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I host and produce the Medicare for All Explained podcast in collaboration with Physicians for a National Health Program. Yes, doctors are experience burnout, but often that burnout is caused by having to deal with insurance companies. Doctors have to fight insurance companies to get them to approve necessary treatments, and often the treatments are covered. Doctors have to figure out what drugs are on their patients' insurance plans. These activities take time away from patients. Doctors don't want to spend time fighting insurance companies. They want to help and treat their patients, which is why a majority of doctors favor a single-payer Medicare for All system.

Second, doctors salaries are a minor problem when it comes to health care costs. Administration costs caused by our fragmented multi-payer health care system is why our health care costs are so high. Doctors spend on average $100,000 on billing and insurance related costs (BIR). If we got rid of insurance companies, doctor's salaries would be more in line with other countries, and they still might have more disposable income. Hospitals have a similar problem. In the U.S. we average about one billing clerk per hospital bed. In Canada a hospital system with just over 1,270 beds has only seven billing clerks. We have more that 931,000 hospital beds in the U.S.

The doctors' tax is not the problem. It is the tax from keeping our fragmented multi-payer health care system with insurance companies. A single-payer system would resolve these problems.

If you think this will benefit anyone other then the rich, you are a fool.

http://pnhp.org/news/rent-seek...

Oh, and found this;

Lack of health insurance and U.S. mortality

and an older article;

New study finds 45,000 deaths annually linked to lack of health coverage

How is this better than the 'socialised' system we have in the UK?

According to the Economist there is significant rent seeking in the US healthcare industry.

And a mind boggling set of layers that push funds and rebates back and forth between them, skimming profit as they go.

Let's hope someone like Amazon can come in and clean this us into a straightforward, more transparent and more efficient architecture

My take away from reading the article was that it seems incredible to me that someone had not stepped in before

The first question is great, a right and proper way to respond to any entitlement program aimed at improving the healthcare outcomes of a subset of Americans. The second question gives up on the promise of the first and is all too typical of the weak US Left.

Right now those who were really unhappy that Donald Trump became US President are letting Pres. Trump set the agenda for how US healthcare ought to work while pointlessly going on about preserving ObamaCare. ObamaCare (nee RomneyCare) was a gift to the HMOs which kept the HMOs in charge. It's time for universalizing Medicare for all Americans, and HR676 is the practical means to do this.

Physicians for a National Health Program have been championing HR676 for a while and for good reason. It's well time to tell the US government how to handle this, not let them come up with another complex means of preserving HMO power (which invariably means needlessly expensive healthcare that doesn't cover everyone, preserves the idea that healthcare is not a human right, and doesn't deliver outcomes which compare well with countries that do universalize their medical care delivery).

I recommend learning more about universalizing Medicare: an interview with Dr. Steffie Woolhandler, more on HR676, and Dr. Woolhandler on the inadequacies of ObamaCare on KPFA radio starting at 20m27s.

The first question is great, a right and proper way to respond to any entitlement program aimed at improving the healthcare outcomes of a subset of Americans. The second question gives up on the promise of the first and is all too typical of the weak US Left.

Right now those who were really unhappy that Donald Trump became US President are letting Pres. Trump set the agenda for how US healthcare ought to work while pointlessly going on about preserving ObamaCare. ObamaCare (nee RomneyCare) was a gift to the HMOs which kept the HMOs in charge. It's time for universalizing Medicare for all Americans, and HR676 is the practical means to do this.

Physicians for a National Health Program have been championing HR676 for a while and for good reason. It's well time to tell the US government how to handle this, not let them come up with another complex means of preserving HMO power (which invariably means needlessly expensive healthcare that doesn't cover everyone, preserves the idea that healthcare is not a human right, and doesn't deliver outcomes which compare well with countries that do universalize their medical care delivery).

I recommend learning more about universalizing Medicare: an interview with Dr. Steffie Woolhandler, more on HR676, and Dr. Woolhandler on the inadequacies of ObamaCare on KPFA radio starting at 20m27s.

The first question is great, a right and proper way to respond to any entitlement program aimed at improving the healthcare outcomes of a subset of Americans. The second question gives up on the promise of the first and is all too typical of the weak US Left.

Right now those who were really unhappy that Donald Trump became US President are letting Pres. Trump set the agenda for how US healthcare ought to work while pointlessly going on about preserving ObamaCare. ObamaCare (nee RomneyCare) was a gift to the HMOs which kept the HMOs in charge. It's time for universalizing Medicare for all Americans, and HR676 is the practical means to do this.

