Health Care Reform: Government Single Payor System   6 comments

Health Care Finance Reform: Government Single Payor System

 Congress is currently working through the proposals concerning health care reform.   Most republicans are not in favor of a public option of any kind. Some democrats are in agreement with no public option while most democrats are in favor of some kind of government option.   Some don’t want the government to have that much control or power.   Some believe that government is inept or wasteful.   I have addressed much of this in previous posts.   I would prefer that government have the control or power rather than the private health care insurance industry.

 Right now the health care insurance industry is spending millions of dollars in an attempt to thwart the health care reform movement.   These millions of dollars are our health care dollars.   They are our premium dollars.   These are dollars that should be used in providing their clients the health care that they need.

 Some are concerned that any kind of public option would drive the private health insurers out of business.   I understand this concern.   That is not a desirable consequence of health care reform.   However, eventually, I believe that this will be the only way that real reform will ever take place.   There is a basic conflict of interest in the health care insurance industry.   The need for a profit in the private sector is too great. Under the present system too many health care dollars go toward salaries and benefits for thousands of employees, compensation packages including huge bonuses for the top executives, return on investment for stockholders, and profit.   I believe in the capitalistic economy that we live under, but it is not working in health care right now.   I would not want to see a government single payor system initially, but would like to see it phased in over a period of a few years.  That would give private health care insurers time to diversify and adjust.   I know that many will cry about “socialized medicine”, but that’s what we have now with the health care plans that congress , medicaid, medicare and the VA Administration have.   I truly believe that more of our hard earned health care dollars would go toward providing all Americans the health care that they need, rather than to all the above costs.   I heard a statistic that only 4% of the revenue that medicare receives goes toward administrative costs.   That’s a pretty impressive statistic.   Far better, I’m sure, than the private sector.   All Americans should have the same basic health care coverage, from the President of the United States to the homeless.  

Thank you for visiting my blog site.  Your constructive criticism, thoughts and ideas for improvement are welcome.  Blessings –

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Posted October 23, 2009 by terryflowersblog in Health Care

6 responses to “Health Care Reform: Government Single Payor System

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  1. Terri, I agree with you, especially that the private insurers have created a socialist system. Personally, I’m not sure how government could do it worse that it is being done now, especially since there are so many people who are uninsured that might be able to get healthcare with a public option. Have you noticed that both the House and Senate versions of the health care reform bills still leave millions of people not covered? That is pretty disturbing to me. Also, I agree with you that all Americans should have the same coverage, but don’t have any hope at all that such an initiative would be popular with any of the branches of government. I personally believe that health care should be a nonprofit enterprise.

    Did you happen to catch Bill Moyers’ program on health care a few weeks back? I thought it was very informative. The program gave a little background on how we arrived to this mess. Back in the 50s, Truman tried to introduce a public healthcare option and the AMA fought it tooth and nail, saying it would create socialized medicine. (Remember how we all shuddered at that word?) Anyway, the physicians being in charge created lots of problems, especially escalating costs, so the insurance companies stepped in to control costs, mainly because they had a vested interest (their stockholders) in keeping costs down. Then we began hearing of terrible healthcare decisions seemingly controlled by corporate number crunchers, rather than compassionate care providers. Anyway, it was interesting to get a perspective on the past motivations for rejecting a public option.

    Do you think there’s any hope for sanity in this mess?

    • Pam, Thank you for your comments. It’s too bad that reform could not have occured decades ago. It would have been much easier on the economy then than now. It is too bad that there will still be so many without coverage. They will have to be subsidized just as the uninsured are now. I don’t think that any legislation that passes this time around will solve all the challenges that we currently face. I do think, however, that it will be a start. Hopefully we will get there someday. Thanks again for sharing. Blessings –

