Oh and three years later and we are still unwell. The health system continues to cause much debate and rage between the politicians and communities. The answer is simple, in my view at least, a National Health system that is motivated by human rights not insurance companies and personal wealth. C’mon America get with the program.

Thank goodness that middle America is beginning to think beyond the ideal and is now looking at the reality for many. Working poor, disadvantaged groups and the many minorities deserve to receive a degree of adequate and quality health care as does those who have the luxury of insurance and choice!

Mar, I appreciate the input on the Canadian system.  While it is a damned sight better than the greed based system in the U.S., that really doesn’t say much seeing as the U.S. ranks beneath some Central American countries.  From my own observations, the UK system of nationalized healthcare seems superior to yours.  Perhaps you can enlighten me on whether you agree or disagree with that assessment.

Correct. The whole area of “extended health benefits” included in many Canadian union contracts and retirement benefits cover such things as semi and private rooms, pharmaceuticals and para services (Physio, spectacles, hearing aids and so on) and of course, dental except for emergency accident dental services, which the main plan covers.  These services are covered by the the private insurers and I believe they are doing very well, thank you.

Right on!

The U.S. is the only industrialized nation in the world that does not have single-payer.  Ours is an illogical system where not only 18,000 people die each year from lack of coverage but others die because utilization reviewers are paid to claim that necessary procedures are not necessary in order to protect the healthcare insurer bottom line?

I would suggest Arnacissie, go down to Best Buy and pick up a copy of Michael Moore’s “Sicko!” and watch what happens supposedly “insured,” hard-working Americans find out that the insurance company they had been paying for years cancels them in the midst of a catastrophic illness, or the tearful sworn Congressional testimony of Dr. Linda Pino when she admits that as a utilization reviewer for Humana she denied a necessary procedure that resulted in the death of a patient; or watch the elderly bewildered woman being dumped by a hospital on a skid row street still wearing her hospital gown with a tube appended to her arm.

31% of the monies spent on healthcare in the U.S. goes to for-profit carriers and HMOs—salaries, CEO compensation, advertising costs etc.—as compared to administrative costs of 1% to 2% in single-payer countries.

The so-called reforms offered by both Clinton and Obama amount to variations on a scheme originally offered by Richard Nixon to head off a proposal for single payer advanced by Sen. Kennedy in 1971.

The U.S. healthcare system is an abject failure and precisely what one would expect to find when profit for the select few is valued over the very lives and health of our citizens.

This is a very good example of real truth exposing its ugly head. Thank you!

Thank you for your insight. As one exasperated C-SPAN caller said one morning: “If the government is not there to help the people, what good is it?”

While the US can and will do what it wants in regard to health care, you should at least find out the facts of alternate systems before you decide.

Having been both an executive and management consultant in Canada’s system I think I know what I am talking about in regard to our system and it is most often wrongly described in the US. But then we like to think of our country as a caring society even though it is thoroughly free enterprise in the essential areas. Doctors practice in accordance with a negotiated fee schedule in each province (read “state”). They and the rest of the health care system operate under an umbrella statutory agreement between the feds and the provinces. Nobody is left out, although some of the the rich who typically “buy” people would rather be on their own. Doctors who once wrote off 20 to 25% of their billings now have everything paid for - except for driver’s pilot’s etc medical exams and other voluntary services similarly not covered where the customer pays. 

To describe the US society as dog-eat-dog and devil take the hindmost sounds like it might be your personal philosophy as well as what the rich and powerful want it to be. Who is your “middle class”? The genius of the rich and powerful in the US is to convince the voters that everyone can aspire to be like them - even the blacks, Hispanics and others like them?

What you are saying really is that the unemployed, the blacks, Hispanics and other recently odds and ends (“welfare” in your world view) do not fit into your conception of the US, even though they meet the requirements of those who who founded your nation - except for the blacks, who have always been your main problem, even though in law their status has changed, if not in practice.  One of the problems of “welfare” is that it denies the dignity of people who are not always responsible for their condition. Remember, there are the lame, halt and the blind in there too.

It is possible to structure a health system that looks after everybody - except the greedy, which amply describes a lot of the medical fraternity, insurance companies and HMOs.  The profit motive kills health care.

{Perhaps the cooperative approach will meet your needs, but not if it leaves anyone outside the door.)

I have found the discussion of Single Payer medical insurance to be rather mystical; people seem to take a religious position and hang on to it.  Among most liberals, leftists, and/or “progressives”, it is an article of faith that Single Payer will be cheaper and more efficient than what we have now, or any other likely alternative.  However, in the U.S., the Federal government does not normally provide cheap or efficient services.  That includes Medicare.  The fact that such services may be cheap and efficient in Canada or Germany is not conclusive; the US has a considerably different assumed social contract than either of those countries.  The American spirit of dog eat dog and devil take the hindmost, when combined with government power, often produces unexpected and undesirable results.  In any case, if you’re going to argue with the insurance companies and the Right, you’d better have more facts, figures and other evidence than I usually see provided by Single-Payer believers.

Another, related problem, which I think is highly disadvantageous to Single Payer, is its conflation with Welfare.  Proponents of Single Payer often point to the fact that there are 47 million Americans without health insurance, or some such figure.  Obviously, most of the 47 million are without insurance because they’re too poor to buy it.  To fix the situation, it is probably necessary to have someone else buy it for them.  For the hard-working middle-income taxpayer, this means one thing: higher taxes, that is, a higher price for the same service.  If I wanted to put Single Payer over with the middle class, the last thing I would want to do is mention the Welfare angle.

