TA...in an ideal world, you may be right. However, unfortunately, living in the most Democratic free society in the world is diametrically opposed to standardized single payor healthcare. As a physician, the absolute greatest failure of the healthcare system in this country is the eating habits, gross obesity, and illicit habits like smoking and excessive drinking.
Is it shocking that over 50% of Americans are technically obese, and interestingly 50% of Americans pay no taxes. The reason a single payor system works in some countries is that citizens...all of them...are expected to contribute to overall costs. In our country, most people would rather buy their cigarettes or alcohol and not buy insurance. Thus, I do not feel that a single payor option will work considering there are no penalties for bad behaviour. Thus, maybe the following would help without breaking the bank.
- Get rid of trial lawyers; physicians order too many unnecessary studies for fear of litigation...especially from those with less means...i.e. blacks, hispanics, trailer park whites
- Tort reform to protect physicians from ridiculous lawsuits
- Tax write offs for physicians for physicians and their practices. For instance, advocate that 5% of your practice is to care for the less fortunate but because the patient has no means to pay the practice / physician can write the visit off against gross income
- As it is, there are very few providers for straight Medicaid or Medicare even in the commuity; try to get an appointment with a PCP with straight Medicare
- With tort reform, malpractice insurance will decline
- Tax the hell out of consumption products; don't VAT tax the whole country....if you want to smoke, put a 100% tax on a pack of cigarettes. If you want to drink...increase taxes there
- Allow insurance companies to negotiate with Canadian pharmacies to obtain meds...agreed that meds in America are ridiculously expensive
- Allow people to shop for their insurance out of their states; cannot believe the Republicans haven't already passed this into law....think of Amazon vs your brick and mortar stores. Why can't I use BCBS of California in Florida; it is ludicrous to have virtual monopolies state to state
- Have clear expenses for services ahead of time...do you know how much that ER visit to treat that migraine is really going to be prior to getting the bill. Bet you nobody has a clue until they get the 5000 dollar bill and see that a Tylenol costs a 100 bucks.
This is but a start. I don't think a single payor is going to be viable in America right now. Beyond that, google Canadian healthcare nightmares and read the horror stories. Three months to see a PCP. Five months to see a specialist. In America, even with the crappy system we have now, you can get in to see a doc timely. Simple, if you are willing to pay for it, you can doctor shop. Can't do that in Canada. Also, think about a panel that denies you a particular service ie chemotherapy, for instance, because you are 70 but otherwise healthy. Don't think they ration care in these countries...think again. If there is only one insurance, what recourse do you have if denied services.
I am not completely dismissing your idea. I am just pointing out obvious weaknesses in the system. The debate will go on.
