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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: TimF who wrote (1779)	8/2/2007 10:53:27 AM
From: Road Walker	Read Replies (1) \| Respond to of 42652

re: I believe the mechanisms you have proposed for saving money through single payer include the savings from economies of scale of having one large insurer, and the savings from additional simplicity for the hospitals and medical practices from only having to deal with one form of insurance claim. I don't see how such savings could come close to the difference in medical care costs between the US and the other countries you mention. The savings are also from making the insurance non-profit (substantial), eliminating most marketing costs and much lower salary costs for government workers over private workers... especially at the executive level. Probably many fewer emolyees dealing with the whole payment process on both the application and payment ends. Would this single action cut our costs to European levels? Probably not but it would certainly be a substantial savings. re: Additional savings could be found if the single payer rations care more than our current insurance companies, but that would be lowering cost by lowering the amount of health care provided. There would probably be less rationing than by the profit motivated insurance companies. re: Tort reform should help, but its not a cure all. The direct and indirect additional costs from lawsuits, malpractice insurance, and more defensive medicine, are large, but completely eliminate the additional level of costs we have in the US and we would still pay more. Also wide spread tort reform isn't a simple or easy change. Tort reform is happening; it just doesn't get much press. In Florida the liability limit for malpractice is $200K. A wronged party has to appeal to the State legislature for a higher award.

To: TimF who wrote (1779)	8/2/2007 10:58:13 AM
From: Lane3	Read Replies (1) \| Respond to of 42652

Here's a question for you, something I've been wondering about. What would it cost if patients really shopped prices as the norm? I'm thinking not about the savings that might be achieved by cheaper or fewer procedures. I'm thinking about the overhead. Given that the costs of physician time is one of the larger health care costs and efforts have been made to minimize that, what would happen if a ten minute consultation turned into a thirty minute consultation when questions about various costs and cost/effectiveness ratios were introduced? The reason I asked is that I just can't imagine having that discussion with a doctor. It's hard enough to decide between different proposed approaches without the doctor needing to be aware of the costs of each and the consultation taking the time to weigh them.