Wednesday, January 19, 2005
Single-Payer
The January 19th issue of JAMA has a review of the book "Lives at risk: Single-Payer National Health Insurance Around the World." The book explores the dark underbelly of socialized medicine around the world and supports many of the conclusions I've come to after a decade of watching Medicare/Medicaid in action.
The reviewers:
"Private administration (of healthcare) is really more efficient than than public. Moreover, the key to eliminating waste and perverse incentives is to get all third parties out of the majority of medical encounters-not to make a federal case out of every single episode of medical care. True insurance is a method for indemnifying subscribers for a catastrophic loss, not a bill-paying service."
Americans are expected to save to pay for cars, vacations, and homes so why is health care any different. Just as one would need insurance coverage for major home damage they would also need this for possible major illness/surgery, that is what insurance is for. There are good health savings accounts available out there for little expense (depending on what type of coverage you choose and the amount of your deductible).
So what should be done now? The authors have some good suggestions:
"Ideas include replacing state mandates for covering particular services with a casualty model; two-way long term commitments to diminish adverse selection and the "death spiral"; and a better division of direct and third party payment. The caveat is that there is no single product that is ideal for everyone-only an optimum choice among available products for each individual. In a free market, a variety of products could develop, some still un-imagined. Avoiding the top-down command and control of the single payer, these authors would allow innovation to flourish."
There is a place for government in healthcare, but not as the administrator of services. Government could set standards and control oversight which it does in various other Fields. It's time to wake-up from the utopian dream of socialized medicine before it kills us all.
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The reviewers:
"Private administration (of healthcare) is really more efficient than than public. Moreover, the key to eliminating waste and perverse incentives is to get all third parties out of the majority of medical encounters-not to make a federal case out of every single episode of medical care. True insurance is a method for indemnifying subscribers for a catastrophic loss, not a bill-paying service."
Americans are expected to save to pay for cars, vacations, and homes so why is health care any different. Just as one would need insurance coverage for major home damage they would also need this for possible major illness/surgery, that is what insurance is for. There are good health savings accounts available out there for little expense (depending on what type of coverage you choose and the amount of your deductible).
So what should be done now? The authors have some good suggestions:
"Ideas include replacing state mandates for covering particular services with a casualty model; two-way long term commitments to diminish adverse selection and the "death spiral"; and a better division of direct and third party payment. The caveat is that there is no single product that is ideal for everyone-only an optimum choice among available products for each individual. In a free market, a variety of products could develop, some still un-imagined. Avoiding the top-down command and control of the single payer, these authors would allow innovation to flourish."
There is a place for government in healthcare, but not as the administrator of services. Government could set standards and control oversight which it does in various other Fields. It's time to wake-up from the utopian dream of socialized medicine before it kills us all.
# posted by Joe Florida @ 9:52 AM 
