Comments on: Single-payer: Is the ivory tower this naive?

By: Anonymous

Anonymous — Thu, 20 Sep 2007 19:08:00 +0000

For better or worse, it would be nice to see the Massachusetts plan actually tried, and see how it works out.

It's barely been implemented.

It's easy for me to say 'cause I'm not in Massachusetts.

By: Roy M. Poses MD

Roy M. Poses MD — Thu, 20 Sep 2007 17:37:00 +0000

It appears Dr Gaines is not a full-time faculty member.
See this link for his private office address:
http://www.med.yale.edu/intmed/education-new/pdf/general_medicine_preceptors.pdf
He is not on what appears to be the roster of full-time internal medicine faculty here:
http://info.med.yale.edu/intmed/faculty/index.html
So regardless of what one thinks about his position on a single payer system, it cannot be blamed on his holding an “ivory tower” full-time faculty position.

By: Anonymous

Anonymous — Thu, 20 Sep 2007 13:44:00 +0000

“As long as our legal system provides huge incentive to overtest we will see a massive excess in the usage of diagnostics.”

It’s always someone else’s fault, isn’t it?

By: Anonymous

Anonymous — Thu, 20 Sep 2007 03:23:00 +0000

Maybe he is right. It’s too early to tell.

However, the Massachusetts plan does nothing to address the spiraling cost of care due to simple increased consumption. As long as our legal system provides huge incentive to overtest we will see a massive excess in the usage of diagnostics. Even that may not be enough to defeat demographics, but it’s a more palatable start than heading straight to rationing of care that is actually useful.

By: masaccio

masaccio — Thu, 20 Sep 2007 03:02:00 +0000

If the host likes the Massachusetts plan, he must love the Clinton plan, which extends it to the entire country.

By: Anonymous

Anonymous — Thu, 20 Sep 2007 00:14:00 +0000

The host of this site believes the Massachusetts example is the way to go. Why is he wrong?

By: Anonymous

Anonymous — Wed, 19 Sep 2007 22:30:00 +0000

“Of course, given that physicians already claim they do this anyway due to “defensive medicine”, won’t this be a wash?”

Uhh.. no? Because they’re not doing it (much) on the 80 million people without insurance? That’s kind of the point.

By: Anonymous

Anonymous — Wed, 19 Sep 2007 21:14:00 +0000

Amazing. The author has done absolutely no research and is devoid of even the most minimal clue. I am astonished this would find its way into print.

Next door in Massachussetts (with the highest per capita U.S. physician population), "reforms" and "universal coverage' are annihilating primary care medicine as we speak. And try to get a PCP in Ontario, despite the presence of single payer tyranny. And the Canadian system goes downhill from there.

Yeah, single payer is the road to responsive, high quality medical care, with a big increase in physician income.

Ed Sodaro MD
Amityville, NY

By: Anonymous

Anonymous — Wed, 19 Sep 2007 19:32:00 +0000

So what are you critics doing that WILL increase reimbursement?

"adding in 80 million people's worth of questionable MRIs and elective hip replacements would far outweigh increased efficiency."

Of course, given that physicians already claim they do this anyway due to "defensive medicine", won't this be a wash?

By: Anonymous

Anonymous — Wed, 19 Sep 2007 18:38:00 +0000

It’s silly to say what “single payer” would or wouldn’t do. A single payer system based on what we have now would cost far more – adding in 80 million people’s worth of questionable MRIs and elective hip replacements would far outweigh increased efficiency. A single payer system based on that of other countries, with rationing for non-emergent cases as a limit on spending probably would cost less.

Of course in neither case will any money go towards increased reimbursements.