Physicians for a National Health Program have been championing HR676 for a while and for good reason. It's well time to tell the US government how to handle this, not let them come up with another complex means of preserving HMO power (which invariably means needlessly expensive healthcare that doesn't cover everyone, preserves the idea that healthcare is not a human right, and doesn't deliver outcomes which compare well with countries that do universalize their medical care delivery).

I recommend learning more about universalizing Medicare: an interview with Dr. Steffie Woolhandler, more on HR676, and Dr. Woolhandler on the inadequacies of ObamaCare on KPFA radio starting at 20m27s.

I challenge your claim that entitlement programs are 2/3 overhead.

(corrected due to technical problems)

Social security overhead seems lower than 2%.

http://www.ssa.gov/oact/STATS/...

Medicare, 1.4%.

http://pnhp.org/blog/2013/02/1...

SNAP lower than 1%.

http://www.politifact.com/trut...

Maybe you didn't bother doing any checking of the claim before repeating it?

--PeterM

I challenge your claim that entitlement programs are 2/3 overhead.

Social security overhead seems http://www.ssa.gov/oact/STATS/...

Medicare, 1.4%.
http://pnhp.org/blog/2013/02/1...

SNAP http://www.politifact.com/trut...

Maybe you didn't bother doing any checking of the claim before repeating it?

--PeterM

You could always choose another insurer, you could choose to pay out of pocket

Even if we went with the libertarian ideal of deregulation and lowered the bar to entry, no. That doesn't solve the problem of restricted access to care. What happens is that people who can't pay *still* get less care because no one will cover them.

Paying out of pocket is right out because of how fucking expensive it is in the US to get health care.

I don't know about you, but I'd rather have a Canadian style system. Mostly because the issues of waiting lists and such are largely bullshit.

Insurance companies want to lower their medical reimbursements to you; they have no vested interest in lowering medical costs overall. Thus they are happy to offer a high-deductible plan, limit you to doctors and hospitals that will give them favorable prices, and refuse to cover things that, although your doctor ordered them as essential to your proper care, would impact the insurance company's bottom line.

Here's an interesting short article on how mixing private insurers into Medicare actually multiplied the overhead costs by a factor of six:

http://www.pnhp.org/news/2013/february/setting-the-record-straight-on-medicare%E2%80%99s-overhead-costs

How much does ObamaCare cost the economy?

As long as you are going to ask that, why don't you ask how much it would cost the economy to:

1. Allow health care costs to continue their current trend without the ACA of spiraling up? As of 2003 the insured saw on average $1000 per year per person being spent on administrative costs. - Woolhandler, et al

2. Lock entrepreneurs with chronic illness into corporate jobs so that they can qualify for health care, instead of striking out with their ideas and boosting our economy?

3. Allow citizens with health problems get so disabled due to lack of care that they slip from the roles of employed, productive, tax paying contributors to society, and go on unemployment and disability and end up TAKING money from government services? (my father was a type 1 diabetic, who got laid off in the 90's from his job, couldn't find work, couldn't qualify for insurance, could barely afford the hundreds of dollars a month on insulin and test strips and died of diabetic complications within a couple of years.)

4. Allow citizens who are foolhardy enough not to buy health insurance delay their medical care until they get bad enough to go to an emergency room where the most expensive care available is given to them for free, and then charged back to us through increasing healthcare costs (see item 1).

5. Allow citizens who are foolhardy enough not to buy health insurance delay their medical care until they get bad enough to go to an emergency room walk around with their infectious diseases, spreading them to others who will then lose work days and to sickness or caring for their sick children.

The non-partisan organization that both Republicans and Democrats depend on for accurate estimates of such matters, the CBO (alternately vilified, and lauded by partisan in congress and the media depending on whether or not the CBO's non-partisan findings support their bias) took all of this into account AND more, and this is what they came up with in reports to both Speaker Pelosi and Speaker Boehner:

“CBO and JCT estimate that enacting both pieces of legislation—H.R. 3590 and the reconciliation proposal—would produce a net reduction in federal deficits of $143 billion over the 2010–2019 period as result of changes in direct spending and revenues.”

To Boehner, evaluating the projected cost to the economy of the first attempt to repeal the law:

“[T]he effect of H.R. 2 on federal deficits as a result of changes in direct spending and revenues is likely to be an increase in the vicinity of $230 billion, plus or minus the effects of technical and economic changes to CBO’s and JCT’s projections for that period.”

