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Is It a Good Idea to Put in Place Socialized Healthcare?

Is It a Good Idea to Put in Place Socialized Healthcare?

Is It a Good Idea to Put in Place Socialized Healthcare?

We have heard for years now from the political left the demand for universal health care, they don’t want to just make it accessible to all, but want a single-payer system that will go with the examples of healthcare you see in Europe and Canada. But is this a good idea? Why not look at this and see if it is? What I hear from many is to look at Canada, they are with socialized health care, everyone can just walk into a hospital, it cost them nothing, and they are taken care of, but is it really this way, is it free? If it is, then how do doctors get paid, and how does their pay compare to the doctors in the US.
First, why universal health care? The push for this came in earnest when Clinton was in office, his wife, the first lady, Hillary made a push to bring about universal health care, at the time it was too early, or the insurance lobby was too strong, or it was not what was needed at the time, but it failed.
We move to the presidency of Obama, in his first two years he and Congress, they had a super-majority at the time, they worked together to bring about what today is known as Obamacare, or by its official title, the Affordable Healthcare Act. The public was not for it, in fact overwhelmingly so against it, by pushing it through despite public outcry against, the Democrats soon found themselves on the losing end of elections, something that is able to be seen from that time on as with seat by seat the Democrats lost until they lost the majority in both houses culminating in the White House being also lost this last year in elections. In addition, the outcry was strong enough it affects the political demographics of state houses, the GOP today has most Governor seats (34 to 15 {there is one independent seat}), seats in state legislative bodies, today they have since Obama took office have lost over 1,000 state legislative seats.
But one must ask, how were doctors and patients affected by this, after all, they are the ones this was passed to deal with. I think the best place to start is how the doctors are relating to this, a great article came out in 2013, and it has only gotten worse, where they interviewed a Gen. Surgeon Dr. Jeffrey A. Singer and an interview he gave with Reason. He goes into how he has been a surgeon for 3 decades, in that time he goes into the changes and how they have affected the profession. He goes into the coding issues put out by Medicare, this then, in turn, caused the doctors who were not getting paid for their services due to be forced to enter into International Statistical Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes, the government to control prices put in place a program named the Resource-Based Relative Value System (RBRVS), this then forced doctors to place patent’s as Dr. Singer writes “What it actually did was force doctors to wedge their patients and their services into predetermined, ill-fitting categories”, in turn because of price controls with (RBRVS), a doctor out of residency and a creator of a medical procedure that had been working in the field for years would be paid the same, this then forced the doctors and their office to make up for shortcomings in pay to start to over-diagnose and run more tests on patients, many who tired of this just got out of treating Medicare patients altogether [1].

Rather than correct these problems, with the growth of Medicare and prescription coverage under the Bush Administration, you then saw this pass on to the pharmacies, they, in turn, had to then start charging highly inflated prices to make up for R&D with patients that were paying cash or had private insurance, this caused consumer backlash, but the consumer nor government did anything to rectify this, instead we then saw the Obama administration put in place the Affordable Health Care Act, or as it is commonly referred to, Obamacare.

Here social medicine took the forefront of medical treatment, by putting in place strict regulations, the Affordable was soon taken out of the contract, patents were expected to pay for coverage of medical procedures they would not use for many years, women over the age of having children were still required to have that added to their insurance cost, even then the whole thing was set up to not be able to sustain itself unless they had a large amount of youth signed into this, their lack of medical needs would save money and make up for the elderly and disabled who had great needs. Because Insurance Companies priced their coverage to include these youth, the failure of them signing up caused the Insurance to drastically increase their coverage cost, thus passing this on to the consumer, in the end the Government was stuck with the tab for the low-income earners who could not afford insurance, the ones that could saw greatly increased cost, sometimes as much as 40% in a single year [2].

Because of a lack of profit, then the next step has happened, the pull out of insurers, if they could not realize a profit, they backed out of the health exchanges set up, in 2018 we will see 48 counties with no health care provider, another 1,300 will have lost all but one insurer, thus enabling them to raise the prices with no competition to offer better prices, some of these insurers are not expected to stay in the program past 2020, thus possibly seeing in the future more counties with no carrier then one with just one [3]

What is more, the cost of increases could soon force many families to drop out due to affordability issues. In the Centers for Medicaid and Medicare services, they are projecting an average increase of medical premiums of $1,130 per family for 2018 [4], in the same organization they forward projected and predict there will be almost a $10,000 increase in family insurance coverage by 64-year old’s [4]. Alaska was predicted to see the greatest increase, an average 64-year-old making over $26,500 a year will see premiums of $49,070, the least of the states were Massachusetts, a 64-year-old there with an income of $26,500 would have to pay out for insurance $10,640, in other words over 40% of their income would be used up by insurance, such a rate is not sustainable, it would force senior citizens to make a choice of lodging and food or medical care, and this is not to mention how pay cuts are forcing many doctors to stop seeing patients from the government insured, they simply can’t afford to keep businesses running, let alone cover the cost of their insurance and pay Doctor wages, this will only rise in the same time period as the government tries frantically to control costs [5].

