So in the Fresno Bee a single payer advocate has a sensible piece on why California should adopt single payer. I don’t agree — I think we should have a multiple-payer system, with lots of single-payer look alike provisions, but at least it’s a sensible argument.
Opposing this view, the Bee has a piece from a complete nutjob. He seems to believe that there’s something terribly wrong with the US Mail (when there isn’t) and that all our health care problems can be solved by sending all illegal immigrants home. Yup he really has that as his number one solution. Who exactly will harvest the fruit & crops that supply Fresno and the central valley with all its income is not explained.
But the most interesting thing is the wingnut’s name. It’s "Michael Der Manouel Jr". Is there any possible slight chance that someone with the name "Der Manouel" is not either an American Indian or straight off the Mayflower? If so, does he have proof that his family are legal immigrants? Sure sounds like a wetback to me. Perhaps sending him back "home" (along with the rest of his "conservative" brethren) might just be the solution to the health care crisis.
I am of Armenian descent. And yes, illegal immigration is crushing the health care system in California. Talk to an ER doctor once in awhile when you aren’t engaging in name calling.
Eric — Now you’re asking for a full semester length class! I wont describe all the foreign alternatives here, and Ezra did a not bad job at it over at his blog earlier in the year. But I will take issue with your core philosphy. There is no necessary connection between a health system and an overall societal system and economy. Case in point is the UK.
It has a single payer government-funded system, with a “safety valve” private sector, essentially for elective surgery. That’s basically the same it’s had since 1945. In the last few years the UK has had lower unemployment and faster growth than any other major economy including the US. Back when I was a kid the UK was basically in the economic toilet with high unemployemnt and rampant inflation. Then marginal tax rates were up to 83% on the highest incomes. Now they’re 40%, which is lower than most high income earners in the Californians and New Yorkers pay.
All that has changed but the health care system is basically the same. So I think that here we can change the health care system (on a largely budget neutral basis to start) and leave the rest of the economy unchanged. I do not see why one need much affect the other.
//shift costs to the uninsured — and no one squawks for them.//
You’re my hero, Matt!
//shift costs to the uninsured — and no one squawks for them.//
Your my hero, Matt!
Matthew, all the costs don’t get shifted to the uninsured. Yes, they bear some of the burden, but alot of the costs are shifted to privately insured (which we see in the form of higher copays and premiums and – ultimately – less coverage). I also think of DSH as the result of cost-shifting. But you do have a good point – the fewer systems, the more noticeable the cost shifting would be and the more likely something might be done to fix the underlying issue.
Alot of people care. We just aren’t the ones running the place. 🙂
Matthew- I would appreciate (and perhaps others would as well?) if you would do some posts explaining the systems in the countries you mention. Please give me specifics– especially about population size, marginal tax rates, medical and product liability restrictions, who pays for higher education, who gets to make end of life and access to care decisions, and government controls over other major industires in the country. I would throw in national unemployment levels as well.
Because I presume that by adopting these countries systems- you want to really have the whole system. If you want to ‘cherry pick’ from multiple countries, please explain how you would do so.
But Hope, if there were two systems and one “shifted” costs to the other, the other would squawk–and something would get done about it. Currently there are multiple systems who in the end shift costs to the uninsured — and no one squawks for them. That’s why universal coverage will bring cost control.
But I’ve been saying this for 15 years and no one cares….and why should they (until the whole thing collapses)
You could have universal coverage without a single system being responsible for all people/entire cost. For instance, if you kept Medicaid/Medicare/Tricare, and had everyone else mandated into a single system — more efficient than current, but still possible for providers to cost shift. Also still issues with the people near/on the edge of Medicaid income eligibility cycling between Medicaid and the other mandatory system.
Abby — I think a version of the German, French, Japanese or Dutch system would work fine here, and be less of a fight than getting in a pure Canadian/British-style single payer. But so long as their is universal coverage I don’t really care which version it is, because universal coverage forces the system to be responsible for all people and its entire cost.
Ron, you get funnier and funnier. So on your loony pal Zandstra’s website he says “…the Canadian system, which consumers (sic)40% of Canada’s Gross Domestic Product….”
This guy is really a candidate for the US Senate? That’s the best you loonies on the extreme Christian right can come up with?
I suggest that he hires an editor AND a fact checker. We’re spending way too much here and we only get to 15% of our GDP. If the Canadians were “consumering” 40% of their GDP in health care, they’d have no money left to freeze their ice rinks and the state would fail!
On the other hand, perhaps Ron you should cut out the middle man and run yourself. How could you do worse?
What kind of multi-payor system do you advocate? I don’t want a nationalized health service, but right now, I’m leaning toward a French sort of system with medicare for all but with top up luxury insurance. Someone told me that this was multi-payor, but I’d like to have one insurer so that when I’m in California and get hit by a bus, I don’t have to worry about out-of-network hassles.
Tripod Economics is the father of consumer-driven health care. Back to the core. The head guy is really smart with numbers with a special focuse on ethics. I set his family tax free with an HSA so we have bonded. He makes things pretty simple, unlike me sometimes. Now I’ve changed my Hurricane saying again. Now it’s, Z-Truth is like Katrina, it blows the PROPAGANDA away.
Ron. You are hysterical, and I mean that in both senses of the word.
You think that I can’t poke fun at loony quasi-racist for falsely blaming domestic problems on immigrants (a classic race-baiting tactic).
You think that the UK doesn’t have single payer because it allows private insurance.
You think that Canadian courts have precedence in the US.
And you think there’s something called Tripod economics, even though your entire article (which somehow just manages to not mention medical underwriting which would invalidate your whole argument) never explains what the hell that is.
So five major logical inconsistencies in only nine lines. That must be a new record!
That is so wrong in America Matthew. You can’t use someone’s name then attack their race, come on. As far as a single-payer being a 2 or 3 payer system just proves you are coming up out of the brain-washing you have been subjected to by reading all of those Democratic talking points. Besides, the Candadian courts have ruled that single-payer is unconstitutional. So that’s finally dead in America (Amen). You wanted me to write a piece on Tripod Economics, so I did Matthew.