|
I agree, though I think a universal, single payer system under government oversight without profit seeking drive would be better. Consolidation under the current system is identical to McDonalds and Burger King consolidating the fast food industry, they will still be driven to outperform the other to consumers and to investors/owners. Instead, a single system under the Us government shifts negotiation of drug prices, care expenses, and more to one entity backed by the government, not just a set of insured customers, which has excessive power to negotiate. Like other nations that function this way, there is no skimming off the top for shareholders or profits and as the only other party at the table suppliers/hospitals can't play opponents against each other or take a kickback to give better pricing to the larger insurer or something. Ideally, it consolidates and simplifies negotiating pricing or allows the government to step in and say, "No thanks, we'll pass a law or budget for that on our own unless you lower prices or cut a better deal. Also, a government system could cut out administrative and bureaucratic paperwork like billing, coding, and more potentially removing a large % of overhead costs that exist currently, by default lowering expenses for healthcare similar to Canada. the biggest issue I see is that about 1/6th of the US economy is built on health care/insurance/etc companies. shifting that away from corporations into private hands could cut tens of thousands of jobs (like billing and adjusters) while shifting that cash flow under the US government as well. There would be fallout as people would need social safety buffer for unemployment or retraining or education. I don't think it could happen without pairing up with reduced/free college and smart expansion of some needs based aid. That requires some sort of tax, maybe like Warren has suggested, to cover intermediate costs and friction. The good news is it could save the average family over $5000 per year in insurance costs alone while bringing millions out of medical debt and providing a better standard of care and options for everyone. It's not libertarian to shift something under the government but if it makes economic and ethical sense to give such a monopoly to the feds (like with infrastructure, the military, and more) while improving choice for citizens (no longer tied to employer healthcare or entering debt to resolve acute or handle chronic medical issues) it could be a huge boon for choice and freedom. I'd be one of the first to start my own business if I didn't have to worry about my chronic health issues being fully covered and paid for by my employer plan. |
* While a government system could cut out administrative paperwork, that doesn't mean they always do. Many government agencies have a lot more paperwork than their private equivalents.
* Negotiations are tricky things. On the one hand, negotiating for a lower price is great, because it means you save money. On the other hand, it also means you are paying a lower price, and that can come with a different set of consequences. Yes, loss of jobs as you indicate, but also potentially less supply of health care. The fact that government is the negotiator doesn't mean that the effect of supply and demand gets suspended.
* I haven't read deeply in the area, but everything I have read indicates that this comes at the expense of wait times. I think, for example, I heard the stat recently that the average wait time for an orthopedist in Canada is 22 weeks.
* I get the moral argument that we should provide care, but I think the single payer raises other moral issues. If the goal is that if a doctor and patient agree on a particular treatment, it's evidently not the case that in socialist medicine that's enough for it to happen (see e.g., https://www.independent.co.uk/news/health/nhs-rations-operat... ).