For those who are confused about what single payer universal health care is, please read this.

[Cleita]

Single-Payer National Health Insurance

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 47 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, long-term care, mental health, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Modest new taxes would replace premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing.

The links below will lead you to more specific information on the details of single-payer:

More at:http://www.pnhp.org/facts/single_payer_resources.php

Also further questions are answered on their FAQs page:

http://www.pnhp.org/facts/singlepayer_faq.php

The whole website is a riches of research and resources that these good doctors have been doing since 1987. Please help keep this kicked. I think it's important to get people educated on this who won't be if it sinks like a brick.

[msongs]

1. purges the fat from the system, just like corporations claim is the RIGHT thing to do unless....

it cuts into corporate profits. If it saves customers money, that is a BAD thing in the corporate view.

good riddance to all the bean counters.

return decision making to the doctors not the paper pushers.

Msongs

[Cleita]

2. Here is a plan proposed by the Joural of the American Medical Association.

http://www.pnhp.org/physiciansproposal/proposal/Physicians%20ProposalJAMA.pdf

[Cleita]

3. Here is the wikipedia information on HR 676 that has already been

introduced to Congress.

http://en.wikipedia.org/wiki/United_States_National_Health_Insurance_Act

This is the improved Medicare for all bill that Congress isn't listening to.

[stopbush]

4. Doctors I have are against this because they're afraid their services will

be ill-compensated by the government. They believe that their salaries would be cut in half.

Is that fear founded, or are they just buying the scare tactics of the big insurers?

[Cleita]

5. The plans calls for bringing everyone to the table,

both medical care givers and bureaucrats to hammer out the details of what the fees will be on a yearly basis or whatever frequency is decided on. Those doctors really need to talk to doctors who are under the system like in Canada. Tell them to go see "Sicko". Michael Moore interviews doctors in Canada and Great Britain and if I remember correctly France and all of them made comparable incomes to America doctors and they had to work less hard for it. For instance, in order for a doctor here in the US to make the same money per hour that a doctor does in Canada, he has to see twice the patients in that hour than the Canadian doctor.

[Lyric]

6. Yes, they aren't going to make quite as much. However,

their operating costs will also be much, much less; no dealing with bullshit insurance companies, no patients who cannot/will not pay (which raises costs for everyone,) and significantly reduced medical malpractice insurance because they will become government contractors--thus allowing the government to pick up a large chunk of the tab for the premiums of well-performing physicians--at least if we make sure that is part of the deal.

And taking a bit of a pay cut isn't going to hurt as much, because THEY will also have free healthcare--so they won't be paying for their own, thus freeing up a sizable chunk of their actual personal income.

I think we also need to do something about the horrific costs of medical school and nursing school; if we expect doctors and nurses to accept a decrease in their pay, we also need to make sure that they aren't loaded down with $150,000+ in student loans. That's only fair. Create a program that allows gradual forgiveness of physician student loan debt in exchange for community service--like working as a rural physician, or at an inner-city clinic.

[Cleita]

8. This where you are wrong.

Their net income goes up because their overhead goes down. For three or four bookkeeping type people that they have to employ now to bill insurance, they only need one. This has already been documented in various articles that have compared the two systems.

[Lyric]

9. Well that's one area in which

I don't mind being wrong at all.

:hi:

[bobbolink]

27. .

:thumbsup: :bounce:

[Gwendolyn]

49. Doctors in Canada do make less. Germany as well.

It's the reason most docs are virulently against it here. But that's not enough of a reason!

[Cleita]

50. If you saw Michael Moore's movie "Sicko" it seems the Canadian doctors

are making more net income and working less hard for it. I don't know why an oscar winning documentary movie maker like Michael, who must stand on his research, would make that up. I don't know about Germany, but I do know that German doctors can refuse to participate and take only private patients for cash. If you have any sources for your allegation, please post them here. It's important to diffuse any and all misinformation about this issue because it's very important and frankly the discontented with their lot doctors argument has been used by our insurance industry to frighten doctors here away from national health care as long as I have been involved in this issue. Here is what PNHP has to say about it and they are specifically talking about Canada.

What will happen to physician incomes?

On the basis of the Canadian experience under national health insurance, we expect that average physician incomes should change little. However, the income disparity between specialties is likely to shrink.

The increase in patient visits when financial barriers fall under a single-payer system will be offset by resources freed up by a drastic reduction in administrative overhead and physicians’ paperwork. Billing would involve imprinting the patient’s national health program card on a charge slip, checking a box to indicate the complexity of the procedure or service, and sending the slip (or a computer record) to the physician-payment board.

[Gwendolyn]

53. I'll try to find whatever info I can.

I lived in Canada for a number of years, so what I said is a little anecdotal perhaps. I remember at the time there were news blips about Canadian brain drain... including doctos heading south if they could, as their profit was better. But I don't want to talk out of my hiney, so I'll double check. In addition that was a number of years ago.

