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Politics : Foreign Affairs Discussion Group -- Ignore unavailable to you. Want to Upgrade?

To: geode00 who wrote (262832)	4/27/2008 12:03:18 AM
From: TimF	Read Replies (1) \| Respond to of 281500

Higher administrative costs due to the hodge podge of public/private systems in the US including the for-profit health insurance system. There may be some scope for savings here, but the supporters of single payer greatly exaggerate it. They include the money that goes to corporate taxes as part of the private insurance overhead costs, while they don't count the parts of Medicare and Medicaid overhead that are not funded as part of those program's budgets. Also to the extent you don't force everyone in to lowest command denominator government insurance, and allow private insurance to provide more or better coverage at an extra price, you still have overhead and profit outside of the government. But if you don't allow such insurance you are forcing many people in to a worse situation. Its not like your building public housing for the homeless, its like your building public housing and forcing everyone to live in it. Higher rate of medical errors due to the lack of a centralized database. Services that get paid for by the government can be done without a centralized database, services that get paid for by the private sector can done with a centralized database (or with controlled sharing of information from distributed databases which is probably the better way to go anyway). Changes in data storage methods and technology are a separate issue than changes in who pays, esp, since your not just talking about insurance data, but the doctors own data. This is as much part of the health care system as it is part of the health care insurance system, and changing the later doesn't necessarily change the former. Failure to negotiate for better drug prices. What you call "failure to negotiate" is a feature, not a bug. Governments setting prices almost always leads to problems (unless the price would be within the government limits, a law that says you can't sell cars for less than a nickel or more than a billion dollars would be silly but not problematic). The problem here would be reducing incentive for new drug development. In the very short run things might be better (for everyone but the drug companies), but in the long run most people would be worse off. Medical malpractice and doctors and nurses with lousy bedside manners. Protection of poor doctors and nurses by their profession. These factors also exist in the countries that you think do a much better job, and would exist in the US if we changed our health care insurance system. The problem that does exist in the US to a greater extent than elsewhere is not malpractice, or bad beside manner, or groups protecting their own, but a more litigious society. This causes more lawsuits, larger awards, more expensive malpractice insurance competition, more defensive medicine, and reduced availability of and competition among certain types of health care professionals in certain areas. Bought and paid for FDA. The usual argument about "bought and paid for FDA" is that it approves drugs it shouldn't. A bigger problem with the FDA is its delay in approving drugs and the cost of meeting its requirements. The 2nd problem probably can't be resolved, only addressed at the margin. Testing drugs for safety and effectiveness is an inherently expensive proposition. The 1st problem can be dealt with to an extent but not simply or completely, and probably not cheaply. We could allow use of unapproved drugs at the user's own risk, but even if we do that, insurance won't pay for those drugs, and most people won't use them, and many people in many situations shouldn't use drugs that haven't been thoroughly tested, so while such a step would increase liberty, and be practically beneficial to some people, it isn't a solution for the issue. Single payer, or any other widely proposed change wouldn't be a solution either. Many of these are related to the private health care system. Most of these are not primarily related to the private health care insurance system, and most, even on the left, are not actually arguing for a public health care system (or true socialized medicine, rather than nationalized health insurance). Are you? And most of the problems and differences you don't list (mainly the one's in my previous link, but I don't claim I've been able to think of them all) have nothing to do with our insurance system, or even our health care system.