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View Diary: A slightly different approach to Single Payer (24 comments)

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  •  To a certain extent, the payment system would (3+ / 0-)
    Recommended by:
    FloridaSNMOM, gustynpip, 88kathy

    have to be worked, but if enough people were on MedicAid, the doctors would find themselves with fewer and fewer patients.
    Greed is the reason your doctor is not accepting new MedicAid patients. In the long run, that's not acceptable.
    Something has to be done to control the explosion of the cost of healthcare and that will include not paying exorbitant MD fees so that the doctor can buy a Maserati (as my local doctor just did).

    If I ran this circus, things would be DIFFERENT!

    by CwV on Mon Nov 18, 2013 at 09:40:24 AM PST

    [ Parent ]

    •  Physician compensation is a small part of (1+ / 0-)
      Recommended by:
      CwV

      exploding healthcare costs in the US. The solution isn't single payer, or lower drug prices although all three (including physician comp) play a small role. The primary difference between healthcare costs in the US versus the G8 is that we teach and practice medicine in the US in a completely different manner than anywhere else in the world. Until we start teaching medicine is a very different manner all of these other issues are tweaks at the margin.

      "let's talk about that"

      by VClib on Mon Nov 18, 2013 at 10:44:31 AM PST

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      •  Agreed. Fee for service is a lousy model. (3+ / 0-)
        Recommended by:
        VClib, 88kathy, wu ming

        And massive uninsured emergency care is a huge drag on the system that universal coverage should reduce, if not eliminate.
        But the idea that becoming a doctor is a road to the top 1 or 2% is another of the things that must change. People's health is not a commodity.

        If I ran this circus, things would be DIFFERENT!

        by CwV on Mon Nov 18, 2013 at 10:49:05 AM PST

        [ Parent ]

        •  It's not fee for service (0+ / 0-)

          Although that is also a part of it. The way medicine is taught is not based on fee for service, or some other competing healthcare strategy such as "outcomes" based medicine. I do think that outcomes based reimbursement plans can have some cost reducing impact, and Kaiser is a very good large scale example, but it is not the big thing we need. A US trained physician would feel as comfortable at Kaiser as they would as a sole practitioner and would practice medicine in a nearly identical way.

          "let's talk about that"

          by VClib on Mon Nov 18, 2013 at 10:59:54 AM PST

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          •  What IS the big kahuna? (0+ / 0-)

            Aside from the profit of the middlemen?

            If I ran this circus, things would be DIFFERENT!

            by CwV on Mon Nov 18, 2013 at 11:01:55 AM PST

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            •  That would take a diary to explain and I will (1+ / 0-)
              Recommended by:
              CwV

              write one eventually. But as a very high level summary, if a patient presented with chest pain to their primary care physician in the US and an identical case presented in London both physicians would query an AI (artificial intelligence) drop down on a computer screen. What would be on each screen, in terms of the recommended diagnostic process and treatment, would be very different. And it would be different than any other country in the G8 or G20.

              "let's talk about that"

              by VClib on Mon Nov 18, 2013 at 11:13:51 AM PST

              [ Parent ]

            •  Profits of Insurance companies is a very minor (0+ / 0-)

              factor in why healthcare costs so much in the US.

              What the US spends on government funded healthcare (Federal and State) - including Medicare, Medicaid and Tricare is about 9% of GDP. This is about what other industrialized countries spend on healthcare for all.  The US then spends another 9% of GDP on privately funded healthcare.

              The most important way to protect the environment is not to have more than one child.

              by nextstep on Mon Nov 18, 2013 at 11:34:03 AM PST

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