On the other hand, having lived there, the health care system was just wonderful!! Even though people talk about wait times, many experiences are contrary; I never had a complaint...and it was an absolute dream to know that you and your family were always covered, no matter what disaster should befall you. It's a feeling of safety that's hard to explain.

[Cleita]

54. You know that our insurance industry is trying to get into Canada as a market

so they are trying to undermine your health care system to do it. They see all that profit to be made. They are experts at getting articles of disinformation published in main stream publications and media. I find them all the time and when I trace the author, I usually find that they are RW writers for RW financial periodicals and are tapped for doing those kind of articles. Usually, their sources are bogus or they are unsourced.

[Cleita]

52. Also, I just looked up some information about Germany and it seems the system is a combination

government health care and private insurance. I think this is where the problem lies. Private insurance will undermine national health care in the long run. There was a blog making some outrageous claims about thousands of doctors leaving Germany linked to a "Der Speigel" arcticle that was non-existent. So if anyone does have a cache or link to that article, all I can say is right now there is no proof of your statement.

[Edweird]

7. My Canadian girlfriend is happy with their system. I know ours sucks ass.

[Rosa Luxemburg]

21. I lived in Canada and it was a good health system

[Kitty Herder]

10. K&R

[Cleita]

11. Thanks.

:hi:
Another :kick:

[midnight]

12. This is a good explaination for the lack of medical treatment, but

what about the army of attorneys that defend this bureaucracy. The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

[Cleita]

14. And here's the rub. We have to inform the public as to what single payer

brings to them. The problem is that the industry has the bucks for those attorneys and the publicists and lobbyists that keep this corrupt system operating. This is where grass roots are going to have to come in. If Daschle is indeed going to form a health board to study this problem then the health care industry is going to have to demand a seat at that table and so are we the people. I think we need our own Washington lobby and hope that the Harvard doctors can get enough money together to do it.

[TrogL]

13. It works here

I walk in any doctor's office of my choosing (or show up in hospital) and all I have to do is give them my health care number. The computers take care of the rest. Pretty soon the patient files are going online as well.

[Cleita]

15. Are you in Canada? n/t

[defendandprotect]

17. And is alternative health care covered???

[Cleita]

24. What do you mean by alternative care?

[defendandprotect]

26. Doctors who do natural remedies ....

[bobbolink]

28. It will only be if we demand it.

I know someone in Canada who worked for 10 years to get midwifery covered by the Canadian system.

They succeeded.

The more we demand from the beginning, the less we have to go back and correct later.

[defendandprotect]

29. As far as I can see America's medical establishment is killing us ---

Caresarean rate is unbelievable -- often now scheduled--!!! --

and women are thankful--!!

[foxfeet]

16. K&R

:kick:

[Cleita]

18. ...

:kick:

[gratefultobelib]

19. What will happen to the health insurance companies?

[Cleita]

20. They can still offer insurance in addition to but not in competition with

the NHC program. Like if rich people need extras, like private rooms in hospitals, private nurses and other non basic care items, they can still offer that insurance. Everyone else will still have necessary, but quality care. Also, really, don't feel sorry for insurance companies. They are very innovative at finding niches to insure and non of the companies have all their eggs in one basket. Most offer a diversity of insurance and all offer life insurance, a waste of money IMHO but a traditional cash cow for them.

On edit, the FAQ link offers this explanation:

Can a business keep private insurance if they choose?

Yes and no. Everyone has to be included in the new system for it to be able to control costs, reduce bureaucracy, and cover everyone. In Canada, businesses can purchase additional private insurance that covers things not covered by the national plan (e.g. private rooms, orthodontia, etc.). However, we support a comprehensive benefit package for the single-payer program that would eliminate the need (and most demand) for supplemental coverage.

Insurance companies would not be allowed to offer the same benefits as the universal health care system, a restriction contained in the traditional Medicare program. Allowing such duplication of coverage weakens and eventually destabilizes the health care system. It undermines the principle of pooling the risk. Health care systems act as universal insurers. At any one time the healthy help pay for those who are ill. If private insurers are allowed to cherry-pick the healthy, leaving the public health care system with the very sick, the system will fail.

This, in fact, is what we see happening to Medicare through the Medicare Advantage program. The government pays Medicare HMOs 13% more than it pays traditional Medicare, yet the HMOs care for a healthier mix of seniors. This is leading to privatization of Medicare and funding shortfalls for the traditional Medicare program.

[gratefultobelib]

32. Thanks for taking the time to answer my question! I do not feel sorry for

the insurance companies, believe me. I'm just wondering what kind of lobbying pressure they will put up to fight the NHC.

[Cleita]

35. Something horrendous but we have to fight them every inch of the way.

Being uninformed and sitting back waiting for the legislators to do something will mean that they will be influenced by the lobbyists who have a lot of money to do this. We have to hit the streets or actually the emails, phones and snail mail on this.

[Rosa Luxemburg]

22. I like the UK health system (the NHS)

I like the services and the midwife system especially.

