What's Wrong with Single Payer?

Normally, I’m pretty conservative about most issues regarding government control and economics, but I’ve been interested in learning about single payer healthcare systems. The obvious negative I see is it would cripple the private insurance companies.

What do you guys think are the pros and cons of a single payer system?

What incentive under a single-payer system do you have to take individual responsibility for your health? An individual who eats right, doesn’t smoke or overindulge in alcohol, doesn’t do drugs, and exercises “pays” the same as someone who eats like crap and does other assorted things to destroy their health. Single payer treats individual irresponsibility no differently than a true victim of unforeseen catastrophe.

Who pays? In our current tax system, 36% of filers in 2008 didn’t pay income tax (going from memory) - so it wouldn’t be “single payer” until each person paid into the pool. But, we won’t have that - we will continue to have an entitlement-consuming class of citizens that has zero incentive to reduce consumption of health care (they don’t have to pay for it, someone else is, so why bother?). Basic laws of supply and demand will push the costs out of orbit, and at some point, the wealth being used to pay for the entitlement can’t sustain the rising costs forever. Getting something for nothing is impossible - there will always be consequences.

[quote]thunderbolt23 wrote:
What incentive under a single-payer system do you have to take individual responsibility for your health? An individual who eats right, doesn’t smoke or overindulge in alcohol, doesn’t do drugs, and exercises “pays” the same as someone who eats like crap and does other assorted things to destroy their health. