Yes, that's why it needs to be federal. Not just a state. The pool is too small.
After you reduce waste, fraud, and a host of other things, a countrywide single payer system would be cheaper. It is not cheaper on a state level. That is most likely accurate.
I would have to have someone show me all of the numbers from a country perspective of course, but almost all economists state that if you fund it over the entire country, the costs would be reduced drastically.
You would also be able to eliminate most malpractice suits also saving a ton of money.
See your logic breaks down. If a state as small as Vermont could not make it work, how could a Republic of 50 states come together in kumbaya to make it work. Countries where it appears to work are different in vast ways. Denmark for instance:
https://www.usnews.com/news/best-countries/articles/2016-01-20/why-danes-happily-pay-high-rates-of-taxesAlthough their tax rate is higher, 90 percent plus pay into the system. They are a small country and fairly homogenous. Sorry to say but blacks and hispanics, who happen to be some of the poorest people in the union, are also the sickest.
I am a nephrologist who currently cares for 400 plus dialysis patients along with four other physicians. Approximately 30 percent of our patients are African American...their percent in the total population is 12 - 13% I believe. Of those, maybe 40% are Medicaid and the rest Medicare and a secondary insurance.
Once again, the single payer system could potentially be viable (although I don't particularly trust the government to do the right thing), but all of the populous has to contribute. In England, 10 percent of the wealthier individuals are so sick of the wait times and subpar care that they pay high rates for private insurance.
http://www.independent.co.uk/voices/if-you-care-about-the-nhs-you-should-pay-for-private-healthcare-a7059156.htmlThus, although I believe as a physician to try to my best to treat all regardless of payment ability, it will be difficult to get a functional, well run single payer model in the USA. The better option would be as follows:
- Open up the free market regardless of state borders
- Do away with pre-existing conditions but realize that if you have certain disease processes you will probably pay more...sorry Charlie
- Tax the hell out of vice products and use the resources to fund Medicaid and Medicare. I love cabernet and will pay the tax if it helps the general cause
- Get rid of frivolous lawsuits
- Do away with a hospitals ability to determine cost of services based on insurance status or ability to pay; it should be set price across the board
- Encourage physicians to do the right thing and care for those less fortunate; if they cannot pay for whatever reason let physicians write off bad debt
- Tort reform with limits on lawsuits
- If a physician makes a blatant f-up, have a medical board decide if there was negligence and then waive said tort reform and go for the jugular
This is but a start. I think the US is too large a system for a one program suits all. I may be wrong, but I doubt insurance companies are going away anytime soon.