Once most people are buying insurance through Obamacare

... You do realize there is no insurance plan that is "Obamacare". The public option was nixed in the Senate before the ACA was voted on. What we have now is are minimum standards which any health insurance provided can provide.

This is as idiotic as saying that the safety regulations imposed by the NHTA on automakers will lead to a "takeover of the auto industry. Just give it time and the NHTA will be the only game in town!"

Seriously, read up on the law.

I wish our energy was really spent figuring out why healthcare costs so much

If only our energy was spent on that and not wasted on putting the brakes on unsubstantiated rumors and right out fabrications.

Funny you mention medicare considering they run a 1% (6% if you include the privatized portion) overhead compared to the ~15-20% private insurers are bitching about having to adhere to .

If I screw up, such as being late with a payment, I get charged a fee. The insurance executives had almost four years to solve the problem, but have no incentive to fix it. They get more money with the status quo. Meanwhile, people go without medical care or go bankrupt from medical costs. It is time to penalize the executives, so limit their pay to a maximum of $400,000 until they solve the problem. Also, for any family that has to pay more than $12,700, each company involved should pay $500 fee for each incident, and three times the amount over $12,700. I bet they solve the problem really fast.

Actually, we (the United States) should just get rid of the insurance companies and implement a single-payer system. Everybody would be covered. Nobody would die for lack of health care. Patients would have more freedom and could choose any doctor they want. Copayments and deductibles could be eliminated, and there would be no medical bankruptcies. The country would save $592 billion in 2014 if we went to a single-payer system.

What confuses me isn't that a large part of americans still favour a private insurance based system. The confusing bit is that there is a majority that supports a single-payer system, but that it is STILL difficult politically.

Then please allow me to clear it up for you;

The truth is that a majority of Americans do not support a single-payer system. Indeed, when the Affordable Care Act was being debated in Congress poll after poll after poll showed sentiment running around 70% against it or any single payer system. There have been a few polls since then that have shown a thin margin of support, but they have all been found to be flawed in one way or another (sampling only in cities, large oversample of Democrats, faulty sample weighting, etc.) In most polls "Obamacare" is still highly unpopular.

You actually just muddied the waters rather than "clearing it up". I'm assuming you understand polling well, so the truth is that you are lying.

Polling to expand medicare ("medicare for all") has consistently been ~60%. I've seen it higher, but I have rarely seen it lower.

Polling for "single-payer" is lower, but usually still a majority. Americans don't like that term. They also don't like anything that says "social". This does not mean they don't favor a single-payer system. It just means they don't like systems that are called single-payer.

Your 70% claim sounds like a fabrication to me, but I have not, in the last decade, seen expansion of medicare polling anywhere near as low as 30%. The ACA is despised by the left (who want single-payer/medicare/nationalized healthcare) and by the right (who are mad Obama stole their idea), hence combined opposition is much higher than the number of people who oppose all universal coverage schemes.

A quick write-up on "single-payer" versus "medicare" can be found here: http://pnhp.org/blog/2009/12/09/two-thirds-support-3/

'Fascism should more appropriately be called Corporatism because it is a merger of state and corporate power.' -- Benito Mussolini, founder of fascism 'Freedom without Socialism is privilege and injustice, but socialism without freedom is slavery and brutality' -Mikhail Bakunin, anarcho-syndicalist Face it, dismantling regulation wholesale, which he proposes, will put us back in the "robber-baron" days-- if you dont grasp that you have had a piss-poor history education. The sanest program out there is http://gpus.org/ .. fielding a Harvard M.D. woman for Prez, who grasps what the docs grasp who were banned from testifying when Obamneycare was being crammed thru: http://pnhp.org/

Frankly, health care costs are bleeding the United States dry. The U.S. is paying a 50% premium for health care that is below average (WHO. The giant deficit that is part of the reason for the downgrade of the U.S. debt rating? There are three main parts: Social Security, Military Spending and Medicare.

There are charitable medical organizations that only operate in undeveloped nations and the United States. The free market approach is working so poorly that poor Americans are getting health care that's the equivalent to what you'd get in Ethiopia or Somalia.

According to this article 62% of all personal bankruptcies filed in the U.S. in 2007 were caused by medical problems (link to study).

Wow, you refuted exactly nothing in your post, provided 0 evidence, and then went off on me for not providing facts, pure idiocy.

here, that took like 3 seconds.

