The failure of single-payer in Vermont

[SimpleDon]

And the keystone of the veterinary system is to intentionally kill those whose treatment is too expensive.

Utter nonsense. The veterinary system legally permits euthanasia. Our human health care system allows it sub rosa.

What is utter nonsense? Do you realize that euthanasia means the same thing as intentionally killing someone?

I personally believe that physician assisted suicide should be a purely medical decision. But that is not the same as euthanasia practiced by veterinarians to avoid the costs of treating conditions, as I said, an integral part of the much lower cost of veterinary medicine that Noble thinks can be applied to people.

 

[SimpleDon]

It is interesting that you are willing to let people die to have a health system that works well. There are a lot of people who believe that letting people die to be indicative of a really poor health care system.

And the keystone of the veterinary system is to intentionally kill those whose treatment is too expensive.

I'm not. Did you not read my post?

Yes, I did. See my bolding.

I'm not an idealist by any stretch. And I hope you don't think I'm defending them. Socialists play the same game. If had a pure free market system it probably would work well, except for the people who die because they don't have enough money. The veterinary medicine system works well.

So you said that a pure free market system would work well except for the people who would die because they can't afford to pay. Which finally means that a pure free market system doesn't work well at all?

Except if we look at the veterinary medical system and we ignore that euthanasia is an important part of the cost containment of the veterinary medical system, not just letting their patients dying but actively killing them, then we will have an acceptable, low cost system?

So where does this leave you? Do you believe that a pure free market system is possible? Or not? Do you believe that a pure free market system would have lower costs than any other system if we could put up with a few people dying that can't afford the much lower costs of the pure free market system? Or if we can put up with a few intentional killings of the very sick, like the veterinary system?

 

[SimpleDon]

This video is a good watch:

http://video.pbs.org/video/2198039605/

A private group of physicians saw how to deliver healthcare to everyone at lower cost. This is private enterprise in action. Well done.

The video doesn't have closed captioning so I can watch it but can't decipher the audio. Can you tell me how many of the cost cutting ideas that they came up with with depend on the private enterprise system? In other words cost cutting ideas that can only be done in a for profit environment, but not in a non-profit one?

 

[AthenaAwakened]

I'm not. Did you not read my post?

Yes, I did. See my bolding.

I'm not an idealist by any stretch. And I hope you don't think I'm defending them. Socialists play the same game. If had a pure free market system it probably would work well, except for the people who die because they don't have enough money. The veterinary medicine system works well.

So you said that a pure free market system would work well except for the people who would die because they can't afford to pay. Which finally means that a pure free market system doesn't work well at all?

Except if we look at the veterinary medical system and we ignore that euthanasia is an important part of the cost containment of the veterinary medical system, not just letting their patients dying but actively killing them, then we will have an acceptable, low cost system?

So where does this leave you? Do you believe that a pure free market system is possible? Or not? Do you believe that a pure free market system would have lower costs than any other system if we could put up with a few people dying that can't afford the much lower costs of the pure free market system? Or if we can put up with a few intentional killings of the very sick, like the veterinary system?

 

[NobleSavage]

I'm not. Did you not read my post?

Yes, I did. See my bolding.

I'm not an idealist by any stretch. And I hope you don't think I'm defending them. Socialists play the same game. If had a pure free market system it probably would work well, except for the people who die because they don't have enough money. The veterinary medicine system works well.

So you said that a pure free market system would work well except for the people who would die because they can't afford to pay. Which finally means that a pure free market system doesn't work well at all?

Except if we look at the veterinary medical system and we ignore that euthanasia is an important part of the cost containment of the veterinary medical system, not just letting their patients dying but actively killing them, then we will have an acceptable, low cost system?

So where does this leave you? Do you believe that a pure free market system is possible? Or not? Do you believe that a pure free market system would have lower costs than any other system if we could put up with a few people dying that can't afford the much lower costs of the pure free market system? Or if we can put up with a few intentional killings of the very sick, like the veterinary system?