  2. The following is from Marvin Kleinau as sent to me by email:
    From: “Marvin Kleinau” Add sender to ContactsTo: “TERRY FLOWERS” Terry, I appreciate your blog and find it very interesting. Much of what you write however, is very general in nature and carries with it a sense of “hope” that the federal government could do better. I would fall on my knees if I felt for one second this was a realistic conclusion. I believe we will have a new system and I believe it will lower the cost to the patient in the initial stage (visits and care), but I am convinced from previous experience that the cost we both object to in the present system will simply be carried over to a tax structure. I suppose I should not object to that if the tax remains truly progressive. But I don’t believe this tax will be the only one the current administration seeks to impose on us. There is a limit.
    I fear a trade off between what we dislike about private insurance (heavy handed decisions about acceptable care) and incompetent oversight by federal agencies. We don’t need a Fanny Mae kind of experience in a vital area such as health. My ideal plan would be to force the private companies to accept all seekers of insurance, accept all doctors decisions, and do so at a reasonable price. (Not free, but reasonable) I believe this can happen if several things occur. First, the older generation ( 65 and above) is forced to pay a portion of their health insurance at a level reflective of their wealth. Today, a very large portion of the health cost is in the older population and they pay very little compared to their use. For example I have a friend that has not paid a nickel for any cost other than medications over the past 15 years and he has had thousands upon thousands of costs. His worth is above one million. It is also reasonable to ask people to pay a small portion of each visit depending upon their IRS income level. That will discourage unnecessary visits and reduce the pressure of time on medicine. Second, a ceiling is placed on the charge an insurance company can make for a policy. That policy can vary depending on the size of the coverage sought by the individual. In other words a ceiling is placed on the profit level a private company can make. That happens today with the utilities companies in which a board sets the margin. Finally, tort law must be changed. Doctors should not be so frightened of law suits that they order MRI’s for toe nails infections. Behind my reasoning are the following—
    1. I do not want complete control of health to be in the hands of a political agent in Washington. All we have to do is look at ethics reform to find the weakness in that kind of system. I don’t want doctors to be servants bowing at the beck and call of a civil servant in Washington.
    2. I do not want the system to bankrupt the country. Without some type of adjustment in payment for health, people will run to the doctor for every type of abnormal condition. I see it now in the emergency rooms and it must be stopped.
    3. Doctors can’t treat patients as they should because the system won’t permit it. Why should a superior doctor be forced to call day after day just to beg for the use of a new drug. Private insurance can’t be allowed to make medical decisions.
    4. Without question those individuals in need of expert care and specialized drugs and treatment must get it.
    5. I do not deny that Medicare has functioned as a very large and very federal agency, with reasonable success. It has treated me well. It is a glimmer of hope. But we should not forget that a complete federal plan would increase the complexity ten fold and leave no basis for comparison of health care costs. I do believe we must cover the health care of people that can’t afford any plan now, including those that can pay for only a very limited plan.
    I want it as badly as you do. But I also fear dependency on the federal government. I do not trust my own representatives to do the right thing in terms of my welfare. Good to talk to you.

    • Marvin, You have some good ideas. They all depend on the government highly regulating the insurance health care industry. If profits that the insurance companies are capped, then that would limit what they could pay their top executives in bonuses and compensation packages. I’m not sure the insurance industry would be any happier with the proposals you suggest as they would be if the government took over the system…except that they would still exist.

      You don’t want the government to have control over our health care system…a lot of people agree with that for a variety of reasons. As far its effect on our work ethic, that would seem to indicate that health care needs to be earned. Do you feel that is the case? We have so many working poor that can’t afford insurance and it is not provided by their employers. How do they earn their health care?

      I don’t like the way the private insurance industry controls our choices now. If government can legislate the proper regulations who would then have that control? Government or the insurance companies? There are some who oppose reform who don’t want government intervention of any kind. At least you are proposing that government regulate the industry.

      As I explained in my posts, health care comprises 1/6th of our GNP and is growing exponentially. How long before it comsumes 1/5th, 1/4th, etc? Will government regulation of the insurance companies control this? If something doesn’t control this…either regulation or government run health care…then we could have another Fannie Mae. A melt down of health care caused by the private sector or the public sector could occur. And you’re right, a melt down in this large a portion of the economy would be devastating.

