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	<title>Comments on: &quot;Administrative barriers, waiting lists and staffing shortages . . .&quot;</title>
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	<description>medical blog</description>
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		<title>By: alexa-blue</title>
		<link>http://www.kevinmd.com/blog/2007/11/administrative-barriers-waiting-lists.html/comment-page-1#comment-81869</link>
		<dc:creator>alexa-blue</dc:creator>
		<pubDate>Mon, 26 Nov 2007 18:42:00 +0000</pubDate>
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		<description>Notes:&lt;br/&gt;&lt;br/&gt;(1) I&#039;m curious about your persistent use of the phrase &quot;pseudo single-payer&quot; to describe the VA.  Since one of the key arguments behind single payer (as opposed to, say, multi-tiered universal care plans) is that private plans can benefit from (and will lobby for) underfunding of any national base system.  Thus, pointing out problems with &quot;pseudo single-payer&quot; plans in a system where private health care exists isn&#039;t just oxymoronic (can tradeoff for dishonest here), it&#039;s actually an argument for a &lt;i&gt;true&lt;/i&gt; single payer system.&lt;br/&gt;&lt;br/&gt;(2) Since the RAND experiment (and likely before), opponents of free health care have pointed to moral hazard to show why health care expenditures will increase with universal coverage.  But maybe RAND simply wasn&#039;t big enough to observe the effects of time-in-line based rationing, which will surely defray some suppy-side spending by making patients accountable for increased opportunity costs of health care.  Anyways, aside from the obvious unanswered distributive question of whether making everyone wait a little is worse than bankrupting a few based on America&#039;s not-quite meritocratic income distribution, there&#039;s another one that seems to be ignored by opponents of universal health care:  it&#039;s not very controversial to make the statement that a great deal of health care delivered in this country is not very useful at improving health.  If that&#039;s true, then why are lines bad?</description>
		<content:encoded><![CDATA[<p>Notes:</p>
<p>(1) I&#8217;m curious about your persistent use of the phrase &#8220;pseudo single-payer&#8221; to describe the VA.  Since one of the key arguments behind single payer (as opposed to, say, multi-tiered universal care plans) is that private plans can benefit from (and will lobby for) underfunding of any national base system.  Thus, pointing out problems with &#8220;pseudo single-payer&#8221; plans in a system where private health care exists isn&#8217;t just oxymoronic (can tradeoff for dishonest here), it&#8217;s actually an argument for a <i>true</i> single payer system.</p>
<p>(2) Since the RAND experiment (and likely before), opponents of free health care have pointed to moral hazard to show why health care expenditures will increase with universal coverage.  But maybe RAND simply wasn&#8217;t big enough to observe the effects of time-in-line based rationing, which will surely defray some suppy-side spending by making patients accountable for increased opportunity costs of health care.  Anyways, aside from the obvious unanswered distributive question of whether making everyone wait a little is worse than bankrupting a few based on America&#8217;s not-quite meritocratic income distribution, there&#8217;s another one that seems to be ignored by opponents of universal health care:  it&#8217;s not very controversial to make the statement that a great deal of health care delivered in this country is not very useful at improving health.  If that&#8217;s true, then why are lines bad?</p>
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