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

To: Alighieri who wrote (16097)	4/4/2010 11:18:16 AM
From: Eric	1 Recommendation Respond to of 42652

Single payer? There are dozens of examples around the world. Yes there are, and some of them work very,very well.

To: Alighieri who wrote (16097)	4/4/2010 11:42:16 AM
From: Lane3	2 Recommendations Read Replies (1) \| Respond to of 42652

The CBO scored both and showed significant savings even with modest participation. Savings over what? It showed significant savings over the proposal without the public option. If I leave the bacon out of my breakfast today I will save 100 calories over the breakfast with the bacon. But I will be consuming more calories than if I didn't eat breakfast at all.

To: Alighieri who wrote (16097)	4/4/2010 12:40:08 PM
From: Lane3	4 Recommendations Read Replies (2) \| Respond to of 42652

Single payer? There are dozens of examples around the world. We weren't discussing single payer. We were discussing the proposed public option. Two different things. Similar in concept but not in particulars or context. Well it's pretty obvious... It's obvious only to true believers and those not paying attention. Let's say that the public option had passed and that Medicare rates were used. In order to save money we'd have to either do less stuff and/or do the same stuff cheaper. Right? Let's deal with cheaper first. You are apparently assuming that Medicare rates would be lower than whatever payment rates were previously in effect for the folks signing up for the PO. But would they be? How do you know that? Let's think about it. Which cohort would gravitate to the PO? It would be people who are either uninsured due to cost or uninsurability or who have individual policies that are too costly or too limited. If they came from HMO's, Medicare payments may actually be higher than equivalent payment rates, particularly if the HMO's were non-profit. But I'll give you that one since it's more likely they're lower than average given Medicare's reputation for squeezing providers. Even though the prior payment rates for many/most of those who sign up for PO had a payment rate of zero given that they didn't have insurers to pay for stuff. So now all those folks are in PO and are using the system for stuff they may have done without before. I'll bet few of the uninsured or HMO insured had colonoscopies. So now herds of people are getting them and they cost money. Then there are the uninsurables, who need lots more stuff than the rest of us. Remember that for some approach to be cheaper it has to do less stuff or the same amount of stuff at lower payment rates. Now we're doing lots more stuff. Even at Medicare rates, that costs money, new money, money that wasn't being spent before. Would the Medicare-rate squeeze on payments for the old stuff, assuming that was, indeed, a savings, be enough to compensate for all the new stuff even at Medicare rates? Not likely at all. Almost impossible, I'd say. Cognitive dissonance time for true believers.