The price of a single-payer system is too high to pay:
Doctors would have set hours due to being employed by the government which is great”¦ except when you look at the shortage of doctors in rural areas. If a doctor in such an area has a set limit of patients he/she can see per year then inevitably there could be months when no physician in such an area was available.
Here’s my biggest beef with single-payer: physicians will be at the mercy of a monopoly with zero recourse to fight back.
Currently, physicians have the choice of dropping Medicare/Medicaid if payments continue to be slashed. Not so with single-payer. The government will be the only game in town.
If you think that doctors are losing professional control now, imagine being at the whim of a monopoly. If the single-payer chooses to drop payment rates or expand hours (yes, I’m aware the NHS is not single-payer, but you get my point) there nothing a physician can do. Except bend over or quit medicine. Why would any doctor agree to that?
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NHS dentists in the UK are my favorite example. Want to self-pay or have BUPA? Come right on in, we’ll see you tomorrow or next week. Want to see the dentist the NHS entitles you to? See you next year.
And that’s the UK, where the population density is high enough that truly rural areas don’t exist.
It is sad to see that you do not understand what “single payer” means. It does not mean that the doctor works for the government, just as you don’t currently work for the insurance companies. It means that you bill the govt for your services and recieve fees based on a negotiated repayment scale. Additionally, the currently available single payer plans all allow docs to work independently, for the rich or for people with better insurance or just for themselves, so you can put your “biggest beef” to rest. you should learn first then write.
physicians will be at the mercy of a monopoly with zero recourse to fight back.
Kevin, I find it extremely disingenuous of you to continually claim that single-payer (socialized insurance) is akin to a national health service (socialized medicine). Student Doctor Bob harps continually on a system where doctors are employed by the government, and that’s certainly not how it works in a single-payer system. It seems like you’re more willing to lump the problems of any system besides the American one as “the terrors of socialized medicine” than to take the more time-consuming and more complex route of figuring out a certain system’s pros and cons. It’s like lumping all analgesics together and saying that they all cause respiratory depression, or are all contraindicated in renal failure instead of getting into the differences between opioids and NSAIDs.
As anon said, in every single-payer system I’ve ever heard of, docs are certainly allowed to work outside the single-payer system if they so choose.
exactly where in Canada is there a system outside of the single payor system?
Yes, but if the government controls 80-90 percent of healthcare dollars then they have a de facto monopoly. I believe that is the point. So in other words there won’t be many doctors escaping to see these patients who have stepped out of the system.
I hope you got a nice big fat scholarship to your private school Graham because if single payer/socialized medicine/government hits medicine you are going to need it.
As a norwegian where we have a rather good and well functioning health service I must say it is always amusing to hear americans talk about socialized medicine like it’s something like the black plague:-)
Norwegian doctors outside of hospitals usually have to have an agreement with the government. That gives them a right to claim a refund for each patient they treat. The patient also pays a small amount for his visit to the doctor. In the bigger cities it is possible to set up a practise without this agreement with the government, and the patient then have to pay what it really costs. (This is of course possible also in rural areas if you want to, but there ain’t enough people to make a living of it since most of the patients will go to the public doctor and pay less)
This is working fine for us,of course there maight be other, and maybe better ways to do this, but really, you americans often sounds like our system is the work of pure evil!
Dr. H: You have to be young, and very healthy to be that naive. Commie Care, the bubonic plague? Let me think a minute.
Commie Care is Cheap Care. No one in your country gets high tech care. They may wait for fictional high tech care, but no one gets it. Your medicine is the same as ours of 30 years ago, like a rural family practice.
Are there trauma centers? You car accident victims expire at the scene, as Princess Diana did under French Commie Care. No helicopters. No trauma centers. No equipment in the rescue vehicle. Untrained incompetents play around with someone with a tear in her aorta at the scene. They take an hour to travel 4 miles to the hospital. The latter is worthless, except for the autopsy. That is Commie Care for a Princess. Imagine Commie Care for the ordinary person.
Are there any transplants going on in Norway? What is the wait for emergency surgery? Your slacker, Commie doctor goes home at 5 PM. In England, they did not want to give a raise to doctor to $90K. They imported cheap terror doctors. The Brit twits earned their terror bombings. These doctors are so inadequate, they only burned their own buddies.
Hound dogs must be used to find a doctor. When you hunt him down, how much does he want to do for the patient, since he is paid the same as my plumber. Euro docs have the same skill as our nurse practitioners.
When a heat wave hit the Commie Care of France, it could not even provide fans, let alone medical treatment. 11,000 people died in the heat, and got “my solidarity” from Pres. Chirac, on vacation in cool Canada.
As a patient, I would fight Commie Care in the US to the death, because of what it is, Cheap Care.
The left was deserted by the facts 100 years ago. All that remains are lies. The poorest person in the US gets superior care than the wealthiest person in lying, Commie Europe.
Great satire, SC! The left was deserted by the facts, that’s hilarious!
As you can see, the US has fewer CT scanners per capita than the OECD national average. So no, so sorry, try again about “no technology.”
Dr. G: Not only have the facts deserted the left 100 years ago.
The Commie doc has deserted the patient with the ice pick sticking in his head, at 5 PM, come hell or high water. Doesn’t emergency surgery have a waiting list in the UK?
We have used CT scans in poverty stricken areas of this country. It’s outdated technology and dangerous.
Does this CT scanner take into all models and also we should take a look at other modalties like MRI, PET, Etc.
There is more than one way to skin a cat. Let’s get the whole picture here Graham.
“Are there any transplants going on in Norway?”
Of course not. We give them two aspirins, tell them to call us in the morning, and if they don’t they are dead. Wich is good because it saves money!
But everybody gets aspirin!