By only bolding half my post you take it out of context which I clarified first. I think arguing for a "pure" system in any fashion is stupid. You seem to think my questioning the general consensus on this forum means I think you should die. There is plenty of profit to be made off of someone like you. If someone else wants you alive they are gonna pay for it. If that someone else is "society" then they are gonna pay for it. Do you really care how the money gets channeled to pay for your condition? Are you going to reject treatment if the financing is not pure? What's to keep a government committee from deciding that you should be let to die for the greater good?

 

[SimpleDon]

Private or public, the fix for America's health care needs to include getting the insurance companies the hell out of the way.

The insurance companies' direct costs and profits are pure additions to our medical costs.

But even greater than these costs are the indirect costs that having hundreds of private insurance companies with different rules about what they will cover and how they will pay. A Kinsey Group Study that I got in about 2007 estimated that this cost was about 400 billion dollars in the entire health care system. This is additional costs above what a single payer system would impose. This is pure waste imposed by having the for profit companies.

Also, we have so many regulations covering the health care system not because the evil government wants to increase the costs of health care, but because we depend so much on for profit companies to deliver our health care. Companies who exist to make profits, not to deliver what we need, low cost, high quality health care.

 

[laughing dog]

Utter nonsense. The veterinary system legally permits euthanasia. Our human health care system allows it sub rosa.

What is utter nonsense?

"he keystone of the veterinary system is to intentionally kill those whose treatment is too expensive"

Do you realize that euthanasia means the same thing as intentionally killing someone?

Yes, that was the point of using the term. Did it confuse you?

I personally believe that physician assisted suicide should be a purely medical decision. But that is not the same as euthanasia practiced by veterinarians to avoid the costs of treating conditions, as I said, an integral part of the much lower cost of veterinary medicine that Noble thinks can be applied to people.

Euthanasia is euthanasia. The reasons for euthanasia (vetereninary or human) differ from case to case.

 

[SimpleDon]

They are single payers for the population that they cover, the aged, the disabled, the poor, veterans and the military.

But that standard so is any insurer.

No, any insurer covers only its customers. It has crafted its coverage, its premiums and its sales approaches to try to get as many healthy customers as possible. This is an expensive, high cost procedure that in the terms of a country trying to cover everyone is completely waste. Their costs are limited to 25% above the medical costs by the ACA. . The private, for profit companies complain that this not enough. They wanted 30% above the medical costs.

Single payers like Medicare cover all of their population. They can't play with their coverages and their sales efforts, they have to cover everyone in their population. It is what is called a community rate based. They have costs of like 3 to 5% above the medical costs.

The post that I responded to said that we have never done single payer. We have.

Yes, half is not a whole. A non-sequitur. I never said that it is a whole.

You must be sooo proud of your tautological point.

I think that you need to look up the meaning of the word "tautology."

Saying that we have had single payer is not a tautology. I don't use two words that mean the same thing in the same sentence. "Half is not a whole" is a repeat of your nonsense.

 

[NobleSavage]

A private group of physicians saw how to deliver healthcare to everyone at lower cost. This is private enterprise in action. Well done.

The video doesn't have closed captioning so I can watch it but can't decipher the audio. Can you tell me how many of the cost cutting ideas that they came up with with depend on the private enterprise system? In other words cost cutting ideas that can only be done in a for profit environment, but not in a non-profit one?

Basically the doctors all got together and said lets make a better system. The Doctors are still in private practice, but they pool all payments (from whatever source). They share info on what works better and costs less. Everyone can get care. My Mother and her Husband, who has an expensive terminal illness, moved there partially for the healthcare system.

 

[SimpleDon]

Yes, I did. See my bolding.

I'm not an idealist by any stretch. And I hope you don't think I'm defending them. Socialists play the same game. If had a pure free market system it probably would work well, except for the people who die because they don't have enough money. The veterinary medicine system works well.

So you said that a pure free market system would work well except for the people who would die because they can't afford to pay. Which finally means that a pure free market system doesn't work well at all?

