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How badly does our liberal establishment hate single payer?

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Submitted by jawbone on

up, yet. I just left this one, not great but wanted to be near the beginning; however, may not have made it if there are lots in the moderation link.

Prof. Krugman, the choice isn't only between "death panels" as stand ins for decisions on what will be covered by health insurance and the current situation, between the ever rising costs we're seeing and having harsh restrictions on coverage.

The real choice is between single payer similar to (or just like) Medicare, as in Medicare for All Improved, with dollar one coverage and with vision and dental -- and ensuring private insurers have mandated "customers" who will continue to pay through the nose and provide huge profits to the for-profit private insurance companies and their extremely highly paid executives, as Obama's health insurance "reform" does.

Please don't fall into the trap of the falsely limited choices. Obama did that to us by taking single payer "off the table."

We don't need you doing that as well.

This link takes readers to the PNHP site, which explains how and why single payer saves so much money and provides so much more for people. Just not for corporate execs.

Or google "single payer Medicare for All." It's out there, but it's just [not] acceptable to be talked about by the MCMers (members of the Mainstream Corporate Media).

Health CARE mavens: Go forth and add better comments, please!

And, drat all, I left an important negative out; thought I'd proofed. Meh.

Submitted by jawbone on

at 6:18PM.

And, to echo Hipparchia, the comments are to get through to Krugman's readers. Perhaps have some effect on Krugman, but mostly affect the readers. Far more eyes go to Krugman than come here (as of, lambert?).

Submitted by Schmoo on

Yes, he is slightly more to the left than Obama but so is the Oak Tree standing outside my window.

We don't need to be engaging in discussion with Krugman,who clearly is part of the Political Class.

We need to be working toward having Third Parties that are viable and have decent contenders to the current crop of "entitled" Political Class Artistes, like Michele and Barry. I want to see a Feingold/Grayson ticket, and have the Obama candidate sink like a stone for being the Traitor to the Working class that he is, was, and always will be.

basement angel's picture
Submitted by basement angel on

Remember, he's one of the assholes who endorsed Obama and offered up the justification for Obama's pro-FISA vote. I think it was something to the effect of , "Obama wants it to pass so that he can fix it when he's president."

I don't know why Feingold would so such a thing but whatever his motivation, it's all you need to know that he wouldn't be anymore independent from Wall Street than Obama is.

Submitted by hipparchia on

the point of leaving comments there is not to engage paul krugman, but to place other - and better - ideas before paul krugman's readers.

Submitted by lambert on

Though it's nice, every so often, to get some hits ;-)

JG's picture
Submitted by JG on

I really don't think that Krugman hates single payer, but it would be useful for him to mention it more often.

As for cost control: when it comes to exponential growth, in the long run the baseline is irrelevant and all that matters is the growth rate. Usually, the economic case for single payer is made based on the baseline cost and not the growth rate. I think that there is some evidence that single payer can cut down on the growth rate as well, but some of this may come down to what Krugman refers to as "death panels". These cost controls (such as the UK's NICE) may be more common in single payer systems (because they aren't able to ration based on ability to pay), but single payer may not be necessary to achieve such cost control.

letsgetitdone's picture
Submitted by letsgetitdone on

If you take a look at the Taiwan case, it's very clear that the rate of increase in health care provider costs is much lower than here. This is due to the fact that the Government is in a very strong negotiating position since it is the only funder.

The same thing would happen here if we went to single payer. On both initial levels and growth in costs, single-payer is better than the system we have now.

Single payer will have problems if we adopt it. There's no such thing as a utopia. But think the problems we'll have with it are much more manageable than the ones we are having with our present system. For heaven's sake, the present system is causing 45,000 fatalities and many hundreds of thousands of foreclosures, and bankruptcies every year. The problems of single-payer pale by comparison.

Submitted by JuliaWilliams on

comparing Canada v US. Tha Canadian system, despite the anecdotal reports used as "news" by the US and even some conservative media in Canada, is not only universal, more efficient, and provides better outcomes, the "growth rate" you're so concerned about is much less than compared to ours, and is proven to have occurred as a result of implementing the single-payer system there. As lets mentions, the untimely deaths of over 45,000 people a year is also caused by our system, and not mentioning that, and the secondary damage resulting from bankruptcies caused by healthcare costs (over 50% in the US), causing entire families to slide into poverty, homelessness, and worse, is a telling non-concern to those mentioning "death panels", when in fact, the "death panels" ARE the insurance companies.

