Single Payer

[ShockerPrez]

Not many people get a catastrophic water bill.

But is water a right?

Cant live without it.

[ShockerPrez]

I would also argue that most people dont have catastrophic healtcare bills either.

[Play Angry]

I get that this is an attempt at a logic trap but the U.S. utility system works fine and doesn't cost normal ppl ~3-8% of their income to pay for access to water that they may not ever need. If it did, you can guarantee that **** would be nationalized in a blink.

I don't think the argument is that every "essential" service should be government-run. It's a reaction to a system that is a horrible hybrid of the free market and socialized service provision. Some think the answer is to just socialize it completely; others think it would be better to implement systemic reform from the private side. The current model is ridiculous and unfortunately the former group seems to vastly outnumber the latter.

[Rocky Mountain Shock]

nm

[Rocky Mountain Shock]

I would also argue that most people dont have catastrophic healtcare bills either.

You must be young.

I'm 39. I'm lucky too, I haven't had any catastrophic healthcare bills either. My parents, however, would be dead broke without Medicaid, and I probably would be too by helping them.

[Aargh]

But is water a right?

Cant live without it.

If you really want to go that route, I'll play.

Let's privatize and deregulate water. Like health care, people would pay anything to have water. In the true spirit of unregulated capitalism, the price would go so high that some would not be able to afford it. There would be no downward pressure on pricing to attract customers. The pressure would be upwards to attract stockholders and investors. The only thing that would stop the upward spiral of price increases would be when enough people who couldn't afford it died because of lack of water. The shrinking customer base would be the only limit to price increases.

Now that I typed out that rather silly scenario, I realized it's eerily similar to how we handle health insurance now.

[ShockerPrez]

My main issue with single payor is translating an issue for 10% of the population into a solution for 100% of the population. Putting our healthcare in the hands of the government is DANGEROUS!!!

I would be willing to spend money on government subsidies all day if it precluded them from having any control. I know thats never gonna happen. Lets just say that 650,000 bankuptcies per year are medical related. Average $100k per bankruptcy... 65 billion to make them whole? Sold.

Its not so much about spending the money for me, its the whole government control idea.

I'd rather go bankrupt and free to pursue a 50/50 chance at being cured than die with my savings because the government deems my case not worthy.

[ShockerPrez]

If you really want to go that route, I'll play.

Let's privatize and deregulate water. Like health care, people would pay anything to have water. In the true spirit of unregulated capitalism, the price would go so high that some would not be able to afford it. There would be no downward pressure on pricing to attract customers. The pressure would be upwards to attract stockholders and investors. The only thing that would stop the upward spiral of price increases would be when enough people who couldn't afford it died because of lack of water. The shrinking customer base would be the only limit to price increases.

Now that I typed out that rather silly scenario, I realized it's eerily similar to how we handle health insurance now.

Where, in unregulated capitalism does the price always go up? True free market capitalism, mind you.

[ShockCrazy]

Where, in unregulated capitalism does the price always go up? True free market capitalism, mind you.

ISP's have largely been unregulated and costs consistently rise with performance increases not matching the costs. In fact providers are seeking more deregulation in order to be able to charge based on sites you access. There is limited competition in various markets likely due to collusion. So that's a strong case of deregulation NOT supporting the consumer.

http://www.pbs.org/newshour/updates/internet-u-s-compare-globally-hint-slower-expensive/

https://www.numbeo.com/cost-of-living/country_price_rankings?itemId=33

https://www.nytimes.com/2014/10/31/upshot/why-the-us-has-fallen-behind-in-internet-speed-and-affordability.html

[ShockCrazy]

My main issue with single payor is translating an issue for 10% of the population into a solution for 100% of the population. Putting our healthcare in the hands of the government is DANGEROUS!!!

I would be willing to spend money on government subsidies all day if it precluded them from having any control. I know thats never gonna happen. Lets just say that 650,000 bankuptcies per year are medical related. Average $100k per bankruptcy... 65 billion to make them whole? Sold.

Its not so much about spending the money for me, its the whole government control idea.

I'd rather go bankrupt and free to pursue a 50/50 chance at being cured than die with my savings because the government deems my case not worthy.