Except if we look at the veterinary medical system and we ignore that euthanasia is an important part of the cost containment of the veterinary medical system, not just letting their patients dying but actively killing them, then we will have an acceptable, low cost system?

So where does this leave you? Do you believe that a pure free market system is possible? Or not? Do you believe that a pure free market system would have lower costs than any other system if we could put up with a few people dying that can't afford the much lower costs of the pure free market system? Or if we can put up with a few intentional killings of the very sick, like the veterinary system?

By only bolding half my post you take it out of context which I clarified first. I think arguing for a "pure" system in any fashion is stupid. You seem to think my questioning the general consensus on this forum means I think you should die. There is plenty of profit to be made off of someone like you. If someone else wants you alive they are gonna pay for it. If that someone else is "society" then they are gonna pay for it. Do you really care how the money gets channeled to pay for your condition? Are you going to reject treatment if the financing is not pure? What's to keep a government committee from deciding that you should be let to die for the greater good?

You seem to be responding to another post where I asked how my treatment would be handled in your ideal system, the one that was not the system that I thought that your post above advocated, a pure free market system in which we would have to tolerate some people dying because they can't afford treatment and an apparently completely meaningless reference to veterinary medicine. But this isn't what you meant. You don't advocate any "pure" system. Because that is stupid.

I understand now. I understand that you are not an idealist, that you are not advocating a pure system, because it means that people will die who can't afford treatment. Excuse my mis-characterization of your post.

 

[NobleSavage]

Yes, I did. See my bolding.

I'm not an idealist by any stretch. And I hope you don't think I'm defending them. Socialists play the same game. If had a pure free market system it probably would work well, except for the people who die because they don't have enough money. The veterinary medicine system works well.

So you said that a pure free market system would work well except for the people who would die because they can't afford to pay. Which finally means that a pure free market system doesn't work well at all?

Except if we look at the veterinary medical system and we ignore that euthanasia is an important part of the cost containment of the veterinary medical system, not just letting their patients dying but actively killing them, then we will have an acceptable, low cost system?

So where does this leave you? Do you believe that a pure free market system is possible? Or not? Do you believe that a pure free market system would have lower costs than any other system if we could put up with a few people dying that can't afford the much lower costs of the pure free market system? Or if we can put up with a few intentional killings of the very sick, like the veterinary system?

By only bolding half my post you take it out of context which I clarified first. I think arguing for a "pure" system in any fashion is stupid. You seem to think my questioning the general consensus on this forum means I think you should die. There is plenty of profit to be made off of someone like you. If someone else wants you alive they are gonna pay for it. If that someone else is "society" then they are gonna pay for it. Do you really care how the money gets channeled to pay for your condition? Are you going to reject treatment if the financing is not pure? What's to keep a government committee from deciding that you should be let to die for the greater good?

You seem to be responding to another post where I asked how my treatment would be handled in your ideal system, the one that was not the system that I thought that your post above advocated, a pure free market system in which we would have to tolerate some people dying because they can't afford treatment and an apparently completely meaningless reference to veterinary medicine. But this isn't what you meant. You don't advocate any "pure" system. Because that is stupid.

I understand now. I understand that you are not an idealist, that you are not advocating a pure system, because it means that people will die who can't afford treatment. Excuse my mis-characterization of your post.

If you are not being sarcastic then cool. I never know on this forum. The only reason I threw in the vet thing was because it's been on my mind. I recently had an injury that could be handled by my local vet cheaper and quicker than the local doctors and hospitals. It's also an interesting way to look at the moral issues. Why should a poor persons pets not get treatment?

 

[SimpleDon]

The video doesn't have closed captioning so I can watch it but can't decipher the audio. Can you tell me how many of the cost cutting ideas that they came up with with depend on the private enterprise system? In other words cost cutting ideas that can only be done in a for profit environment, but not in a non-profit one?

Basically the doctors all got together and said lets make a better system. The Doctors are still in private practice, but they pool all payments (from whatever source). They share info on what works better and costs less. Everyone can get care. My Mother and her Husband, who has an expensive terminal illness, moved there partially for the healthcare system.