PNHP has published a series of peer-reviewed studies over the past 20 years showing a steady increase in health administrative costs. While some aspects of administrative cost estimation (e.g. physicians' billing costs) require special studies, others, such as insurance overhead, can be easily tracked from publicly available data. These figures show no evidence of a fall in administrative costs since our most recent (2003) comprehensive estimate that administration consumes at least 31% of U.S. health care spending.

So if it isn't greed, why do private insurance companies spend so much in administrative overhead? Why is it that private health insurance costs so much more than public health insurance? Answer me, or are you just going to go off without any facts again while claiming the facts are on your side. The private health insurance execs love idiots like you that blindly believe whatever they are fed so the execs can continue fucking you over for fun and profit.

Private insurance is legal in Canada. http://www.copemanhealthcare.com/ That one is mostly foreign based customer driven. Need an MRI but don't want to wait? (I love the 'there are more MRIs in ($city) than all of Canada' myth) http://www.findprivateclinics.ca/Diagnostic_Imaging/Radiology/MRI_Scan/82-0.html

There are many places that will provide private care for a fee. Most of the them go bankrupt, because the public system delivers plenty good care, at a much cheaper price.

A basic income would eliminate poverty (and was endorsed by Nobel Prize winners):
http://en.wikipedia.org/wiki/Basic_income
http://www.basicincome.org/bien/aboutbasicincome.html
http://www.usbig.net/
http://www.pdfernhout.net/basic-income-from-a-millionaires-perspective.html
The right amount of vitamin D would reduce sick care costs by maybe a third in industrialized countries:
http://www.lewrockwell.com/sardi/sardi111.html
http://www.vitamindcouncil.org/treatment.shtml
A good diet, occasional fasting, and moderate exercise would reduce another third or so of sick care expenses by helping people break out of a pleasure trap from supernormal stimuli:
http://www.amazon.com/Pleasure-Trap-Mastering-Undermines-Happiness/dp/1570671508
http://www.amazon.com/Supernormal-Stimuli-Overran-Evolutionary-Purpose/dp/039306848X
Single payer health care in the USA would reduce expenses (for paperwork) by a third as well (these are not all additive, of course):
http://www.pnhp.org/facts/what-is-single-payer
Reinstating regulation on children's TV might help prevent damage to kids:
http://www.amazon.com/War-Play-Dilemma-Childhood-Education/dp/080774638X
http://www.amazon.com/So-Sexy-Soon-Sexualized-Childhood/dp/0345505077
A more vegetarian diet would also free up three-quarters of agricultural lands in the USA:
http://www.westernwatersheds.org/watmess/watmess_2002/2002html_summer/article6.htm
Renewable energy has been cheaper than fossil fuels and nuclear, when you factor in the externalities, like pollution, defense spending, and risk:
http://en.wikipedia.org/wiki/Brittle_Power
http://en.wikipedia.org/wiki/Externality
http://www.energyandcapital.com/articles/oil-gas-crude/461
Switching to electric cars would probably reduce our electricity use, and eliminate the need for much oil (since it takes more electricity to refine the oil into gas than it would to run electric cars the same distance as a gallon of gas in an ICE car):
http://www.evnut.com/gasoline_oil.htm
We can develop the technology of being able to produce almost anything from commonly found raw materials:
http://www.islandone.org/MMSG/aasm/
We know how to make healthier communities:
http://www.bluezones.com/makeover-about
http://www.amazon.com/Surviving-Americas-Depression-Epidemic-Community/dp/1933392711
Nuclear weapons and military robots are ironic because the same technology could produce abundanc

Bullshit. Thousands of people every year die because they leave it too late to get symptoms checked out, or are dumped by their insurance company.

Oh yeah, and you don't even treat your vets with respect either -

Harvard researchers say 1.46 million working-age vets lacked health coverage last year, increasing their death rate - Over 2,200 veterans died in 2008 due to lack of health insurance

http://www.pnhp.org/news/2009/november/over_2200_veterans_.php

Unfortunately you have a point. Were I president, I would move to solve that problem with ethics rules (enforced ones, not that ones that Obama put forward and then didn't follow) that prevented anyone from getting a bigger share of the government's ear than the common man. At the same time, I would move to implement single-payer health care by means of a slightly changed H.R. 676 (mostly making it more clear that it applies only to citizens, lawful permanent residents, and refugees / asylees).

But maybe I'm just too idealistic.

Okay, so your point is a family of four's total cost to the system is about $1600 per month in Canada. That's about $400 per person. In 2009, US healthcare spending was about $8300 per person per year, or about $33,200 for a family of four, or about $2770 a month. So we're still spending about 73% more per capita (and clearly don't get 73% better results than Canada).

