comments

I used to be for single part until I listened to a recent episode of econtalk (http://www.econtalk.org/archives/2017/06/christy_ford_ch.htm...). Christy Ford described how the current medical system evolved and how the American Medical Association made the current, insurance based system happen. Before this we used to for example multi-disciplineray offices of doctors that you could directly buy health care coverage from. That was made illegal. What we currently have is the worst of any world. It's a artificially constrained market that's practically devoid of competition. On top of that we have insurance which is clearly the wrong model for something you know you are going to need. And it's employer provided on top of it. How could this market possibly be less functional? Let's try to fix the market before we pour out the baby with the bath water.
I have to respectfully disagree. It's time to burn down the current system and go straight to single payer.

Collect premiums via payroll taxes->fund healthcare providers. That greatly simplifies it, but there are many other first world models we can pick from. This is not hard.

> Collect premiums via payroll taxes->fund healthcare providers. That greatly simplifies it, but there are many other first world models we can pick from. This is not hard.

I entirely agree with you on that and your assessment on how the finance/tax part of it is not as scary as some would think, it might even perhaps not be the hardest part of the problem.

My personal belief in single-payer is that it is the only way to create a leverage to either create a public offer of healthcare goods and service, or radically modify the power imbalance and drive the prices of goods and services way down. The thing that worries me is that in both cases, what I understand as being a total healthcare bubble, which I am sure is a well organized lobby, won't exactly be thrilled at letting things happen without a fight :)

Are "worse outcomes" controlled for lifestyle choices, demographics, and obesity? Or is it a stepping stone to a soapbox?
Life expectancy, infant mortality, and quality of care.

http://www.pgpf.org/chart-archive/0011_health-outcomes

Americans being "fat", sedentary, and certain demographics having expensive chronic illnesses aren't the cause (except perhaps heart attack mortality, which I'm not going to spend the time this evening digging into), if that's your implication.

I saw the chart, but I don't see how it shows the causes. Why don't unhealthy lifestyles and obesity cost us more?
Having used healthcare in a wide variety of settings, super-deregulated private healthcare in countries like India, Mexico, etc. is vastly superior to government-run healthcare or the US's red-tape-choked "private" healthcare system.

I just pay for everything under the table with cash and it's much cheaper. If doctors can avoid American "insurance" providers (which are not allowed to function as actual insurers, and have to keep margins up by being as stingy as possible), they can save a lot of money and effort.