Submitted by hipparchia on

i was just now composing a reply with this link in it [and some other links too] but the intarwebz ate it.

Submitted by hipparchia on

i love that one! [i hadn't seen it before]

Submitted by hipparchia on

I think that there is some evidence that single payer can cut down on the growth rate as well, but some of this may come down to what Krugman refers to as "death panels". These cost controls (such as the UK's NICE) may be more common in single payer systems (because they aren't able to ration based on ability to pay), but single payer may not be necessary to achieve such cost control.

it's the prices, stupid!

you are correct, single payer is not necessary. what is necessary is government-imposed price controls on the costs of care, which is pretty much what all the rest of the world does, be they single payer countries or multi-payer countries. multi-payer systems are generally more complex to administer, so in those countries you waste some money on administration that could have been spent on care instead.

as for death panels, nice-like groups tend to appeal to the neoliberals, who want prices to remain unregulated, but they do very much like it when go vernments regulate the amount of care it pays for. keeping overall prices high and rationing care by who can afford it is a neoliberal preference.

the neoliberals have been working on privatizing the british nhs since margaret thatcher. it's worth noting that the uk's nice only came about after the neoliberals had been dismantling the nhs for some years [and they're still at it].

Submitted by SinglePayerActivist on

Price controls are secondary, not primary.

Cost elimination is primary. Read on.

It is time for Improved Medicare for All via single-payer health care.

As T. R. Reid has clearly communicated ("The Healing of America" pp. 237-238), health-care-for-all systems around the world started with the objective of covering everybody, and cost control naturally occurs as part of getting everyone covered and having everyone covered.

So ... prices are secondary topic in the big picture. The big picture is seen in the SIMPLICITY flow chart ... NOT by looking at the COMPLEXITY flow chart and then wondering how we'll do this.

We must first move from the complexity to the simplicity.

All three types of bureaucracy must be eliminated.

We can have the very best.

Have you ever seen these charts?

That link takes you to the starting point of the charts, which is to eliminate that bureaucracy.

However, not much of any discussion / effort on this topic matters until millions of Americans are informed.

On Saturday (11/13/2010) at the Healthcare-Now annual meeting in Philadelphia PA one of the speakers stated: "People don't understand single-payer." No kidding. And until Americans (millions of them) know what "Improved Medicare for All" is and that it is critical for our recovering/adding/keeping jobs and for reducing the size of our government (one of the 3 types of bureaucracy) and for improving our health ... then we might as well all just roll the dice for which one of us goes bankrupt next.

(Perhaps I should have ... or should ... put this on my Corrente blog. I'm a new participant here, so bear with me. For now I must get back to getting ready for great progress in 2011.)

Submitted by hipparchia on

... and cost control naturally occurs as part of getting everyone covered and having everyone covered.

reid is a pretty smart guy, but he's being either disingenuous or downright stupid with that statement. yes, eliminationg complexity in our system has the potential to eliminate a lot of the cost, but just eliminating providers' costs is not a guarantee that they will then pass on those savings to the rest of us. this is why every successful system also has price controls [and there are plenty of price controls in hr676] - to prevent price gouging.

Submitted by SinglePayerActivist on

1 - Prices ... negotiated

HR676 mentions price in only one paragraph, which refers to negotiated prices.

Perhaps that's a key clarification in this exchange. In other words, perhaps you are referring to negotiated prices as equivalent to "price controls". If yes, then fair enough. That is, the United States' outstanding ability to negotiate due to only having one health insurance plan and due to having the largest population of free-market countries allows us to have the best negotiating power.

2 - Payments of Providers ... negotiated

Payment of providers in HR676 [scroll down to 202(b)(2)] is also that the (USNHC) "Program shall negotiate a simplified fee schedule ..."

Perhaps you are using the word "controlled" as your synonym to "negotiated". (?)

Pass on Savings? Price gouging?

You also wrote about "pass on savings" and "price gouging".

Yes, ... there will be a positive impact on the income of family physicians (general practitioners, primary care physicians).

