While a profit-driven company may not have its customers savings at the forefront of its mind, it will be motivated to provide efficient and effective services to its highest-paying clients.
Under a multi-payer model, the more you pay, the better service you get. Wealthy citizens on premium plans can get better care and a wider array of options. Non-essential and cosmetic services would not be covered by a single-payer insurance plan, and would thus be exposed to higher costs. But the bogeyman of single-payer causing a steep drop in the quality of care is largely bogus. In , Public Health published a review of 49 studies on multi-payer versus single-payer systems found no difference in the quality, effectiveness, or efficiency of care.
What it did find, however, was that single-payer systems were vastly more equitable. This is the crux of what single-payer healthcare seeks to promote: equitable health services for the people who need it most. But there are valid concerns about how it looks in practice. The single-payer system for veterans in America, for example, has been met with strong rebukes as to the quality and efficiency of its care. How a single-payer system provides its care is largely a function of its design, which can vary drastically.
Each single-payer system across the globe is tailored to its own specific context. The single-payer system in Denmark differs from the system in Canada, which differs from the systems in Taiwan and the United Kingdom. The U. It needs to be rebuilt from the ground up. How about the cost of prescription drugs or gender reassignment surgery? Technicalities can quickly become extremely contentious and partisan points of division.
Leveraging the infrastructure of both the Affordable Care Act and Medicare, a single-payer system could be rolled out to every citizen over the course of a decade, slowly lowering the age and loosening the admissions requirements for these programs.
A slow and methodical rollout of existing systems allows for time to make adjustments along the way. Individual states could choose their own level of involvement and speed of adoption, increasing the ability to customize and hybridize a single-payer model that works for every context, every region, and every person.
For those who prefer the multi-payer model, the answer to these questions is to avoid them and work with the system we already have. While that would spare government resources, it would also do little to address the current gap in healthcare coverage and do nothing to assuage the valid concerns of a majority of Americans. Do you prefer a system where insurance is determined by an employer, the deals that employer has with health insurance companies, the deal those companies have with certain doctors, and the deal those doctors have with drug companies?
Is that your idea? Please go spew your right-wing nonsense somewhere else. Just ask the people that voted for Brexit, and may well come to regret it. If the U. However, I also wonder just how much medical advance we would have made without the growth of publicly owned companies in this system. Those shareholder dollars paid or great advances. The flip side is that it was shareholder money, and that means driving profit, instead of better patient-based outcomes, such as satisfaction and customer service.
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Harvard Health Blog Single payer healthcare: Pluses, minuses, and what it means for you. Print This Page Click to Print. Diane J.
And while some studies have noted that Canadians and Germans, for example, have longer life expectancies and lower infant mortality rates than Americans do, they are misleading.
Those statistics are extremely coarse and depend on a wide array of complex inputs having little to do with health care, including differences in lifestyle smoking, obesity, hygiene, safe sex , population heterogeneity, environmental conditions, incidence of suicide and homicide and even differences in what counts as a live birth.
Santorum: Rand Paul is wrong on health care bill. The truth is that the UK, Canada and other European countries for decades have used wait lists for surgery, diagnostic procedures and doctor appointments specifically as a means of rationing care.
And long waits for needed care are not simply inconvenient. Research for example, here has consistently shown that waiting for medical care has serious consequences, including pain and suffering, worse medical outcomes and significant costs to individuals in foregone wages and to the overall economy.
In contrast to countries with single-payer health systems, it is broadly acknowledged that "waiting lists are not a feature in the United States" for medical care, as stated by Dr. Sharon Wilcox in her study comparing strategies to measure and reduce this important failure of centralized health systems.
What has been the response to the public outcry about unacceptable waits for care in single-payer systems? First, a growing list of European governments have issued dozens of "guarantees" with intentionally lax targets, and even those targets continue to be missed. Second, many single-payer systems now funnel taxpayer money to private care to solve their systems' inadequacies, just as we now do in our own Veteran Affairs system, and even use taxpayer money for care in other countries.
Follow CNN Opinion. Instead of judging health system reforms by the number of people classified as "insured," reforms should focus on making excellent medical care more broadly available and affordable without restricting its use or creating obstacles to future innovation. Reducing the cost of medical care requires creating conditions long proven to bring down prices while improving quality: increasing the supply of medical care, stimulating competition among providers and incentivizing empowered consumers to consider price.
Single-payer systems in countries with decades of experience have been proven in numerous peer-reviewed scientific journals to be inferior to the US system in terms of both access and quality. Americans enjoy superior access to health care -- whether defined by access to screening; wait-times for diagnosis, treatment, or specialists; timeliness of surgery; or availability of technology and drugs.
Incremental steps did continue throughout the decades. Medicare and Medicaid were established in , essentially becoming a de facto single-payer system for certain groups of the population — senior citizens, and young children and the poor, respectively. One fact often used to defend the concept of a single-payer plan is that the U.
Canada, for example, has a life expectancy of 82 years while the US sits at 79 years. Just ask citizens of Canada or the United Kingdom, two nations famous for their universal healthcare systems. Neither doctor salaries nor cardiopulmonary bypass pumps are cheap, and the money to pay for them has to come from somewhere. Increases in per capita healthcare spending in Canada have kept pace with those in the U. In the meantime, watching the months pass is an unavoidable component of Canadian healthcare.
If you want a new hip or knee, prepare to live with your old one for at least half a year. Wait times are a fact of life under socialized medicine in the United Kingdom, too. The U. Then rising costs led to the notion of a single-payer. Governments and private insurers often have conflicting agendas regarding treatment, but a sick person never does.
The patient simply wants to get better. Harry S. Truman Library. Josh Blackman.
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