The average health insurance plan in the US has increased to almost $5000 for an individual (see this article, for example), approximately doubling over the last 9 years, while average deductibles and out of pocket expenses have increased massively as well.

And while Canada's income tax rates are modestly higher than in the US, I don't think the difference is particularly startling - see, for example, the chart here.

And the studies seem to indicate that the quality of health care in Canada is at least as good as that provided in the US as in this study.

None of this is exhaustive, and I agree with your point that the OP was comparing apples and oranges, but it doesn't take rocket science to conclude that Canada's health care system is significantly more efficient than the US system at providing health care, and that their system works far better for the average taxpaying citizen than our system here in the US.

Oh, and some states are seeing 40-50% premium increases for individual and small business health insurance plans for 2010. Even mid-sized corporations are seeing rate hikes of 20-30% for 2010 and being forced to make tough choices, cut workforce numbers, and move jobs overseas to remain competitive in the face of the drag on their bottom line that health insurance costs are creating. All of this makes the comparison with countries like Canada that much less favorable.

The particular study that Rep. Grayson was referring to when he made these remarks claims that they "calculated approximately 44789 deaths among Americans aged 18 to 64 years in 2005 associated with lack of health insurance". The study goes on to say that this was in spite of things like free emergency room treatment and community health clinics.

Because somehow getting revenge for 3000 lives in a decade is protecting our country. Yet saving the lives of 22,000 people who die EVERY YEAR because they don't have health insurance isn't.

Single payer has come up several times as a system and several more progressive groups are angry that Obama has said quite simply, that it's off the table for discussion. However, while he never said he'd like a single payer system now, he did say if we were starting from scratch, that's what he would do. It almost seems contradictory, but here's an example: "Well, if I had to start over, I'd buy a Mac. As it is, I'm going to upgrade to Windows 7 rather than sticking with Windows XP".

I don't necessarily see anything wrong with the current proposals, but I'm a liberal. I also really like the healthcare co-op idea that's been floated -- but unfortunately the early report is that pundits can't tell the difference between a non-profit and a gov't I guess -- despite its success in conservative places like northern Idaho.

Both private plans subsidized by small employers (one plan available, take it or leave it) and a public plan could be difficult if the disagreement is with insurance company itself. I have argued with bureaucrats, and upward. Those around me have shown me the frustration of fighting with an HMO for a second opinion, and third. A patient actually needs someone to show up daily to check on the staff and the care given in most health care facilities, regardless of the type of insurance. Dollars talk more than any complaint form. Again, others experiences will be different, but I have seen poor care given for more frequently that good care for illnesses that are not done in a day or two. The threat of money being lost gets management moving, while complaints are just handled.

The last proposal that I read any of was HR676, 2007, which establishes a new American national health insurance program by creating a single payer health care system. The bill would create a publicly financed, privately delivered health care program that uses the already existing Medicare program by expanding and improving it to all U.S. residents, and all residents living in U.S. territories. It certainly seems to seek expanding Medicare into an HMO, effectively rolling up the private practitioners into it.

So I Google about for Obama national health insurance to find some details on current plans, and find quite a few references to HR676. Ignoring those hits, http://www.barackobama.com/issues/healthcare/ gives the high-level vision and no details. http://www.orthosupersite.com/view.asp?rid=31812 has some more overview, all sounding good, sort of like everyone gets what they want and for less cost, because the federal government said so. I'll believe it when it shows up. I'm not saying this is impossible, just that it is heavy on hope.

We have to get rid of the greed in the system to get costs down, which means getting down the greed pretty much everywhere.

The problem with the cost of health care is not the system, it is the society it exist within. And the society is what I do not see changing.

I'm a med student. Single Payer Universal Health Care for the win. http://www.pnhp.org/

...a baby killing, tax and spend, socialized medicine advocating, way out on the left wing commie liberal democrat

Don't worry, abortion is a nice wedge issue they can use to distract you from discussing the money issues that affect far more people far more profoundly (including distracting away from corporate crime). It's a good thing that the Republicans are so intent on keeping government small. Imagine how much egg they'd have on their face if they were responsible for creating the Department of Homeland Defense with almost $45B/year budget.