So where does this take us? I think the plan all along was to price out health insurance so insurers could not afford to stay in the program, an average Senior Citizen would not be able to afford medical coverage, the outrage and outcry would force the government to act to put in place a single-payer health care system, just after Canada’s and Europeans have. We have heard from the left how wonderful that is but is it, let’s look at that.

Single Payer Health Care

A euphemism for “government-run,” “single-payer” means that instead of every person in the marketplace paying for his or her own healthcare, there’s just one payer. A monopsony. In some parts of the world, such a system has been entrenched for so long that it’s difficult to conceive of any other way. In others, in particular, the United States, there’s still plenty of debate on the issue. It’s easy to talk about a fundamental “right to healthcare,” but the issue gets complicated when one realizes that entitling a person to certain time and resources means putting an obligation on someone else to provide the same.

The push in the US for single-payer health care is nothing new after Truman took office, one of the first things he did was go before Congress and ask for this system to be set up. Medicaid and Medicare were established in the 1960’s to take care of the disabled and elderly, was expanded under Bush to include medicines. When President Clinton was in office you had a push by his wife, Hillary to try to set up the Health Security Act (was referred to as Hillarycare), it was the outright rejection of this idea by the American public and the GOP along with many within the democratic party made her and others see that another tact was going to be needed to institute this, then along came Obama. After seeing that the  Health Security Act failed because it demanded a 100% enrollment, no one was allowed to withdraw once in, the Obama Administration knew another tact would be needed, so they started with “If you like your Doctor, you can keep them!” Also had the same thing said about health care plans, promised that it was not a tax, Pelosi famously stated that we should support and pass the bill, it would be a “Surprise!” Needless to say, this was rejected, the voters made the Democrats pay at the polls.
But what was the real intent? I think Senator Sanders has been the most open about this, he has time after time pushed for a single payer system, openly admits to it. By what you see with the deferral of hikes in coverage, the outright deception by the Obama administration in putting into place Obamacare, not to mention the terrible problems first with accessing the portal due to ineptness in setting up a web site, then promising people they could keep their coverage and doctors, that turned out to be false, that it was not a tax, we found out in the argument before the Supreme Court we were lied to about that as well, with escalating premiums the administration knew the program was not viable in the long term but had figured out by the time the public knew about it, and they felt Hillary was a shoe in to take the office of President, they could fix this up when she was in office, could say due to rising cost the only fix was to put in place a Canadian or European style one payer system, Trump won, needless to say, things did not work out the way they expected.

But is putting in a Canadian or European model of universal health care a way to fix this? How about we look at the Canadian system, see how it is doing.

Canada’s Health Care System

The Canada Health Act (CHA), introduced in 1984, governs the complicated fiscal agreement between the provinces, who administer health services, and the feds, who manage their health-insurance monopoly and transfer funds to the local governments. Unlike in the United Kingdom, where health care is socialized and hospitals are run by the National Health Service, in Canada health care is technically delivered privately, although, given the Kafkaesque regulations and restrictions that govern it, the system is by no means market-based. In fact, Canada’s government-controlled health-care system has become more restrictive than communist China’s.

Debates about health-care policy typically revolve around three key metrics: universality, affordability, and quality.

Canada passes the first test with flying colors: Every resident of the country is insured under the CHA, with covered procedures free at the point of delivery. While medical providers are independent of the federal government, they are compelled to accept CHA insurance —and nothing else — by a prohibition on accepting payments outside the national-insurance scheme so long as they wish to continue accepting federal health-transfer funds. The spigot of money from Ottawa thus ensures a de facto government monopoly in the health-insurance market.

When it comes to affordability, the Canadian system also passes, if just barely. Canadians pay for health insurance through their taxes; most never see a medical bill. But that doesn’t mean the system is affordable. Au contraire, it relies almost entirely on current taxpayers to subsidize the disproportionately large health-care needs of elderly Canadians in their final few years of life. Rather than pre-funding the system to deal with the coming tsunami of aging Baby Boomers, Canada’s provincial governments pay and borrow as they go — and rank among the most indebted sub-sovereign borrowers in the world. According to Don Drummond, an economist appointed by Ontario’s Liberal government to help fix its finances, Canada’s largest province is projected to see health-care costs soar to the point where they will consume 80 percent of the entire provincial budget by 2030, up from 46 percent in 2010 [6].