But, no, ... there is no option of passing on ... or not passing on ... their improved net income of their practices.

If your reference to "price gouging" means "double billing", then yes ... normally none of them will legally bill us for anything :) , as specified in H.R. 676 ...

HR676 Section 202 [scroll down to 202(b)(2)(F)] specifies no balance billing can be done.

Bottom-line ...
We'll simply show our card and get care.

Submitted by hipparchia on

negotiated payments to doctors; negotiated drug prices [and for medical devices too]; global budgets for hospitals; no balance billing allowed - yes, these are all price controls [or you can call them 'government actions to protect us from price gouging', if the phrase 'price controls' is too scary].

it only takes a few words, and not much space in the overall bill, to describe these controls, but they are very powerful and important tools.

the complexity of our present 'system' imposes a lot of costs on providers, and the removal of much of that complexity automatically increases providers' net incomes without their having to raise their prices even a penny. if the removal of complexity makes providers' net incomes go up by 5%, probably nobody will care if providers keep all of the gains. if, however, providers' net incomes go up by say 40%, or 60%, or ... then hell yes, we the patients are going to expect them to lower their prices significantly. and since that price lowering is unlikely to happen spontaneously, we impose government price controls to make sure it happens.

Bottom-line ...
We'll simply show our card and get care.

bingo! what obama said.

this message resonates with people. we need to be saying it all the time, to everybody [and it doesn't hurt for them to hear from real canadians either].

Submitted by SinglePayerActivist on

Excellent follow-up. Thanks.

To add to what you wrote about hearing from other countries ...

People can also hear from many Americans in many countries who have worked ... and/or lived and worked ... in those countries (like I did in Canada and Germany and others).

Many testimonials are available to read ... now including experiences of American travelers.

One of my favorites was just posted last month titled "Would not take a penny for first-class treatment"

Show card and get care.

Thanks for that positive feedback.
The Vision web page at Medicare for All was dramatically improved recently
... thanks to the combination of inputs from a fellow PNHP member in California and a citizen in Oregon (the latter being a long-term member of the Medicare for All review team).

I love that much-improved Vision web page. It's a shining example among the hundreds of inputs that have been making ... and still are making ... the Medicare for All website better and better as we head toward its planned "completion" date in 1st quarter 2010. All feedback very gratefully appreciated. ["Completion" simply means it's ready for a more robust promotion of the Million Letters for Health Care campaign. As a nurse in Missouri wrote to me, a good website is always a work in progress.]

Submitted by lambert on

And feel free to post here, not just comment. As you may know, Corrente was a hotbed of single payer activism during the HCR debacle.

Submitted by SinglePayerActivist on

Thanks, Lambert, on all points.

I just double-checked to make sure that correntewire is on the start-up checklist. The plan is to have final projects sometime in the first quarter, so I look forward to taking you up on your offer to post ... especially after those projects are done and the start-up is underway. If anyone reading this wants to be a detailed / picky reviewer of the content of a couple of very important web pages (one of which is long, but extremely important),
they can let me know.

We can and will get Improved Medicare for All.
     Get more. Pay less. Cover everyone.
More jobs. Less government. Better health.
             Show card and get care.

Submitted by lambert on

Since you have a Corrente account, by definition you have front page posting privileges (we let Darwin sort it out....).

So, when you're closer to launch date, post an appeal. I think you'll get a better response that way. Thanks!

Submitted by SinglePayerActivist on



Deliberately trying to remain somewhat in hiding for now. Need to be not only ready with projects done and content stable / solid, but also (in parallel) ready to support the network of 435 teams of 1 or more per U.S. Congressional District who will be needed to help get single-payer with one of the largest grassroots activities the USA has ever seen.

Finally ... OOPS ... I just realized what your reference likely is. If you were referring to my asking for people interested in reviewing that very important web page, not to worry, as they say in Britain. My most critical needs are covered on that, but I'm glad for your input. After the first rounds of refinements from the first reviewers, I may send out a more public announcement to get the need for a "final round" to confirm all is well. I need to try to minimize the amount of work still required on content at the time of start-up (of the robust promotion of the campaign to help get Improved Medicare for All.)

Too many words here, but I gotta get going.

Thanks again.

All the best,