[defendandprotect]

30. I recall the Thatcher reign was "starving" the health system ...

[Cleita]

36. They were and the neo-cons are doing the same to Medicare today.

They are now making doctors wait for payments for six and more months by holding back the payments which are now outsourced to private insurance companies. I tell you the private insurers have got to go. This is why people say the system doesn't work, but it's Republicans who do this. Medicare has been working since LBJ signed it into law, but the neo-cons are doing everything to destroy it.

[defendandprotect]

57. I hope everyone is getting ready -- and I think it will require another revolution ..

Have most Americans woken up 30 years too late--?

You bet!

And now it's either survival of humanity/planet -- or corporations/capitalism.

Capitalism is a ridiculous "King-of-the-Hill System"

Unregulated capitaslism is merely organized crime --

All of these corporations should be broken up and re-regulated to the hilt --

OIL and other natural resources should be nationalized --

and all privitization of government REVERSED --

And move to a democratic socialism --

[BrklynLiberal]

23. Kicked for later reading..

[Delphinus]

25. Kick for HR 676

Universal Health Care for all - NOW!

[TexasObserver]

31. we do have Single Prayer health care

Dear Lord, I don't have coverage, so little help here?

[Cleita]

33. I understand your pain.

No prayers needed with this except to get our politicos to do it. Then you will have coverage. The health care industry are going to be a hard nut to crack, but the fact that it seems Obama's administration have this on top of their agenda gives us hope. We have to make them do it right.

[TexasObserver]

37. I'm one of the lucky ones, with coverage. I was speaking for those who don't.

that was my intent, perhaps unclearly expressed

[JNelson6563]

34. Excellent post!

Thank you. :toast: K&R

Julie

[Cleita]

38. Thank you!

:-)

[Merlot]

39. Anyone have any idea how long it would take to enact this?

I've read that Obamas plan was incremental, because he knows the insurance companies and lobbyists won't go with out a fight.

How does something this big get implemented?

[Cleita]

42. 60% of health care delivered in America is government health care from

Medicare, Medicaid, VA, Champus, Schips and others I can't remember right now. Since Bush has been in power trying to privatize or eliminate everything, most of these plans have been eroded, defunded or not updated in any way. I think John Edwards had the best idea and that was to throw Medicare on the open market to compete with the private insurers. Since Medicare can deliver the same health care for less, it can undersell the privateers and they will eventually get out of the business because it won't be profitable anymore. Those guys are the middle men between the patients and the health care providers anyway and their whole purpose really is to deny as much health care as they can and deliver profits to Wall Street. Medicare does not deny health care for any reason, preexisting conditions, chronic conditions or nothing else really.

Once we get them on the run, we can make Medicare or another complete coverage single payer plan extend to and cover everyone. We also should be covering the uninsured at this point. We need to update the fee schedule on a regular basis to one that health care providers are happy with, extending coverage to eye care, mental health care and dentistry. We can eliminate the deductibles and co-pays. The only thing you would pay is a premium to participate that is never anymore than you can afford because it's a shared risk. In order for it to work participation would be mandatory but spread out by ability to pay. Those who cannot pay (children, elderly, handicapped, unemployed) would be eligible too because this is what is shared risk for the common good. We have to put a stop to Medicare giving money to private HMOs because it erodes the system and we can't allow any private insurance to issue the same coverage or get money from the federal fund or we will get a plan that won't work and that will be too expensive to run. However, the latter is what is being talked about now including in the Obama camp. It makes me shudder because it's all wrong.

[slipslidingaway]

40. Thanks K&R, also interview here from last year...

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=4507724&mesg_id=4508559

[Cleita]

51. Thanks for reposting this.

I hope Dennis starts getting involved in this issue in a big way again.

[slipslidingaway]

55. My pleasure, it is one of the most important topics, we should

push for a debate in Congress.

[Greyhound]

41. K&R , thanks Cleita. If we keep posting and talking about this, eventually

the facts will seep through.
:kick: & R

[Cleita]

45. That's the plan.

I will try to put as much information as I can a couple of times a week all the way up to the inauguration. If we educate ourselves on it, then we can educate the new administration. We don't have the money, lobbyists, publicists, lawyers, and advertisers the insurance industry does, so each of us will have to reach out and educate those in their orbit. I envision us being a ripple in a pond that gets bigger and bigger. I have discovered that when you reach out and explain this to people that 70% like the idea both liberal and conservative. That's what we need 70% to influence the lawmakers in Washington.

[antigop]

48. I agree. I'm trying to get the word out to my family and friends. n/t

[antigop]

43. Thanks, Cleita. Great post. K&R n/t

[Cleita]

46. To you, I'm preaching to the choir.

:hi:

[antigop]

47. Yep, but I appreciate your diligence in keeping this issue alive. n/t

[Uncle Joe]

44. Kicked and recommended.

Thanks for the thread, Cleita.:thumbsup:

[happydreams]

56. K&R! Great post Cleita. Well I'm to late to rec it....

:hi: