Stanley Feld M.D.,FACP, MACE
In a government controlled single payer health care system the government provides the healthcare coverage for all. The government pays providers for various services at a cost determined by the government.
Advocates of a single party payer system in the United States have publicized that Canada, Britain and the European Countries have successful single party payer systems.
These declarations are untrue.
The definition of success is variable, problematical and questionable. It is successful in the fact that healthcare coverage is universal.
It is problematical in the sense that access to care is difficult. The rationing of medical care has inevitable because of the escalation of costs.
It is questionable as to whether these countries can afford to cover everyone. The National Healthcare System in Britain is falling apart rapidly. Hospitals are closing because of lack of funding. Patients’ waiting lines are increasing, access to care and rationing of care is increasing.
Britain has a robust private healthcare insurance industry for those who can afford to pay. The National Healthcare Systems costs are unsustainable.
In Britain the private healthcare insurance industry is thriving.
In Canada the healthcare system is absorbing 50% of Canada’s GDP.
Canada’s unsustainable healthcare system has resulted in government rationing of care as well as long waiting lines for patients to receive even rudimentary care much less hip or knee replacement.
The United States has three single party healthcare systems: the VA healthcare system, Medicaid and Medicare.
The VA Healthcare System is a treatment and financial disaster. It has evolved into a bureaucratic monster. Employees who do not perform cannot be fired according to government rules. Too many employees have been hired to try to get the job done. The infrastructure is administratively bloated.
The second reason for the VA Healthcare System’s problems is there is no intellectual or financial incentive to do a responsible and better job on the part of employees.
The culture of the VA System is that of a typical government bureaucracy. The federal government throwing more money at the VA System, to help our veterans receive better care, has not improved the system.
Patients are not satisfied with Medicaid because there is limited assess to care. Physicians do not accept Medicaid patients because reimbursement is too low. Medicaid provides an opportunity for the indigent to receive medical care. However the ability to get medical care is limited.
Seniors are satisfied with the care available through Medicare. However, as reimbursement is decreasing and the delivery of care is becoming more bureaucratic, physicians are leaving the Medicare system and demanding cash from seniors for medical care.
There is also an increase in concierge medicine for seniors.
Drugs are increasing in price. Seniors cannot afford their medication. Medicare Part D coverage (Drug Medicare) has become too expensive to afford.
The result is patients are becoming sicker because they cannot afford the prescribed medications. Then they end up in the hospital. The result is an increased cost to the Medicare System. Since deductibles and co-pay are increasing seniors are being bankrupt by the Medicare system.
The advocates of a single party system ignore basic inefficiencies inherent in government controlled bureaucratic systems.
These bureaucratic systems are inefficient and ineffective. They become unsustainable in all the single party payer systems in existence.
The deception sold to the public by progressive politicians is the advantage that medical care is free to all. The simple concept that nothing is free is ignored.
A system must replace these failed systems that provides incentives to consumers for consumers to drive the system.
- Healthcare Coverage is Universal
This should be the goal of any healthcare system.
The problems with healthcare systems in which consumers are entitled almost always get abused. The healthcare system has to be developed where people are responsible for their health and healthcare dollars.
- Decrease Amount of Necessary Paperwork
That a single party payer system will “decrease the amount of necessary paperwork” is a fictitious advantage. It will increase the amount of paperwork as has been proven over and over again.
The goal of any government run healthcare system is to measure what the healthcare system is doing so that the government can determine the quality of care delivered on the basis of the information provided. The fact that the information provided could be fudged is immaterial to the documentation.
The delivery of medical care is complex. It is almost impossible to commoditize. In an effort to measure quality of care there are increased regulations and documentation requirements.
The more complex an illness is the more paperwork will be needed to enable evaluation of the quality of care.
The result will be there will be less time, not more time, for the medical staff to spend providing care for the patient.
The belief of single party payer advocates is “providers will have more time to spend with patients.”
Additionally because medical care is free the entitled inevitably overuse the healthcare system making it even less efficient.
“Advocates believe the costs of single payer health care systems will be lower.”
- Lower Costs
Progressives think the reasons for “the lower costs is there isn’t any competition, a not for profit structure, and a reduced number of administrative staff.”
“ The high salaries for administrators and sales people are eliminated in a single payer system.”
The costs of government run systems are never lower. The costs to patients are lower because it is free. The costs to the healthcare system are higher because there is no incentive to be competitive.
The government will have to outsource the administrative services to the healthcare industry. The healthcare industry will make the money even as they do now.
Obamacare’s administrative costs were supposed to be lower. The administration is in panic mode because of its high costs and impending failure.
A small part of the failure is the result of healthcare insurance companies non-participation in the health insurance exchanges and the failure of government set up Co-Op Insurance funds.
President Obama paid only 12% of what the healthcare insurance companies claim they are owed to cover their loses through the crazy reinsurance program the government promised the healthcare insurance industry.
President Obama, through the Justice Department is going to raid the Treasury’s “Judgment Fund” to pay the insurance industry what they were promised in the reinsurance program.
It is essential for the survival of Obamacare that the healthcare insurance industries participate in Obamacare’s health insurance exchanges. Justice and the Treasury are ignoring the appropriation power of the congress.
This happens to be against the law.
In a 1998 letter the Government Accountability office pointed out that the Judgment Fund “is not a tool to circumvent congressional restrictions on appropriations.”
This is precisely what President Obama is doing.
“The Administration will do anything to rescue its flailing Affordable Care Act, and nothing so meager as the law will interfere. This damage to the separation of powers, not a health-care bill, will be President Obama’s abiding legacy.”
The problem is congress will letter President Obama get away with doing this.
- No Insurance Companies Needed
The notion that the “healthcare insurance industry is not needed” for administrative services is a deception that progressive politicians continue to state falsely.
- Only One Buyer Required
“Only one buyer (the government) is required” is partially true and false. In the military the cost of drugs are cheaper than either the cost of drugs for government employees with Medicare Part C or seniors with Medicare Part D. The government is restricted from negotiating prices for drugs. The middlemen infrastructure for purchasing drug will remain.
I believe Americans are becoming more and more cynical about big government’s intentions and efficiencies. They want a change for good reason.
The following the ideas of progressives is not working. It is destroying the healthcare system.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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