[georgeplusplus]

> I'd much sooner get behind something like a single payer/universal coverage and kill off the useless insurance industry.

At least in Germany most people still have a private care insurance option because the free stuff doesn’t cover everything and it’s just as expensive as the USAs insurance so I don’t think the insurance industry will go away just because their is a single payer system.

[dfilppi]

Killing off industries is not what free societies do.

[ksk]

Nobody is asking the government to make sneakers.

Universal access to healthcare is a human right, and insurance as a product by its very nature - is non-universal - as it relies on denying access to make profit.

The pre-existing conditions loophole in the current system means that you can purchase insurance one day before you get sick or need a major medical procedure and a private company is mandated by the government to pay up. The whole Obamacare plan is a clusterF*.

[georgeplusplus]

>> Universal access to healthcare is a human right.

Healthcare comes from a provider. Would you say a provider has an unequivocal obligation to provide its service to the people?

[ksk]

Well, they can't deny emergency care to a human being who is about to die/in critical condition, can they? So lets start on that common ground - They do already have unequivocal obligations in the current system. Now from that end of the spectrum to the other end, say perhaps an elective purely cosmetic surgery that is non-essential (agreed, this is subjective) we can find some middle ground, can we not?

As a practical matter of policy, the government can incrementally build the path towards universal coverage. By identifying problems in the outcomes of the existing system, and using various common-sense priorities to draft legislation, this can be done in a slow and sustainable manner. There are various proposals out there drafted by people far smarter than I. Its not that I think any particular one is a silver-bullet, but the current system where people go bankrupt due to medical costs is very alarming. We need to start somewhere if we are to tackle this problem.

I totally get the fear of creating yet another entitlement program, and how hospitals will possibly milk the government, but the current system isn't working, people are quite literally dying and/or having their lives be destroyed due to medical costs, so it about time we did something. I've seen some of this damage first hand and its terrifying to think it could happen to people I care about or even myself.

[georgeplusplus]

>> Well, they can't deny emergency care to a human being who is about to die/in critical condition, can they? So lets start on that common ground

Let’s first find our common ground. If you are a doctor and a patient comes to you, and the doctor refuses on the grounds he will not be paid enough, you think you have the right to compel this doctor to perform the service anyway?

The emergency care example you give is an extreme and shouldnt be used as the basis for all other policy. I would say a doctor who chose the job as an emergency care provider acknowledges your stance when he took the job, to provide service to matter what, not because it is a right but a contractual obligation.

[ksk]

I think the "what right do you have" or "can you force someone" phrasing is adversarial and can't drive a conversation.

Lets instead look at distilling the universal access idea to its essence, we need

  1) A capital pool to fund the program
  2) A legislative framework that
    2.1) Lays out the products and services and the pricing of those
    2.2) Allows for price negotiation based on geography and other market driven criteria
    2.3) Drafts fines for inappropriate behavior - excessive billing, using unapproved medication, etc
    2.4) Defines licensing terms for a provider to bill the government 
  

Now #1 is no different from any other regular insurance, you collect individual payments at the federal level. #2 would also be federal legislation. #2.4 would be similar to how medicare-certified hospitals operate.

Now the question really becomes - why would any provider not take this deal? Certainly, there could be several reasons, and those can be addressed on a case by case basis. But the point I want to make is, we can start small, maybe we only tackle preventative care at first.