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To: Lizzie Tudor who wrote (90938)	9/30/2007 6:27:02 PM
From: Sr K	Read Replies (1) \| Respond to of 306849

Re: Single payer You have to charge more for smokers, more for those at risk or with pre-existing conditions, or you make those who don't smoke and those who take actions to prevent disease pay for those who who have higher costs. We need to link cost to payment, and co-payments are not enough of a solution for a stable, single payer system.

To: Lizzie Tudor who wrote (90938)	9/30/2007 9:56:29 PM
From: lifeisgood	Respond to of 306849

In theory, every employed person could pay a doctor's office/hospital $100 per month and then, when the need arises, utilize basic health care services of said doctor and hospital. Non-core services (e.g., implants) would be discretionary and up to the consumer to pay out of pocket. The government would pay the $100/month for the disabled/unemployed. In practice, there are multiple levels of insurance administration (e.g., from human resources people to insurance processors, hmo's, accountants, actuaries, reinsurers) which literally drain money from the system that would otherwise be spent on health care. In the end, only a fraction of what people put into the system gets spent on health care. The remainder is wasted (notwithstanding the argument that actuaries/accountants/claims processors need jobs too). best... LIG

To: Lizzie Tudor who wrote (90938)	9/30/2007 11:35:19 PM
From: patron_anejo_por_favor	Read Replies (1) \| Respond to of 306849

I'm not against single payor in principle. It's not a panacea for all that ails the US health care system. It would solve some of the problems or rather, exchange those for others which may be less objectionable. GDP expenditure on health care would be reduced, and there would be no "uninsured" by definition. Cost-shifting would be eliminated, resulting in significant savings. If tied in with an effective tort reform proposal, more savings would be realized (and some of the expected loss in medical manpower would be attenuated a bit). On the downside, there would be a real reduction in availability of care on demand i.e., waiting lists for services where there are currently none (of course, for the uninsured the "wait" can be infinite currently). Certain services would be eliminated (things like dialysis for patient's over a certain age, some transplants, some marginal operations that have limited proven benefit). I don't think people who are proponents (of single payor) have realistic expectations on this, and how it will impact the average person. In my opinion, it's a "pick your poison" choice, but the more dysfunctional the current system gets, the better by comparison single payor is.