A pseudo single payer system has already been tried in the US – it was called HMOs, and look how that debacle turned out:
The United States has tried something roughly equivalent to the private insurance version of a single-payer system. Health Maintenance Organizations (HMOs) were designed to keep health care costs down by restricting certain types of treatment. However, it quickly became apparent that HMOs were not the panacea to curbing costs. While HMOs were somewhat successful at controlling costs and maintaining quality, patients routinely objected to having certain treatments restricted by their health insurance companies. In fact, a series of studies by Robert Miller and Harold Luft found that those enrolled in an HMO were less satisfied with the quality of care they received and their interactions with doctors.The lesson learned from HMOs not only provides evidence that Americans are likely to reject a single-payer system, but also sheds light on why the United States spends more than any other country on health care. Americans spend more because they have a higher demand for health services. This fact should come as no surprise. Americans have generous health care plans and their premiums are predominantly paid by their employer. This insulation from cost gives Americans little incentive to seek cost-effective treatment and thus routinely results in patients receiving a series of high-tech tests and treatments, which economist Arnold Kling refers to as “premium medicine”.
(via Health Care BS)
Related posts:
- Single-payer in Sweden: A cautionary tale
- Single-payer: Will Americans go for the Prius?
- Single payer: The assault continues
- The public isn’t convinced about a single-payer system
- Single-payer: Is the ivory tower this naive?
- Single payer ills, part 2
- The make-believe savings of single-payer
{ 6 comments }
HMOs are definitely NOT single-payer. But it is indeed easy to find a corresponding target if you want. Look at the VA and the military medical system. They are indeed single payer systems. I eagerly wait for data showing that they are (a) more expensive and (b) have worse outcomes than standard US indemnity plans. I’ve sure never seen it, but I’d love to.
You should become a medical student/resident and rotate through the VA. That’s all I need to see.
Eva didn’t ask for evidence that the residents didn’t like the VA. She didn’t even ask for evidence that the patients were unhappy. She asked for evidence that showed the VA had worse outcomes. That will be hard to produce since it doesn’t exist.
In fact the very real problems the VA has and will continue to have are because the results are adequate enough (at considerably lower cost) that the Republican Congress kept refusing to allocate desparately needed funds for the explosion in utilization caused by the Iraq war. In other words, the VA gets better results for less money; they get better results for dirt cheap.
The VA has done great, all of these stories about Walter Reed are obviously made up. If those things happen in the private sector, market force correct it by putting them out of business. People go elsewhere. When you have no choice and have to go to a certain hospital and physician, exactly what is their motivation for customer satisfaction? And spare me the duty and for the good of the patient retorts. Patients have the trump card now they have their two feet to do the talking.
If single payer goes through and everyone waits, I can’t wait to see Wally from the YMCA ahead of Donovan McNabb for ACL reconstruction. Money equals votes and the middle class on up to the super rich is not going to put up with waiting 6 months for a MRI or 18 months for a knee replacement.
Evidence that the VA has worse outcomes? You mean as in numbers. Why would I trust them if I saw them. They made up vital signs on my dead patient, why would I trust them to not make up anything else that serves their institutional interest. Fool me once . .
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