We next have to look at accessibility, if it is accessible to all, and no one thinks they are paying for it, even though they are through taxes and borrowing to make up shortfalls, is it accessible? This is Canada fails miserably, in fact, every place that has single payer health care does, when a people feel that a service is free, they will use as much as possible, they don’t think they are paying for it. This has caused a backlog of services, if you look at the wait time for services In polling, while the Canadians love the idea of free healthcare, or at least what they perceive as free, they are equally unhappy with the wait times for that care, in polling they rank dead last in developed nations for waiting for services [7]. In 2014 only 43 percent of Canadians are able to snag same- or next-day appointments at their regular place of care, such as their doctor’s office. About 20 percent of Canadians end up waiting about seven days. Ninety-three percent of us have a doctor we go to when we’re feeling sick, though [8], as time has progressed it has only gotten worse, in 2016, last year the average wait period was 20 weeks. What this then caused was many to go to emergency rooms due to the length of waiting, thus clogging up emergency services. What was worse, the rates went much higher depending on where the people were. The list here shows the waiting time to go see a general practitioner.

British Columbia: 25.2
Alberta: 22.9
Saskatchewan: 16.6
Manitoba: 20.6
Ontario: 15.6
Quebec: 18.9
New Brunswick: 38.8
Nova Scotia: 34.8
P.E.I.: 31.4
Newfoundland and Labrador: 26.0 [9]


So How Do We Fix This?

To claim that such a system is something that we would love in the US, which is what politicians like Sanders love to claim, shows the lack of understanding what most Americans are willing to accept. Is there a way to fix this? Yes, but anyway we deal with it is not going to be cheap. We would be better off either repealing Obamacare outright, or strip it down, take the parts that don’t work, we will have to then subsidize what will be left, and we still will have in place a plan that will be full of cost overruns, no incentives for youthful insurers to join, thus you would not have their offset against the elderly who use up most of the health care service money, all we would be doing is not fixing it, we would be prolonging its demise, and would be doing so at the expense of the taxpayers and our future generation’s debt obligation.

The other way to fix this is to expand Medicare to aid in helping the poor be covered, this is not going to be cheap, but we as a nation need to figure if we are going to aid in what they can’t afford or watch them pass away by the wayside due to a lack of status. We would also have to set up a high-risk fund, this will be the most expensive, like it or not, half of the population spends little or nothing on health care, while 5 percent of the population spends almost half of the total amount. Examining the distribution of health care expenses among the U.S. population [10], in that sense some of Europe does have this right, rather than spend on care, they spend more on preventative care, this saves them money in the long run, they reduce the amount at the other end due to a healthier population. We need to figure out a way to help prevent the 5% from failing in health so badly, maybe more creative ways could be used to help fund their health care expenses, if you could separate this 5% from the rest, you could see a great reduction in health care cost.

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The other problem and I know I am going to offend a lot of people from both sides of the aisle, is the cost of malpractice insurance. While I agree that doctors who through negligence destroyed a way of life, or in some cases the life itself, the practice of suing for petting things needs to have a cap on it. A new study reveals that the cost of medical malpractice in the United States is running at about $55.6 billion a year – $45.6 billion of which is spent on defensive medicine practiced by physicians seeking to stay clear of lawsuits [11]. We need some type of tort reform, if we are going to tackle the cost of health care, then we need to look at the cost of legal expenses, you control one, not reduce but control it, you would greatly see a reduction on the billing side, not to mention reducing the time the doctors have to spend on paperwork due the need to cover themselves legally.

Last, competition is a great driving force to reduce prices. If you have one part of the nation that health care costs are much lower, to allow insurance companies to cross state lines, they could then add in the lower cost in areas with the higher medical cost areas, thus enabling them to offer a better solution at a better rate. And not only that but cutting off cross-border competition, you cut off quantity of providers, by narrowing the pool of providers you give rise to collusion with the providers to keep the prices higher than they would normally be.

Is there a perfect plan? Nope, just a series of steps that we could take to improve the quality and cost of care that is provided. As with all things you have to stay within a set of parameters that see to it that doctors are rewarded for their work, insurers are able to handle ensuring without unacceptable risk, and we the consumer are better served because of it.





About The Author

Timothy Benton

Student of history, a journalist for the last 2 years. Specialize in Middle East History, more specifically modern history with the Israeli Palestinian conflict. Also, a political commentator has been a lifetime fan of politics.

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