Kevin: You have a nice sized medical audience in the US. It may interest them to read some guest blogging from our European colleagues. I suggest inviting European clinicians to guest blog.
I would like to know about what goes on, in terms of real world medicine. Does any country use helicopters? Do they have specialized trauma centers? Do they believe there is a golden hour? What are their survival rates for car accidents, compared to ours? Similar questions may be asked in other specialties.
Costs are double over there. Salaries are half of ours for everyone, down to the maids in hotels. How do people live like that, and put up with their oppressive governments?
Our Supreme Court Justices summer in Europe. Our academic elites do the same. Each year, they return with idiotic Euro ideas, and seek to impose central government rule on our free people. Such guests would serve a great purpose in giving us warning about our futures.
Dr. H: You’re funny. But seriously.
Does anyone in Norway get expensive care, for example, costing 5 figures?
Supremacy Claus: Really, I’m not a doctor, just the son of one, and he’s been dead for a few years. But I’ll try to answer your questions if you have any.
I’ll start here though: “Costs are double over there. Salaries are half of ours for everyone, down to the maids in hotels.”
That is just not correct, at least not for Norway I believe. I don’t know what the average wage is for hotel maids in the US, but I found one reference after a quick googling suggesting that it’s about 10 dollar pr.hour? If that is correct it’s actually the other way around: Our hotel maids make twice as much as yours do?
You will probably find that jobs that requires little or no education will be better paid in Norway than in the US. On the other hand, education will get you a higher wage in US than in Norway.
So a hotel maid will make around 40 000 dollar a year in Norway as of now with the dollar being rather weak, while my wife who is a physiotherapist makes around 55 000. A doctor working at a hospital or similar will make about 100 000 dollar a year, while a doctor with a private practice will make at least twice that, some of them making as much as 400 000 dollars a year.
Now this is getting to be a long comment, so I finish it up now by saying that yes, we do have and use helicopters. We do transplants, and specially our heart surgeons are at a high international level. Being a small country we probably have less specialists in fewer fields than the US, but our health care is not cheap. Patients do get expensive care over here as well.
Now I’m not saying that our system is better than yours, (even though I tend to think so, being a norwegian) I just think that many americans have a wrong view of “socialized medicin”
Hjorthen does private healthcare also exist in Norway?
Some docs I know, Swedish nationals, corrected me about their country. I naively assumed there was no private health insurance in Sweden. They both said their families back home have private insurance to cover healthcare either not offered, or may offer unacceptable (to them) waiting lists.
How about Norway?
H: Thanks for the thoughtful reply. Our hotel maids do not make $40K. They make about $20K a year.
I suppose there are advantages and disadvantages. The odds are good. We are too expensive, and Euro care is too stingy.
The wages of the doctors are low, but they likely work less. The average doc here works 2500 hours a year. Still they are reasonable. I would not want my doctor to be angry about his not making the $90K he demanded from the British government. I want him content and motivated to do all he can for me. I do not want him going home at 5 PM, on the dot. So, I have to wait for his return the next day, or the next week, to remove the ice pick from my head.
We get our impression of Europe from the British system.
There is also an assumption in the US, government does nothing well. It has no known exceptions.
Health is too important to settle for government incompetence for everyone. If people loved the Walter Reed Army hospital scandal, they will love Obama Care.
This does not bash government workers. Once they leave, they are superb workers, usually deserving many times their government salaries. The problem is not with the workers. It is with the influence of politics.
Also, the government is the biggest entity in the US. It is a wholly owned subsidiary of the criminal cult enterprise that is the lawyer profession. The lawyers make 99% of the government decisions, and seek to plunder clinical care. It can destroy even innocent doctors by generating legal defense costs. One has to then attack the lawyer personally, filing complaints, countersuits, seeking legal fees, injunctions, and demanding discovery of the land pirates personal computer. The government cannot get even a frivolous countersuit dismissed for less than $1mil. Generate massive government defense costs to take out the budget of the oppressor.
One should always find child porn, a federal offense, on the land pirate’s government computer, if one looks hard enough. Let the government land pirate defend that. No doctor should live with uncertainty without tons of government lawyers living with the same torment. Always attack back, if one is innocent.
However bad and frustrating insurance is to doctors, the risk of a government monopoly, a dictatorship with police powers over the $2 tril health budget is pure evil and lethal to anyone with a serious illness or injury.
“Hjorthen does private healthcare also exist in Norway?”
Yes it does, much the same as Sweden I suppose. But of course it’s difficult to maintain a private clinic in the rural areas of Norway. They are for the most situated in the bigger cities.
“Are there any transplants going on in Norway?” asks SC.
Especially when it comes to kidney transplants the main hospital (Rikshospitalet) in Oslo is among the world leading. It is one of the ten biggest centres for kidney transplants in the world, it has one of the highest rates for success and it has one of the shortest wait lists.
One of the reasons for the short waiting lists is the use of living kidney donors. I know that in other countries the use of living donors is not that common because it is seen as too risky. In Norway there haven’t been any incidents where the person donating a kidney has endured any life threatening or life changing injury.
And this is a governmental hospital, the treatment ends up with costing the government more than 5 figures as the patients live on medication the rest of their lifes.
Marit: Reassuring to hear about Norway’s busy transplant service. Transplants are expensive but cost effective compared to dialysis. The bonus is the patient goes back to work or school. In fairness to the left, the US funded dialysis and transplant by Medicare, our Commie Care. I also assume the skill of the transplant team gets adequate reward with a competitive salary, sufficient to keep them at work past 5 PM when things go wrong with the patient.
Britain had age limits on dialysis. So for them, dialysis was cheaper. Come some birthday, it was happy birthday and no more dialysis. Syonara, baby.
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