But what they are doing is something that can be done in either a for profit or a non-profit system. It is not something that can only be done in a for profit system, correct?

What I am saying is that there is no reason to believe that health care delivered by a for profit system will be anything but more expensive than a non-profit system, a single payer system for example. This video gives us no reason to doubt this.

 

[T.G.G. Moogly]

Americans want it all when it comes to health Care

Yes, that poll is 11 years old but I doubt much has changed about how people think, which is why Obamacare, subsidized for profit health care, is here to stay.

In an extensive ABCNEWS/Washington Post poll, Americans by a 2-1 margin, 62-32 percent, prefer a universal health insurance program over the current employer-based system. That support, however, is conditional: It falls to fewer than four in 10 if it means a limited choice of doctors, or waiting lists for non-emergency treatments.

Unless I'm missing something, this is largely why Vermont's plan failed. That, and politics.

 

[NobleSavage]

Basically the doctors all got together and said lets make a better system. The Doctors are still in private practice, but they pool all payments (from whatever source). They share info on what works better and costs less. Everyone can get care. My Mother and her Husband, who has an expensive terminal illness, moved there partially for the healthcare system.

But what they are doing is something that can be done in either a for profit or a non-profit system. It is not something that can only be done in a for profit system, correct?

It would depend on the rules. If the government system says you can't work outside the system, then no they couldn't do it.

What I am saying is that there is no reason to believe that health care delivered by a for profit system will be anything but more expensive than a non-profit system, a single payer system for example. This video gives us no reason to doubt this.

The video really doesn't address that question and I don't want to go down that rabbit hole.

 

[laughing dog]

No, any insurer covers only its customers. It has crafted its coverage, its premiums and its sales approaches to try to get as many healthy customers as possible. This is an expensive, high cost procedure that in the terms of a country trying to cover everyone is completely waste. Their costs are limited to 25% above the medical costs by the ACA. . The private, for profit companies complain that this not enough. They wanted 30% above the medical costs.

Single payers like Medicare cover all of their population. They can't play with their coverages and their sales efforts, they have to cover everyone in their population. It is what is called a community rate based. They have costs of like 3 to 5% above the medical costs.

Private insurers cover their population (i.e. their customers). The principle of "insurer covers their population" is the same, just the scale is different.

I think that you need to look up the meaning of the word "tautology."

You think wrong.

Saying that we have had single payer is not a tautology.

I agree because it is a factually incorrect statement: the US has never had a single payer as it is normally understand. Under your definition, all insurers are single payers which makes your claim inconsequential.

I don't use two words that mean the same thing in the same sentence.

Good for you.

"Half is not a whole" is a repeat of your nonsense.

I see the problem. You think factually correct statements (half is not a whole) are nonsense. I think you need to look up the meaning of the term "nonsense".

 

[Jolly_Penguin]

Private or public, the fix for America's health care needs to include getting the insurance companies the hell out of the way.

The insurance companies' direct costs and profits are pure additions to our medical costs.

But even greater than these costs are the indirect costs that having hundreds of private insurance companies with different rules about what they will cover and how they will pay. A Kinsey Group Study that I got in about 2007 estimated that this cost was about 400 billion dollars in the entire health care system. This is additional costs above what a single payer system would impose. This is pure waste imposed by having the for profit companies.

Also, we have so many regulations covering the health care system not because the evil government wants to increase the costs of health care, but because we depend so much on for profit companies to deliver our health care. Companies who exist to make profits, not to deliver what we need, low cost, high quality health care.

Excellent points. The problem in the US really is the insurance companies. I have fought them tooth and nail in car accident cases and can not imagine having to do that for every little medical expense in day to day life. I just pop out my OHIP card and *KAZAM* medical expense paid for. I know that I probably pay just as much into taxes as I would have paid for that procedure, but I have the convenience of not having to wade through red tape, the comfort of knowing that I am taken care of if I am unfortunate to need a really expensive procedure, and the pride of knowing that my entire province, and nation, is covered, even those who have no other means of paying. Universal Single Payer Health Care is one reason I am proud to be Canadian.

