DesideriScuri
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Joined: 1/18/2012
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quote:
ORIGINAL: freedomdwarf1
quote:
ORIGINAL: Lucylastic
A) In a system where government doesn't negotiate prices down, prices will be higher.
B) In a system where for-profit companies need profit margins and advertising, prices will be higher.
I've been maintaining this stance for ages but DS can't see it.
He wants to see proof that going to single-payer will reduce costs.
I say, just look at the results: all the single payer systems are shitloads cheaper than the US.
Even by the chart he posted - the US is well expensive compared to everyone else.
It's dead obvious to me.
In a single-payer system, they have the power of monopoly bulk-buying to drive the unit price down.
A single-payer system doesn't have to make a profit and it doesn't have the cost of advertising.
No, FD, my chart doesn't show that moving to a NHS-style system would lower our costs. Why? My chart does not show anyone's costs dropping. It does show a reduction in the rate of increase for those who have national systems. Let's just assume that the US is paying 17.2%GDP in health care (the exact number isn't really important). The UK is spending 8.6% (which isn't exactly true because that's just the NI tax, which doesn't necessarily mean it's not spending more than 8.6% and doesn't include private spending), leaving a difference of 8.6%. If we adopt a national system here and our rate of increase matches that of the UK, one, 10, 50 years from now, we'll still have a 8.6%GDP difference, no?
That's the part you aren't seeing, or aren't acknowledging that you see.
At no point in time have I ever disagreed that government negotiating prices would reduce the prices. Medicare and Medicaid, generally, have the lowest reimbursement rates around. Federal health care spending is already 10%GDP. There is no way that we're going to add twice as many people to that pool of people, and reduce costs below that 10%, is there?
You make it out like if we would only move to a single payer system, that the costs of procedures and services would drop. If a hospital is charging $300 for something and is carrying 20% profit margin, how are we going to see that charge dropped to $100 (which is about what it would cost in national system countries)?
When you institute a price control, you are putting it on the care provider. What happens to that provider if the cap is set below actual cost? What happens if the provider can't gather the resources necessary to provide that product (medication, procedure, service) for less than the price control cap?
What happens if you can't find enough providers to provide the services at the reduced reimbursement rates?
http://www.cnn.com/2013/10/29/health/obamacare-doctors-limited/
Access is being reduced. How do you really think the Market is going to respond if reimbursement rates are forced down?
Obamacare was supposed to - according to the politicians - make access to affordable care universal. What it really only did, was shift the costs of insurance without making anything more affordable. It's entirely possible that everyone could be covered by an insurance policy by the end of next year. But, having insurance still doesn't make care affordable, if the only covered providers aren't your local providers.
http://www.nbcnews.com/health/congress-passes-chance-fix-medicare-doctor-pay-1C7802713quote:
The American Academy of Family physicians estimates that the average family doctor would have suffered a $27,000 Medicare pay cut without the fix.
Some experts say the issue has helped scare doctors away from taking on Medicare patients. “This last-minute action on the part of Congress is a clear example of how the Medicare program is increasingly unreliable for physicians and patients,” Lazarus said.
AARP, which represents people over 50, makes the same argument. AARP executive vice president Nancy LeaMond praised Tuesday’s legislation but says it’s not enough. “Millions of seniors in Medicare will have the peace of mind in knowing that they will still have access to their doctors,” LeaMond says.
“However, for too long, the so-called ‘doc fix’ has been an annual game of chicken on Capitol Hill. And with another temporary patch in place, both the size of future cuts and the cost of fixing the flawed physician payment system continue to increase.”
The “doc fix” problem dates back to a 1997 law that was meant to cut costs. It gave doctors who treat Medicare patients modest raises for a while, but physicians started protesting loudly in 2002 when it provided for a pay cut. Instead of really fixing the formula, Congress just continually finds short-term solutions.
The Congressional Budget Office says it would cost $300 billion over 10 years to permanently preserve pay for Medicare doctors and Congress has never been able to agree on a good way to find the money. Easy sources of cash went elsewhere in the 2010 health reform law.
If physicians are leery of 27% reimbursement cuts, how are we to cut expenditures further?
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What I support:
- A Conservative interpretation of the US Constitution
- Personal Responsibility
- Help for the truly needy
- Limited Government
- Consumption Tax (non-profit charities and food exempt)
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RE: A rather large presumption - 
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