I have suggested a different reform: cooperative, that is, user-owned and user-managed insurance companies and HMOs.  For some strange reason they exist only in Wisconsin, as far as I can determine.  These could lower insurance and medical-care costs for middle-income people directly, and Welfare could brought in as a separate project.  But I have been unable to elicit interest.  Everyone wants the authorities, their great leaders, their lords and masters, to save them, after they have done such a great job in other areas of our lives.

Well i don’t drive around in a hummer.  And i agree with you about what would cost more.  Moreover, i’ve lived in multiple countries with single-payer systems; i know full well that they’re grand.  And since i’m of the uninsured, this issue affects me directly.

None of that changes the fact that We the People can’t really afford anything at all right now.  Not a hummer not a Prius…not even a bicycle.

Most single-payer countries control costs and even the pay of doctors.  (The grandfather of an ex-girlfriend had been the chief of staff at the largest hospital in Salzburg, Austria…but he made far more money after he retired and opened a private clinic to treat varicose veins.) So while we could spend less than we currently do, we’d also have to convince doctors and hospitals to make far less money then they currently do. 

Would it work out much better for all concerned in the long-term?  Yes, without a doubt.  But it would require sacrifice…the dirtiest word in American English.

Your logic sounds like the person driving around in a Hummer saying that they can’t buy a Prius because they are spending all their money on gasoline!

Yes there will be transition costs but our government is already spending a larger portion of its budget to provide medicare, medicaid and emergency care to the indigent care than single-payer countries spend to provide care to everybody. 

What we can’t afford is the current system.

Single Payer health can be based on the Medicare program which has an alternative for those that cannot afford to pay their portion, that is Medicaid.
With Medicare able to negotiate medicines and Medical Fees their would be enough savings to make available, basic dental services for every man, woman, and child. Insurance Co’s are the only nay-sayers in this mix..and that is because of the high profits they make are second only to what the big Pharmaceuticals make.
It is nice to see the Dr.s are finally seeing the wisdom of single payer health. Of course none of the presidential candidates have the correct answer, but we know they serve a master…and that’s not us people.

Good points, spincycle.  There is no doubt that national health care is actually cheaper than private insurance…in both the short and the long terms.

My point about not being able to afford it was that the United States cannot really afford anything right now.  The last GAO audit pegged our real deficit at $53 Trillion…mostly due to unfunded entitlement liabilities.  That arose from bad financial management; surpluses were borrowed from the funds by the federal government.  That would be fine, except now we don’t have any way to repay those borrowed funds except by borrowing more money from someone else.

As a nation, we’re like the individual who lives the high life off of credit cards and home equity loans.  This was all possible when the dollar was a strong, reserve currency.  Its current weakness combined with its continued role as the world’s reserve currency puts us in a difficult bind…the exact opposite of the good ole days of pleasant living through printing money.

That’s why i said that these reforms should have been made when times were good, because we could finance them.

People talk about national health care as something we can’t afford.  But the simple statistics are that the US spends a greater fraction of its GDP on health care than any other major country and a greater percentage of government spending is on health care than in most other countries.  Think of it.  England and Canada for example spend less of their government budget to provide health care to everybody than what we spend on providing it to only a fraction of our population.  And their life expectancy is longer!

The problem is not just all the profit, it is also that the incentives are all wrong.  Like most companies insurance companies have trouble looking beyond the next annual report.  So treating problems early and preventative care are all denied because they are hoping that by the time you get the major problem that could have been prevented and will cost far more then either:

1.  You will be retired and the government’s problem

2.  You will have first become too sick to work, have lost your job, and will no longer be their problem.

3.  You will have changed jobs and be somebody else’s problem.

4.  They will find some other means to deny you coverage, like declaring it was pre-existing.

5.  Even if nothing else, I will have taken my golden parachute and be out of here anyway.

So if we can’t go to single=payer we need to change the rules so that the incentive is not to deny care.

1.  Companies can set rates based on risk factors but they have to take you.

2.  Companies can only drop you for failure to pay premiums.  The company will be required to cover you until death.  The elderly will be given a subsidy for premiums rather than be switched to a different system.

3.  The government will offer an alternative single-payer plan for anybody who wants to participate.  It will basicly be the ability to buy into the current Medicare system at any age.

There is no reason why a single-payer system would have to put the insurance industry out of business.  In many countries with single-payer health care, citizens are free to purchase supplementary health insurance.  And many do.

A good argument could be made that covering everyone to a fair degree would lower insurance costs enough to allow more people to purchase insurance in the market…or allow more companies to offer supplementary insurance as a benefit.

Of course, we should have done this when we were flush with money.  Now, we’re broke.  If you don’t have any sails, it doesn’t really matter which way the wind blows.

My clients who have medicare have no dental insurance.As a result their teeth are rotting out of their mouths.These are people with unskilled jobs, they keep their jobs for a lifetime usually and work their butts off. They take the public bus to go shopping and for commuting to work. They have to choose between getting gas, if they have an old car, or getting food and medicine.  They are the working poor and are ignored as they and dont turn the dollar for Korporate Amerika