Under single payer, who pays the doctors and who do the doctors work for?
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The PPACA Thread Part III - Let's have a healthy debate!
- Thread starter joecct
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Under single payer, who pays the doctors and who do the doctors work for?
Re: The PPACA Thread Part III - Let's have a healthy debate!
Not even sure if we still use insurers to help manage care or not. As I said, I personally need to see a lot more details.
Good article here regarding ACA:
http://touch.latimes.com/#section/-1/article/p2p-83865959/
You know, some may say this ruling saves the GOP from doing something on healthcare, but does it? Every leading Republican candidate for President is committed to "repeal and replace". What exactly do they say when asked what "replace" means in front of 60M people in the Presidential debates? "I'll get back to you on that?"
Mittens got killed by even right leaning publications like The Economist when he couldn't be bothered to explain how cutting $5T in upper income taxes + $2T in additional defense spending would lead to a balanced budget. Likewise, if you can't be bothered to explain how you plan on throwing 20M people off of the insurance rolls and give back $$$ to the insurance industry yet still produce a deficit neutral law, voters are going to wonder why.
Not even sure if we still use insurers to help manage care or not. As I said, I personally need to see a lot more details.
Good article here regarding ACA:
http://touch.latimes.com/#section/-1/article/p2p-83865959/
You know, some may say this ruling saves the GOP from doing something on healthcare, but does it? Every leading Republican candidate for President is committed to "repeal and replace". What exactly do they say when asked what "replace" means in front of 60M people in the Presidential debates? "I'll get back to you on that?"
Mittens got killed by even right leaning publications like The Economist when he couldn't be bothered to explain how cutting $5T in upper income taxes + $2T in additional defense spending would lead to a balanced budget. Likewise, if you can't be bothered to explain how you plan on throwing 20M people off of the insurance rolls and give back $$$ to the insurance industry yet still produce a deficit neutral law, voters are going to wonder why.
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Kepler
Si certus es dubita
Re: The PPACA Thread Part III - Let's have a healthy debate!
And I think this is where the emotion-driven politics of the right of the last twenty years hurts them badly. The right didn't have to do the hard work in the 90s or 00s, they just had to throw out thought-terminating cliches like "big government" or "job killing taxes" or "red tape" and their voters didn't ask about the details. But since the Great Recession that rhetoric doesn't cut it anymore and they have to offer substance, and, mostly, they aren't prepared. The next gen conservatives will be, but these guys are at sea.
And I think this is where the emotion-driven politics of the right of the last twenty years hurts them badly. The right didn't have to do the hard work in the 90s or 00s, they just had to throw out thought-terminating cliches like "big government" or "job killing taxes" or "red tape" and their voters didn't ask about the details. But since the Great Recession that rhetoric doesn't cut it anymore and they have to offer substance, and, mostly, they aren't prepared. The next gen conservatives will be, but these guys are at sea.
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Re: The PPACA Thread Part III - Let's have a healthy debate!
The GOP are saying that they'll get rid of the ACA because the polls are not fully in favor (which shows brainwashing at work). It really comes down to the fact that these guys have to stand for something. In the case of Obama, it was easy. He was going to salvage the economy. Since Bush left things in a mess which puts the GOP solution in doubt, GOP candidates have struggled with what they're going to actually do (rather than just stop the Dems). This is something they can do. Whether it actually improves the country is another story.
The GOP are saying that they'll get rid of the ACA because the polls are not fully in favor (which shows brainwashing at work). It really comes down to the fact that these guys have to stand for something. In the case of Obama, it was easy. He was going to salvage the economy. Since Bush left things in a mess which puts the GOP solution in doubt, GOP candidates have struggled with what they're going to actually do (rather than just stop the Dems). This is something they can do. Whether it actually improves the country is another story.
Re: The PPACA Thread Part III - Let's have a healthy debate!
What??? the doctors want to get paid? those heartless, selfish bashturds. Who do they think they are?
think of the poor children who will die otherwise.
Let's face it, most of us won't be seeing doctors at all any more, nurse practitioners will be what most people get.
