Single Payer

[wufan]

But according to everyone if the government were in charge it would take 3 times as many people! Think of all the tax revenue! And all those people could then invest in businesses! /sarcasm since I probably need it

There's a benefit to for profit corporations to be efficient. There is not a benefit for gov to be efficient. Also, who is single payer going to invest in new businesses? A free market capitalist system is designed to create growth through new markets, new research, and new services. Government run systems are designed to replace another existing service, and because of this they stymie growth (or in this case, replace an existing market).

If this is an argument of capitalism vs socialism, then just say so and we can have that debate.

[wufan]

Seems like a bit of an over simplification. The board dictates the direction of the company through selection of executives. The board is elected by the shareholders. Why would the shareholders elect a board who would not seek profits for the shareholders in a publicly traded company?

Capitalism is the mutually beneficial exchange of money for goods or services. Companies offer services and consumers purchase them. If there is no value, they won't purchase them.

Share holders give a company money to expand their services. For this they take on the risk/reward of the company. If the company can provide more markets with more services, they can make more money and everyone is better off.

[MoValley John]

Seems like a bit of an over simplification. The board dictates the direction of the company through selection of executives. The board is elected by the shareholders. Why would the shareholders elect a board who would not seek profits for the shareholders in a publicly traded company?

No **** it's an over simplification, it's a message board not econ 101. Also, your statement that shareholders don't bring a benefit was both inaccurate and the grand daddy of over simplifications

[wufan]

Seriously! Why is the uber-efficient government paying the exact same amount for partial coverage that B Sanders plan costs to insure everyone?

Anyone?

[jdshock]

I'm asking honest questions. Why do we accept it? Honestly. Why is it soooo important that health insurance remain a private entity? What are the benefits? I'm looking for honest reasoning as to what we gain by having for profit health insurance companies. Maybe single payer doesn't work, what if health insurance had to operate as a non-profit?

My gut reaction is that requiring insurance companies to act as a non-profit is the least desirable of the options. Non-profit companies do not have the same financial incentives as for-profit businesses. It's also kind of a meaningless title, since they could just allocate "profit" to executive salaries to become non-profit. And if you cap executive salaries, then you're talking about enough government oversight that you might as well make it government controlled.

[jdshock]

Anyone?

It's not a particularly good argument.

Sure, in all honesty, a single payer system almost certainly costs more than the status quo. But let's assume that it would be cheaper and the government is more efficient than the private sector, senators and representatives choosing not to pursue a single payer option because it would be politically unpopular doesn't mean government employees or programs are more inefficient. It just means they couldn't get this program, that is more efficient, passed.

[ShockCrazy]

No **** it's an over simplification, it's a message board not econ 101. Also, your statement that shareholders don't bring a benefit was both inaccurate and the grand daddy of over simplifications

My point was relative to public health and the healthcare industry at large. They bring direction to the company certainly, but what does the average citizen gain? Especially if there almost certainly will forever be an individual and employer mandate(which has pros and cons). My point is we are not being served by the objectives of the health insurance industry and it's counter-productive to general health.

[ShockCrazy]

My gut reaction is that requiring insurance companies to act as a non-profit is the least desirable of the options. Non-profit companies do not have the same financial incentives as for-profit businesses. It's also kind of a meaningless title, since they could just allocate "profit" to executive salaries to become non-profit. And if you cap executive salaries, then you're talking about enough government oversight that you might as well make it government controlled.

Oh I agree, I was just throwing it out there, since I can't hardly get a real discussion from a lot of people other than government bad. Non-profits are subject to the same exploitation as for profits, see professional sports, the college bowl system etc. Which all are non-profits.

[ShockCrazy]

There's a benefit to for profit corporations to be efficient. There is not a benefit for gov to be efficient. Also, who is single payer going to invest in new businesses? A free market capitalist system is designed to create growth through new markets, new research, and new services. Government run systems are designed to replace another existing service, and because of this they stymie growth (or in this case, replace an existing market).

If this is an argument of capitalism vs socialism, then just say so and we can have that debate.

There is a benefit to being efficient in public companies. Consider low level employees at any large company, who are the ones who get things done, what is their incentive to be efficient? Well of course the objective of staying employed. The fundamental issue I think people have with public companies is... the lack of at-will employment, which I would agree and that needs to be changed. But I think it's false that there is no incentive to be efficient, because everyone is beholden to the person behind the purse strings. And when it comes to a public company it's the electorate at large, as long as there is at will employment. I am not a proponent of socialism and providing free public healthcare isn't the sole dictator of a socialist country.

[MoValley John]

My point is we are not being served by the objectives of the health insurance industry and it's counter-productive to general health.