And I think the true litmus test. Even die hard conservatives that I know here in Ontario would balk if you took OHIP away. And I think the same is true in the USA, if you put the system in, and had it there for a few years, I think it would become political suicide to seek to undo it. Maybe that is why US conservatives freak over it.

 

[NobleSavage]

And I think the true litmus test. Even die hard conservatives that I know here in Ontario would balk if you took OHIP away. And I think the same is true in the USA, if you put the system in, and had it there for a few years, I think it would become political suicide to seek to undo it. Maybe that is why US conservatives freak over it.

Yes, and some have stated exactly that.

 

[George S]

A private group of physicians saw how to deliver healthcare to everyone at lower cost. This is private enterprise in action. Well done.

The video doesn't have closed captioning so I can watch it but can't decipher the audio. Can you tell me how many of the cost cutting ideas that they came up with with depend on the private enterprise system? In other words cost cutting ideas that can only be done in a for profit environment, but not in a non-profit one?

I, myself, use closed captioning when available. Sorry you haven't listened to the video.

There is almost nothing that could, in theory, work in a not-for-profit environment. I worked for Blue Cross one summer when I was 17. It was a not-for-profit corporation at the time. Since then legislation has forced them to be a for-profit company.

Marxism could work in theory. Take from society only a standard uniform amount, and give to society all that you are able. From each according to his ability; to each according to his need. It doesn't work.

People feel they should have more wealth than they have. They want to live in better housing. They want health. They want successful children. People want. Want more.

The logic of these physicians in Mesa County was to treat the patient population as "us." They are in the family. No one denies care to family. The physicians own/are the insurance company. They take a salary, not fee for services. They are true physicians who put the needs of their population first. It is similar to the ancient Chinese physician who was paid only when the patient was healthy. When healthy those who can afford it pay premiums. All collect (how Marxist) when ill. One important point is that preventive care (especially pre-natal) is done because it saves on net cost to the health insurance company. Especially important for those who cannot afford it because any later illness will be paid by everyone else.

The advantage of private enterprise over public policy is that policy is immutable or can be changed only slowly. Private enterprise allows for experiment. Mesa County Colorado is a successful experiment. Also in the video was one of the failures.

The same thing can work in a socialist environment, of course. Make all the physicians employees of the state on a fixed salary. The government the only insurer. Politicians the only controllers of health care.

 

[T.G.G. Moogly]

And I think the true litmus test. Even die hard conservatives that I know here in Ontario would balk if you took OHIP away. And I think the same is true in the USA, if you put the system in, and had it there for a few years, I think it would become political suicide to seek to undo it. Maybe that is why US conservatives freak over it.

I've come to the conclusion that conservative opposition to social spending is just a manifestation of the Dunning Kruger effect. In essence, they only oppose it when it's for someone else.

The article states that Obamacare is unlikely to be repealed because insurance companies, many who make big contributions to conservative lawmakers, are enjoying record profits. This came as a surprise to me and I'm not sure if this is a bit of liberal genius or just dumb luck. But Obamacare seems here to stay for that reason and because there are millions of people who now depend on it for their healthcare.

 

[NobleSavage]

And I think the true litmus test. Even die hard conservatives that I know here in Ontario would balk if you took OHIP away. And I think the same is true in the USA, if you put the system in, and had it there for a few years, I think it would become political suicide to seek to undo it. Maybe that is why US conservatives freak over it.

I've come to the conclusion that conservative opposition to social spending is just a manifestation of the Dunning Kruger effect. In essence, they only oppose it when it's for someone else.

The article states that Obamacare is unlikely to be repealed because insurance companies, many who make big contributions to conservative lawmakers, are enjoying record profits. This came as a surprise to me and I'm not sure if this is a bit of liberal genius or just dumb luck. But Obamacare seems here to stay for that reason and because there are millions of people who now depend on it for their healthcare.

And once the framework is in place we can work on cutting costs.