What??? the doctors want to get paid? those heartless, selfish bashturds. Who do they think they are?
think of the poor children who will die otherwise.
Let's face it, most of us won't be seeing doctors at all any more, nurse practitioners will be what most people get.
Re: The PPACA Thread Part III - Let's have a healthy debate!
This is a big reason why they do will in mid-terms but get killed in Presidential years. In the mid-terms you can get away with being the opposition. In the general election, you have to spell out what you'll actually DO if elected to the WH.
This is a big reason why they do will in mid-terms but get killed in Presidential years. In the mid-terms you can get away with being the opposition. In the general election, you have to spell out what you'll actually DO if elected to the WH.
I'm about to turn 60. Screw the kids!! What about me?!?!?!
http://www.washingtonpost.com/opini...e2c9d4-1a82-11e5-93b7-5eddc056ad8a_story.html
unofan
Well-known member
Assume it'd work like Medicare, which is essentially single payer health care for everyone over the age of 65.
There's your answer
unofan
Well-known member
Fine. Medicare is essentially single payer healthcare on a national level. It works for the most part, even the tea party derps want the "government hands off their Medicare."
There's your answer. Expand Medicare to cover everyone.
Re: The PPACA Thread Part III - Let's have a healthy debate!
Fair enough. But it the same? As in, today the system is hybrid. There is a large segment that is a single payer...and a large segment that is not. This second segment does in fact have a pay for service attached to it. Therefore (if I understand correctly), the pay for service segment does encourage more R&D and other forms of healthcare development. You eliminate that, you eliminate incentives for heightened levels continuous improvement, and one would expect quality to go down. Not saying the final outcome would be better or worse, just saying its uncharted territory that's not all better.
Fair enough. But it the same? As in, today the system is hybrid. There is a large segment that is a single payer...and a large segment that is not. This second segment does in fact have a pay for service attached to it. Therefore (if I understand correctly), the pay for service segment does encourage more R&D and other forms of healthcare development. You eliminate that, you eliminate incentives for heightened levels continuous improvement, and one would expect quality to go down. Not saying the final outcome would be better or worse, just saying its uncharted territory that's not all better.
Don't doctors refuse to participate in Medicare because of the pee poor reimbursement rates?
unofan
Well-known member
You're thinking Medicaid, not Medicare.
Ok. Thanks.
WisconsinWildcard
The plural of anecdote is not data
Re: The PPACA Thread Part III - Let's have a healthy debate!
I do not think this is true at all. How does the pay for service segment encourage significantly more R&D than a single payer? Our veterans are all under a socialized medicine program and there is tons of R&D out of the VA system.
I do not think this is true at all. How does the pay for service segment encourage significantly more R&D than a single payer? Our veterans are all under a socialized medicine program and there is tons of R&D out of the VA system.
Re: The PPACA Thread Part III - Let's have a healthy debate!
Yeah. But how is the product outcome? If you google the quality of care in the VA system, the results are mixed (note: it is being used as a political football). But I found kind of a consensus that performance was lower in the past and then in many folks eyes, is somewhat better now. It seems to have gotten bad press for awhile. Once you pull private market benchmark's, what's good?
Here's Mayo's POV...which I'd take as the experts who have used a high quality process to determine the best health outcome (note: not single payer). Seems somewhat similar to where we ended up from what I can tell...
Mayo Clinic Recommends Universal Health Insurance Plan
By MILT FREUDENHEIM
Published: September 15, 2007
The Mayo Clinic jumped into the national debate on improving health care yesterday, calling for every individual to have basic universal insurance as a step toward gradually replacing the current employer-based system.
But Mayo, in a proposal hammered out over 18 months by a panel of more than 400 health policy experts, is not advocating a government-run single-payer system. Instead, it suggested that private insurance companies be required to offer standard plans with many options, like the Federal Employees Health Benefits Plan available to government workers. Applicants for this insurance could not be turned down, under the Mayo plan.
The policies would be paid for by individuals, in some cases with help from employers. Lower-income people would get government help on a sliding scale. Mr. Mekelburg, who took part in the Mayo project, said the recommendations had “a pretty good chance” of winning serious consideration from policy makers. “Mayo is extremely well respected,” he said.
