"If American Veterans Can't Trust The Govt With Their Medical Care, Why Should The Rest Of Us?"
That's the end line of a Paul Hsieh piece at PJMedia. Here's a bit the precedes it:
According to Kaiser Health News, the VA health scandal isn't relevant to their cause because "the VA system is fully government-run, and not the same as single-payer, where doctors and hospitals would remain private, with payment from the government."But this is a distinction without a difference.
The federal government sets the budget for the VA, determines which doctors can work for them, and ultimately controls what care patients may receive. Except for cosmetic differences, the same applies to any single-payer system. Even if doctors remain nominally private under single-payer, he who pays the piper calls the tune.
Single payer means single decider on treatment and control by bureaucracy.
Nobody went to work in a VA hospital and said "I'm gonna kill some veterans today." The bureaucracy got the upper hand and strangled the hospital.
A single-payer bureaucracy that arbitrarily decides what treatment it will pay for and how much it will pay creates logjams in the availability of certain treatments - which creates waiting lists. And waiting lists grow. And when the lists grow large enough, people on those waiting lists die.
An open and competitive system means that if there's enough demand for certain treatments, the price goes up and as a result new treatment centers are opened to take advantage of the demand. Newly minted doctors gravitate to the specialty treatment studies. Widespread availability of treatment centers means no waiting lists.
When there's no money in opening a treatment center, no one will open one. When a specialist earns barely more than a GP, very few people will be willing to endure the stress of being a specialist. And we'll have shortages of specialty treatment providers.
A 2012 report on waiting times for specialty treatment in Canadian healthcare reported that "Specialists are also surveyed as to what they regard as clinically 'reasonable' waiting times in the second segment covering the time spent from specialist consultation to delivery of treatment. Out of the 104 categories, actual waiting time exceeds reasonable waiting time in 73 percent of the comparisons." [emphasis mine]
Converting to a single payer system will exacerbate, not solve, the problems inherent in centralized medical care delivery and decision-making.
The VA scandal was not an anomaly. The UK NHS scandals were not anomalies. All of these are what happens when bureaucrats decide when, where, and how much treatment is available.
Conan the Grammarian at May 28, 2014 8:21 AM
To sum up, "single payer" does not mean "get anything you want and the government will pay for it". An awful lot of people are in denial about this.
Cousin Dave at May 28, 2014 8:48 AM
Can we just acknowledge that the amount of care we receive is going to be determined by the government, our insurance company, our personal finances, organized medicine, or some combination of the above? Something will control the amount we can spend on care that provides less and less quality of life at increasing cost...
MarkD at May 28, 2014 9:07 AM
MarkD:
Something will control the amount we can spend on care
By definition, no resources are infinite. (Econ 101).
the amount of care we receive is going to be determined by the government, our insurance company, our personal finances, organized medicine, or some combination of the above?
Yes. The difference is the bolded part is the one you have control over.
Unix-Jedi at May 28, 2014 9:28 AM
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