      You raise some good points. Many questions remain unanswered. If only we could see the future. We don’t even know yet what the final legislation that comes out of congress will be. I do believe that there will be those on both sides of the issue that will not be happy with the final bill for different reasons.

      If this were an easy and uncomplicated challenge we would not be struggling with it as we are. You comments are good food for thought. I’m sure that at time passes and I have time to reflect that I my views will adjust. Perhaps I will think of why your ideas will not work. Perhaps I will begin to think that they might have some merit.

      I do think that government could do a better job than what the insurance companies are presently doing. Can the insurance industry improve? Will they resist the need for profit for the good of their clients? It will depend on the specifics of how the government regulates the industry and if regulation is inacted.

      Thank you for sharing your thoughts. I hope that we can continue the dialogue.

      Blessings –

      • Email from Marvin:
        I can agree with much of what you say and I certainly don’t claim any real mastery of this situation, but, I do have my years of experience to help me.
        For some reason, perhaps just a gut feeling, I want the private enterprise system to work, even in the health business. That means I want share holders and some level of profit EVEN in the health business. I just believe the incentive bring creative innovation and technology. However, I oppose insane profits for those companies and I oppose insane bonus programs. As I indicated, I move in the direction of the kind of control we have over the public utilities.
        No, I don’t believe health care should be earned. But I do believe (almost Zionic) in sharing the cost of health care. I have no problem with a reasonable cost attached to health care and the ability to pay. IRS forms reflect the level of the ability to pay and I find that a reasonable responsibility.
        In some instances I would, as you suggest I believe, a complete ownership of the health program by the government. But that would be only if the state of health care was so terrible and the private agencies so outrageous in their actions. I don’t see that. What I see is 1) about 15,000,000 people in need of help. 2) a system of expanding costs. Both of those problems can be fixed by the present system. Medicare proved it. I favor setting rules that private insurance companies must follow. If they don’t like it they can go home and bother someone else. Yes, I am talking regulation but not the kind that leaves you only once choice . At any rate we shall see what is going to happen shortly. The bill will b ecome law before the end of the year and by this time 2011 we will have some answers. I hope they are all “hey, it works pretty good.”

  3. My reply to Marvin:
    I guess that we agree on about as many points as we disagree. As you say, about 15 million people are in need of help. However, according to reports, that number continues to increase and is expected to continue to increase under the current system. I am well covered at this time in regard to health care, as I assume you are. My concern is that the current system will eventually become so bad that many of us who are currently covered will no longer be.

    It looks like there will be a public option. Whatever comes out in the end will not be perfect. I’m sure that there will be attempts to refine and correct any inadequacies that result after it has been in place for a while. Whatever comes about, it will be at least 2012 before it goes into effect. When 1/6th of the economy is so radically changed it will take time to establish an infrastructure and systems to accommodate it.

    10/27/09
    I have been doing some more thinking in regard to the “profit motive” and the idea that it creates the incentive for creative innovation and the development of technology. It has occured to me that this concept of “profit motive” is a two edged sword. On the one hand, I would agree that it can and most often does create a creative climate. On the other hand it can be profit simply for the sake of profit.

    Let’s apply this to the health insurance industry. I have been trying to think in what ways the profits that have been generated in this industry have created incentives for innovation and development for the good of the larger society. So far I have not thought of any. This industry is a service industry and, as such, does not create or develop technologies of any kind. As far as I can see they have a two fold purpose. First, to provide financing for their clients’ health care expenses. Second, to create a profit for themeselves and their stockholders. The second is in direct conflict with the first, hence the atrocities that we hear almost daily about claims being denied, etc.

    Please don’t misunderstand me. In industries where there is a need for innovation for development, I can easily see the benefit of the “profit motive”. It can be a positive thing for the developer as well as the larger society.

    I think that you can see where I am going with this thought process. I would be interested in knowing your thoughts and perspective on how the “profit motive” applies to the health care industry..

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