But two issues that really affect Americans in their everyday lives are war and health care. And when it comes to health care the Democrats are just as in favor of the corporatized health care delivery system the US has as the Republicans are. The Democrats of today are running as fast as they can from the universal health care Truman proposed 60 years ago, Americans just can't be allowed to have what Ralph Nader calls "a program with quality and cost controls and an emphasis on prevention". HMOs give to candidates in both parties and that's the way those candidates like it despite that a majority of Americans in CBS and CNN polls say they'd prefer universal health care even if it means higher taxes to pay for it (an oddly supportive notion given that the US spends "twice as much as other industrialized nations on health care, $7,129 per capita."). Kucinich/Conyers' health care plan (HR676) hasn't garnered a lot of cosponsors. I guess it will take a few more million Americans doing without health insurance (and thus making health care significantly more costly as well as making chronic care virtually unavailable until disaster strikes) to change that; over 45 million so far and this figure is going up.

When it comes to the continued occupation of Iraq the Democrats won't stop funding it out of a shared desire to "control [...] our major economic competitors in the world -- Europe and northeast Asia (China and Japan).". Sabre-rattling with Iran is also fodder for both major political parties. War crimes a plenty, according to AWARE (an Illinois-based anti-war group). All this for trillions Americans could have spent on domestic issues, chiefly those of the poor.

Really, the Democrats and Republicans aren't very far apart on these two major issues of the day (both money issues).

Your taxes already do pay for research - through NIH grants, tax breaks for pharmaceutical companies, and then after the drug is almost fully developed the government often gives the patent to an industry 'partner' to bring to market. A good example is AZT, the first ever anti-HIV medicine. The lion's share of the cost for developing AZT was paid by our tax dollars. Then Glaxo-Wellcome stepped in for the last bit and viola, they have an exclusive right to sell a life saving drug for whatever the market will bear.

From Physicians for a National Health Program's website: "15. Taxpayers pay for most research costs, and many clinical trials as well. In 2000, for example, industry spent 18% of its $13 billion for R&D on basic research, or $2.3 billion in gross costs (National Science Foundation 2003). All of that money was subsidized by taxpayers through deductions and tax credits. Taxpayers also paid for all $18 billion in NIH funds, as well as for R&D funds in the Department of Defense and other public budgets. Most of that money went for basic research to discover breakthrough drugs, and public money also supports more than 5000 clinical trials (Bassand, Martin, Ryden et al. 2002). Taxpayer contributions are similar in more recent years, only larger." http://www.pnhp.org/news/2004/february/will_lower_drug_pric.php

So they paid 2.3 billion (tax subsidized), and we kicked in 18 billion. Then they get to charge us for access to the drugs for which we paid 95% of the basic research costs.

Though you may say that PNHP is a bunch of hippies, so if you prefer a more grandfatherly source the AARP do a decent job too: http://www.aarp.org/bulletin/prescription/double_taxation.html

Of course that is the reason that while you may not trust the government, they could be a much better steward of medical research than market forces. Market based R&D is inherently morally corrupt. It can't be otherwise. If its not obvious because of the fact that more R&D is spent developing drugs to give octogenarians a hard-on and a full head of hair than to offer effective treatment for malaria that kills millions each year in the developing world, MSF gives a great summary of the reasons that market based R&D is wrong: http://www.accessmed-msf.org/main/medical-innovation/introduction-to-medical-innovation/what-is-wrong-with-r-d-today/

Though I do agree with you that at present I don't trust the government. Not that they do bad research... the NIH and the researchers they fund are amazing. But I don't trust the corrupt system that gives the breakthrough drugs that the government develops into the hands of private industry so that they can extort millions of Americans for the price that the 'market will bear' for drugs they may need to survive.

True enough, but there is such a thing as a bit less fancy, cheaper lunch. There is also such a thing as a way overpriced lunch. Guess what you're having? Anyway The Physicians for National Health Program Single-payer FAQ explains some of the savings you could have by moving to a single-payer model.

It's hard to have hard evidence about long-term savings since we can't exactly run these systems side-by-side in equal conditions at will. And the numbers, well, they'll be fucked up by your politicians in all likelyhood anyway ("If we raise cigarette tax to pay for children's healthcare it might not work because people might stop buying cigarettes." Way to not see the long term or the big picture).

Anyhow, Physicians for a National Health Program Single Payer FAQ says "For the vast majority of people a 2% income tax is less than what they now pay for insurance premiums and in out-of-pocket payments" and "For large employers, a payroll tax in the 7% range would mean they would pay less than they currently do (about 8.5%)." Wow, less taxes and costs, how can you not sell that to your voters! And the current hard facts: check out the numbers on per capita expenditure on healthcare in the U.S. and Canada (and others), and tell me that something isn't royally fucked up in the U.S.

