Once again, Medicare payments are at below cost for most providers.
Medicare also has very high fraud rates.
If providers are losing money they go out of business. So you get a shortage. Which is why there are long wait times in England
Once again, Medicare payments are at below cost for most providers.
Medicare also has very high fraud rates.
If providers are losing money they go out of business. So you get a shortage. Which is why there are long wait times in England
I see, but who decides the salaries for those doctors, nurses, and lab techs? You say the government. Just because they have a diploma on the wall does not make all doctors, nurses, or lab techs in the same field equal. What happens if some heart surgeon has a 95% success rate, will he make the same standarized rate as the doctor with a 40% rate? If not, who or what board in the government makes that decision? The way the system works now (good or bad for us) is the best doctors go to the best hospitals (such as the Mayo Clinic) and are rewarded for their competence. I guess the new system either rewards mediocrity or depends on a good old boy network of government appointies to hand out raises. Also I agree with you about jumping the queue, the whole system will be rife for coruption. Those willing to grease the palms will get preferential treatment. Its the American way. So in effect when it comes to getting treatment in cases like the virus one were in, who do you think will get treatment first?
Uhhhh...I said just the opposite. The companies that employ those doctors, nurses, and lab techs now will still employ them. I didn't say the government would pay the doctors. I only said that it would pay those doctors who are in private practice. That's the way Medicare works now.
You ignore the fact that the best doctors can still demand higher pay from the institutions they work for. Those institutions would provide higher pay for the best doctors because it would be in their interests to have the highest patient success/survival rates possible--even if they didn't necessarily get more money as a result (besides, there are other motives than profit).
Let me tell you how it works in England, Canada, Denmark, and Norway (four countries I happen to know a fair amount about re their health care). As in the US, they submit their reimbursement schedules to the government. The government evaluates them on patient outcomes and quality of care and reimburses them accordingly. The amounts paid for various procedures are standardized, but there is a lot of latitude allowed. Furthermore, the procedure itself is not the only thing that is billed--time in the hospital, medications, outpatient care, etc. etc. are all billed as well.
The best doctors and facilities are in the highest demand, but in those countries, patients are assigned to doctors in order of application (presenting with a given condition) and nothing else. So you can't count on getting assigned to a particular, say, heart surgeon, because you don't know exactly where you'll be in the queue. This is fair, as it gives everyone the same chance at the absolutely best care. A rich person cannot, in fact, "jump the queue."
I think that in the US, however, the only way the populace will swallow universal health care is if for-profit private practice is allowed to continue to some extent. We're too wedded to the concept of "only the rich deserve the best" to abandon it altogether.
Originally posted by: Kevin Lewis
Uhhhh...I said just the opposite. The companies that employ those doctors, nurses, and lab techs now will still employ them. I didn't say the government would pay the doctors. I only said that it would pay those doctors who are in private practice. That's the way Medicare works now.
You ignore the fact that the best doctors can still demand higher pay from the institutions they work for. Those institutions would provide higher pay for the best doctors because it would be in their interests to have the highest patient success/survival rates possible--even if they didn't necessarily get more money as a result (besides, there are other motives than profit).
Let me tell you how it works in England, Canada, Denmark, and Norway (four countries I happen to know a fair amount about re their health care). As in the US, they submit their reimbursement schedules to the government. The government evaluates them on patient outcomes and quality of care and reimburses them accordingly. The amounts paid for various procedures are standardized, but there is a lot of latitude allowed. Furthermore, the procedure itself is not the only thing that is billed--time in the hospital, medications, outpatient care, etc. etc. are all billed as well.
The best doctors and facilities are in the highest demand, but in those countries, patients are assigned to doctors in order of application (presenting with a given condition) and nothing else. So you can't count on getting assigned to a particular, say, heart surgeon, because you don't know exactly where you'll be in the queue. This is fair, as it gives everyone the same chance at the absolutely best care. A rich person cannot, in fact, "jump the queue."
I think that in the US, however, the only way the populace will swallow universal health care is if for-profit private practice is allowed to continue to some extent. We're too wedded to the concept of "only the rich deserve the best" to abandon it altogether.
I agree 100% with your last statement, thats why Medicare for all will never pass in America. It also wont pass with Mayor Petes plan that eventually prices out the private sector.
Originally posted by: Rightdownthemiddle
I agree 100% with your last statement, thats why Medicare for all will never pass in America. It also wont pass with Mayor Petes plan that eventually prices out the private sector.
Which is a shame. Medicine never should have been a for-profit enterprise in the first place. It's like the military, which also used to be for-profit--resulting in routine murder, rape, and pillage, sometimes of one's own side. It should be a public good, paid for by the government and financed by taxes.
If we treated our fellow citizens as we do our families, we would absolutely prioritize their health--the way we do that of our children, spouses, and parents. If we acted as one nation, we would budget for the people's well-being first and foremost. But we still have this "rugged individualism" stupid shit mindset. Everyone says they are not their brother's keeper.
It doesn't take much of a leap of the imagination to think of a national system wherein medicine is not practiced for profit. There are dozens of nations where that is working quite well--and now, cue the Con fools who say what about all those horrible wait times in Canada, blah blah blah.
There are tens of millions of people in the US for whom their wait times are forever, because they died before they could get any care. And yeah, I would actually accept a mild decrease in the quality of the care I receive (I'm insured) if that meant that no one would be deprived of access to such care.
Originally posted by: Kevin Lewis
Which is a shame. Medicine never should have been a for-profit enterprise in the first place. It's like the military, which also used to be for-profit--resulting in routine murder, rape, and pillage, sometimes of one's own side. It should be a public good, paid for by the government and financed by taxes.
If we treated our fellow citizens as we do our families, we would absolutely prioritize their health--the way we do that of our children, spouses, and parents. If we acted as one nation, we would budget for the people's well-being first and foremost. But we still have this "rugged individualism" stupid shit mindset. Everyone says they are not their brother's keeper.
It doesn't take much of a leap of the imagination to think of a national system wherein medicine is not practiced for profit. There are dozens of nations where that is working quite well--and now, cue the Con fools who say what about all those horrible wait times in Canada, blah blah blah.
There are tens of millions of people in the US for whom their wait times are forever, because they died before they could get any care. And yeah, I would actually accept a mild decrease in the quality of the care I receive (I'm insured) if that meant that no one would be deprived of access to such care.
Not for profit business has worked so well across the globe
Originally posted by: Boilerman
Not for profit business has worked so well across the globe
Actually, it has worked very well, in dozens of countries. Virtually every government institution is not-for-profit.
Even China and Russia have decided over the years to privatize most of their industry.