Dr. Denis Cortese, the clinic’s chief executive, said that under the proposals, employees could keep their individual policies when they changed jobs, an important issue for workers. One in four changes jobs each year, and 47 million Americans of all ages do not have health insurance.
http://www.nytimes.com/2007/09/15/health/policy/15mayo1.html?_r=0
Yeah. But how is the product outcome? If you google the quality of care in the VA system, the results are mixed (note: it is being used as a political football). But I found kind of a consensus that performance was lower in the past and then in many folks eyes, is somewhat better now. It seems to have gotten bad press for awhile. Once you pull private market benchmark's, what's good?
Here's Mayo's POV...which I'd take as the experts who have used a high quality process to determine the best health outcome (note: not single payer). Seems somewhat similar to where we ended up from what I can tell...
Mayo Clinic Recommends Universal Health Insurance Plan
By MILT FREUDENHEIM
Published: September 15, 2007
The Mayo Clinic jumped into the national debate on improving health care yesterday, calling for every individual to have basic universal insurance as a step toward gradually replacing the current employer-based system.
But Mayo, in a proposal hammered out over 18 months by a panel of more than 400 health policy experts, is not advocating a government-run single-payer system. Instead, it suggested that private insurance companies be required to offer standard plans with many options, like the Federal Employees Health Benefits Plan available to government workers. Applicants for this insurance could not be turned down, under the Mayo plan.
The policies would be paid for by individuals, in some cases with help from employers. Lower-income people would get government help on a sliding scale. Mr. Mekelburg, who took part in the Mayo project, said the recommendations had “a pretty good chance” of winning serious consideration from policy makers. “Mayo is extremely well respected,” he said.
Dr. Denis Cortese, the clinic’s chief executive, said that under the proposals, employees could keep their individual policies when they changed jobs, an important issue for workers. One in four changes jobs each year, and 47 million Americans of all ages do not have health insurance.
http://www.nytimes.com/2007/09/15/health/policy/15mayo1.html?_r=0
Gee whillikers!! I've been advocating universal FEHB for a while. Glad the Mayo clinic reads these forums.
Re: The PPACA Thread Part III - Let's have a healthy debate!
Join the club! My brilliant political commentary is often ripped off by national pundits who read the board and then pass it off as their own.
Gee whillikers!! I've been advocating universal FEHB for a while. Glad the Mayo clinic reads these forums.
Join the club! My brilliant political commentary is often ripped off by national pundits who read the board and then pass it off as their own.
WisconsinWildcard
The plural of anecdote is not data
Re: The PPACA Thread Part III - Let's have a healthy debate!
That is kind of shifting the goalposts from your original comment.
Regarding the VA, I have only worked in two so I have limited experience. Both of the VAs were extremely highly rated so I have a skewed view. However, I was just addressing the R&D aspect. It is widely known there are some terrible VAs out there and some serious problems. Both of the ones I worked at have many areas that are significantly better than the academic counterpart hospital. There are areas that are not as good. But the main point is that there was a significant effort in both systems to improve continuously.
That is kind of shifting the goalposts from your original comment.
Regarding the VA, I have only worked in two so I have limited experience. Both of the VAs were extremely highly rated so I have a skewed view. However, I was just addressing the R&D aspect. It is widely known there are some terrible VAs out there and some serious problems. Both of the ones I worked at have many areas that are significantly better than the academic counterpart hospital. There are areas that are not as good. But the main point is that there was a significant effort in both systems to improve continuously.
Re: The PPACA Thread Part III - Let's have a healthy debate!
More ammunition for the it's a flawed law crowd.
http://www.bostonglobe.com/metro/20...federal-law/hepngiitrOUTJz04luWauI/story.html
More ammunition for the it's a flawed law crowd.
http://www.bostonglobe.com/metro/20...federal-law/hepngiitrOUTJz04luWauI/story.html
Re: The PPACA Thread Part III - Let's have a healthy debate!
Tell them to stop whining already.
Tell them to stop whining already.
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