Also you are misconstruing single provider with single payer. Single payer does not mean the government is involved in healthcare decisions. Single provider does.

[jdshock]

If you really want to go that route, I'll play.

Let's privatize and deregulate water. Like health care, people would pay anything to have water. In the true spirit of unregulated capitalism, the price would go so high that some would not be able to afford it. There would be no downward pressure on pricing to attract customers. The pressure would be upwards to attract stockholders and investors. The only thing that would stop the upward spiral of price increases would be when enough people who couldn't afford it died because of lack of water. The shrinking customer base would be the only limit to price increases.

Now that I typed out that rather silly scenario, I realized it's eerily similar to how we handle health insurance now.

Yeah, water seems like a strange comparison because there is basically no competition in the water market. Most individuals in the country have one choice, and we see a huge efficiency benefit by allowing a monopoly in the market.

[ShockerPrez]

ISP's have largely been unregulated and costs consistently rise with performance increases not matching the costs. In fact providers are seeking more deregulation in order to be able to charge based on sites you access. There is limited competition in various markets likely due to collusion. So that's a strong case of deregulation NOT supporting the consumer.

http://www.pbs.org/newshour/updates/internet-u-s-compare-globally-hint-slower-expensive/

https://www.numbeo.com/cost-of-living/country_price_rankings?itemId=33

https://www.nytimes.com/2014/10/31/u...rdability.html

This sounds like supply and demand. But if the ISP is colluding to own a monopoly, thats not pure capitalism at play.

[ShockCrazy]

This sounds like supply and demand. But if the ISP is colluding to own a monopoly, thats not pure capitalism at play.

Supply and demand??? Not even close. How is it not capitalism at play? It is more profitable to make $100 per customer off 80-90% of a given market than it is to make $30-40 on 50% of two especially when you start factoring in infrastructure costs. If you don't even have to maintain your network because no one is going to compete that's significantly cheaper than having to maintain two because there is competition.

[SHOXJOCK]

The VA is actually single-provider, versus Medicare which is single-payer. It is well worth pointing the difference because in practical terms they represent two fairly different levels of government intervention.

In a single payer system, the government pays. You go to the hospital, get treated, and eventually the hospital gets the money for the service from the government (and them, from tax payers). There is a still a private market of hospitals, insurers, and pharmaceutical companies competing to keep costs low.

In single provider, the government provides. They run the hospitals, the run the pharmaceutical companies, they run the research. If they don't think a procedure is worth paying for, you can't turn to a competitor because the government is the only option.

A big reason the VA is so inefficient (even over other government programs) is that the government directly administers VA Medical Centers. This results in all sorts of silly mandated inefficiencies. For example, the government makes VA doctors translate medical records from one hospital to another themselves (a big problem when every military branch has its own set of medical records). Private hospitals hire medical records specialists, which is far more efficient and doesn't force doctors into doing needless paperwork. Then you have use-it-or-lose budgeting, impossible to fire administrative employees, long wait times, etc.

Even if we do go to single-payer, it will be more like Medicare and less like the VHA, and it isn't really a choice. To have something like the VHA or NHS the government would need to essentially buy out or bring in every hospital and private practice. Just the dealing with the laws of 50 different states would make it difficult, let alone trying to bring in 4,862 hospitals and about a million doctors into the federal system (which currently has 212 hospitals, to give some idea to the scale).

Totally agree on your take on the VA being inefficient. If you take all of the budget that the VA spends on medical and hospital care of veterans and give it to Medicare. Then move the veteran's over to Medicare, Veterans will be better off and we could close all of the VA hospitals and get rid of thousands of federal employees, not overnight maybe over 3 years. A win for Veterans and the smaller government people like myself.Yes I know it's still government but at least it's more efficient.

[ShockerPrez]

Supply and demand??? Not even close. How is it not capitalism at play? It is more profitable to make $100 per customer off 80-90% of a given market than it is to make $30-40 on 50% of two especially when you start factoring in infrastructure costs. If you don't even have to maintain your network because no one is going to compete that's significantly cheaper than having to maintain two because there is competition.

Why not charge $200 or $300 then?