Cost it out then.

Depends on what's provided. Woolhandler and Himmelstein showed that almost 60% of health care spending is already publically financed. Some suggest that we could provide bare-bones health care for every American at that public spending level, if we cut administrative costs and paid providers less.

For more complete coverage, Physicians for a National Health Program suggest covering the remaining amount with a payroll tax (around 7%) on employers and an income tax (around 2%) on individuals.

The payroll tax replaces current employer expenses; the income tax replaces insurance premiums, co-pays, deductibles, and out-of-pocket payments. Yes, government spending goes up - but since we're already paying for a large chunk of health care with government dollars, not as much as many people think. Tax rates go up but business and individuals are no longer paying insurance shareholders for the privilege of seeing a doctor; since billions in administrative costs would be saved by moving to single-payer, most people's total costs go down.

Remember if you borrow the money...

Irrelevant. I'm not suggesting borrowing money to fund health care, nor would anyone with a lick of sense. Money should be borrowed only to finance short-term projects over a longer term - things like building public works and conducting wars. One never borrows to fund on-going expenses. You might borrow money to re-wire your house; you don't borrow to pay your electric bill. (Unless you're in some sort of trouble and need a stop-gap.) The only borrowing relevant to health care is maybe local governments issuing muni bonds to build hospitals or buy ambulances. (And in many cities now, the problem isn't building new hospitals, it's that existing ones are being closed.)

Your insistence on bringing borrowing into this discussion suggests that either you are deeply confused, or that you are deliberately trying to cloud the issue.

Cost it out then.

Depends on what's provided. Woolhandler and Himmelstein showed that almost 60% of health care spending is already publically financed. Some suggest that we could provide bare-bones health care for every American at that public spending level, if we cut administrative costs and paid providers less.

For more complete coverage, Physicians for a National Health Program suggest covering the remaining amount with a payroll tax (around 7%) on employers and an income tax (around 2%) on individuals.

The payroll tax replaces current employer expenses; the income tax replaces insurance premiums, co-pays, deductibles, and out-of-pocket payments. Yes, government spending goes up - but since we're already paying for a large chunk of health care with government dollars, not as much as many people think. Tax rates go up but business and individuals are no longer paying insurance shareholders for the privilege of seeing a doctor; since billions in administrative costs would be saved by moving to single-payer, most people's total costs go down.

Remember if you borrow the money...

Irrelevant. I'm not suggesting borrowing money to fund health care, nor would anyone with a lick of sense. Money should be borrowed only to finance short-term projects over a longer term - things like building public works and conducting wars. One never borrows to fund on-going expenses. You might borrow money to re-wire your house; you don't borrow to pay your electric bill. (Unless you're in some sort of trouble and need a stop-gap.) The only borrowing relevant to health care is maybe local governments issuing muni bonds to build hospitals or buy ambulances. (And in many cities now, the problem isn't building new hospitals, it's that existing ones are being closed.)

Your insistence on bringing borrowing into this discussion suggests that either you are deeply confused, or that you are deliberately trying to cloud the issue.

Cost it out then.

Depends on what's provided. Woolhandler and Himmelstein showed that almost 60% of health care spending is already publically financed. Some suggest that we could provide bare-bones health care for every American at that public spending level, if we cut administrative costs and paid providers less.

For more complete coverage, Physicians for a National Health Program suggest covering the remaining amount with a payroll tax (around 7%) on employers and an income tax (around 2%) on individuals.

The payroll tax replaces current employer expenses; the income tax replaces insurance premiums, co-pays, deductibles, and out-of-pocket payments. Yes, government spending goes up - but since we're already paying for a large chunk of health care with government dollars, not as much as many people think. Tax rates go up but business and individuals are no longer paying insurance shareholders for the privilege of seeing a doctor; since billions in administrative costs would be saved by moving to single-payer, most people's total costs go down.

Remember if you borrow the money...

Irrelevant. I'm not suggesting borrowing money to fund health care, nor would anyone with a lick of sense. Money should be borrowed only to finance short-term projects over a longer term - things like building public works and conducting wars. One never borrows to fund on-going expenses. You might borrow money to re-wire your house; you don't borrow to pay your electric bill. (Unless you're in some sort of trouble and need a stop-gap.) The only borrowing relevant to health care is maybe local governments issuing muni bonds to build hospitals or buy ambulances. (And in many cities now, the problem isn't building new hospitals, it's that existing ones are being closed.)