That is an opinion, not fact.

I don't absolutely oppose single payor, but you are going about it with half truths, opinions and strawmen.

We need to identify waste and the real reasons for the rise in health care costs long before we talk about switching systems. If your solution to rising health care costs is switching to single payor without addressing costs, well single payor will simply be the next system that covers out of control costs in healthcare system.

I will give you a hint on one place to look, plus blame. Healthcare coding, billing and regulations. But before you kneejerk blame private insurance, medicare created the coding, billing and regulation fiasco, not private insurance. Private insurance simply lazily adapted to work and utilize medicare coding, billing and regulations.

[ShockCrazy]

That is an opinion, not fact.

I don't absolutely oppose single payor, but you are going about it with half truths, opinions and strawmen.

We need to identify waste and the real reasons for the rise in health care costs long before we talk about switching systems. If your solution to rising health care costs is switching to single payor without addressing costs, well single payor will simply be the next system that covers out of control costs in healthcare system.

I will give you a hint on one place to look, plus blame. Healthcare coding, billing and regulations. But before you kneejerk blame private insurance, medicare created the coding, billing and regulation fiasco, not private insurance. Private insurance simply lazily adapted to work and utilize medicare coding, billing and regulations.

Certainly it's more than single payer, I'm not even saying single payer is THE solution. I'm arguing it could be the solution. Costs certainly are the root of it. I think that single payer could help control costs, by having a single negotiator of costs, but there could also be drawbacks certainly. Coding and billing certainly are a cause of bloat, but both private and public face these issues, and it has more to do with the fact it's hard to convince shareholders or government officials it's worth re-working. It has an steep up front cost, it certainly doesn't generate revenue, and it's hard to quantify the efficiency and time savings.

[Kung Wu]

Not necessarily.

The vast majority of both Keynesian and Austrian economists recognize that price controls do not work in the long term (and rarely in the short term), and almost universally result in the opposite of the desired effect: Artificially elevated prices.

Guess when price controls were implemented in the chart below?

[Kung Wu]

Why is it soooo important that health insurance remain a private entity? What are the benefits? I'm looking for honest reasoning as to what we gain by having for profit health insurance companies.

Thomas Sowell puts it perfectly: "The fact that most goods are more widely affordable in a capitalist economy implies that profit is less costly than inefficiency. Put differently, profit is a price paid for efficiency."

This has been borne out over, and over, and over in history so many times that it is crazy that people still buy into the thought that "maybe this time the government will get it right!"

[ShockCrazy]

Thomas Sowell puts it perfectly: "The fact that most goods are more widely affordable in a capitalist economy implies that profit is less costly than inefficiency. Put differently, profit is a price paid for efficiency."

This has been borne out over, and over, and over in history so many times that it is crazy that people still buy into the thought that "maybe this time the government will get it right!"

This is true(also note it says most, it's not universal is healthcare an exception, maybe yes, maybe no) but there are fundamental issues when comparing it to healthcare. Can we individual shop for a specific treatment and seek the best price? Do you know what you are paying upfront for a given service when you go to a clinic or hospital? In many cases is this even possible for either? Certainly not in any urgent care scenario. Do these things fundamentally make it impossible for profit seeking capitalism to properly provide accessible care to those that need it? The issue is not capitalism as a whole, which overall provides most things at a lower cost, the question is if healthcare is an exception to the rule.

Ignore outcomes, which can be subjective, how is it that other industrial countries spend less and are universally more satisfied than us even with more government involvement?

Edit: One further final question that just came to me. Capitalism is built on a fundamental choice from the consumer: do I want this thing? Healthcare is NOT a choice, not a single person, who can get better, wants to die. Those who do, are mentally ill, and guess what, they can get better.

[wufan]

It's not a particularly good argument.

Sure, in all honesty, a single payer system almost certainly costs more than the status quo. But let's assume that it would be cheaper and the government is more efficient than the private sector, senators and representatives choosing not to pursue a single payer option because it would be politically unpopular doesn't mean government employees or programs are more inefficient. It just means they couldn't get this program, that is more efficient, passed.

The current government spending is 1.4 trillion dollars per year on healthcare. The proposed "universal" healthcare by Bernie Sanders, where you don't pay a nickel at the doctor (just pay in taxes) is 1.4 trillion per hos economist. How can this be? How is it possible that the government is currently spending 1.4 trillion dollars and not insuring everyone, when someone has a plan to insure everyone for the exact same amount? Is it possible that his economist understated the cost? Is there some trick to lowering costs if you add another 250,000,000 people to Medicaid/Medicare?