Your insistence on bringing borrowing into this discussion suggests that either you are deeply confused, or that you are deliberately trying to cloud the issue.

I have yet to see such a thing.

It's kind of hard to collect taxes without the threat of being confronted by them.

Render unto Caesar that which is Caesar's. Takes care of the "Christian" part.

Not according to the original poster. He's the one who brought government into the picture and associated a socialized system with being synonymous with "Christian values".

How does this tie in, except in Canada? Has anyone in the US called for that?

Physicians for a National Health Program seeks to establish a Canadian-style system in the U.S.

Bulk of expenses is for marketing. This includes direct marketing to consumers (TV ads), buying dinners to doctors, outright bribes to prescription drug managers.

Let's not forget the army of lobbyists.

Two minutes of googling claiming 2:1 ratio of marketing to R&D. I've seen 3:1 quoted more often.

http://www.pnhp.org/news/2001/july/new_report_debu nks_d.php

http://www.calicocat.com/2004/12/how-to-lower-cost -of-drugs.html

The NIH document shows how crucial taxpayer-funded research is to the development of top-selling drugs. According to the NIH, U.S. taxpayer-funded scientists conducted at least 55 percent of the research projects that led to the discovery and development of the five top-selling drugs in 1995.

Every comparative study done on healthcare puts the mostly-public healthcare of Canada and Western Europe as equal to or better than that found in the US, despite the US spending a much larger fraction of its total GDP (13.6% vs. 9.5% of American vs. Canadian GDP goes to healthcare, vs. 6.8% ot 10.7% of GDP for major Western European nations).

(Before you complain about the link sites, the first study was done by the World Health Organization, the second by Johns Hopkins, the third by an author formerly from the conservative Fraser Institute. And before anyone complains that this is a Canada-vs-US thing, read especially the first study - most countries in Western Europe get better healthcare results for less money than the US, and many are better that way than Canada.)

The reason for this is, according to studies, wasteful bureaucracy in the US system. According to those who have analyzed the systems, this may be one place where a government program is actually more efficient than a collection of private programs. As plenty of posters in this thread have amply explained, that can, does, and should be expected to happen sometimes. Many governments run programs more efficiently than a collection of private companies could do; if a certain government never does so, that's a problem with that government, not with government programs in general.

Perhaps true. However, every comparative study done on healthcare puts Canada's healthcare as equal to or better than that found in the US, despite the US spending a much larger fraction of its total GDP (13.6% vs. 9.5%).

(Before you complain about the link sites, the first study was done by the World Health Organization, the second by Johns Hopkins, the third by an author formerly from the conservative Fraser Institute. And before anyone complains that this is a Canada-vs-US thing, read especially the first study - most countries in Western Europe get better healthcare results for less money than the US, and many are better that way than Canada.)

The reason for this is, according to studies, wasteful bureaucracy in the US system. According to those who have analyzed the systems, this may be one place where a government program is actually more efficient than a collection of private programs. (The mind boggles, I know...)

In other words - ignore most of the data, and you can get any answer you're looking for. Study all of the data, and you'll find you're demonstrably wrong.

The insurance industry and its attendant administrative expenses are by far the leading cause of the spiralling costs of the US healthcare system. Quoting from the above-linked article:

Insurance overhead (one component of administrative costs) rose by a whopping 16.8% in 2002, after a 12.5% increase in 2001, making it the fastest growing component of health expenditure over the past three years.

The problem is not Universal Healthcare or lack of money.

According to all the chicken-littles here in the US, Europe should have went broke ten years ago and all its people starving in the streets.

Universal healthcare can be done, either through traditional UH like in Europe, single payer/voucher plans, or expanding medicare to include children and the poor (Dean's Plan).

You can argue this point until the cows come how but the wealthiest country in the world is also the only western nation not to have some kind of universal healthcare system. That's simply wrong and these doctors agree.

Sure the poor are pised, but they are ineffective.

On the contrary, the poor are effective at spreading virulent diseases when they become too poor, whether they want to or not. This is why the Republican party is proposing an expanded medicare drug benefit for seniors. Are they supporting socialization of medical care? Of course they are, and if you care about the quality of life measures that most people say they care about, then you can count your lucky library finds and use them to promote sustainable technologies.

I support the use of economic incentives to encourage the development of educational technologies appropriate for the prevailing circumstances.

Big deal.

The Canadians know: single payer is where it's at.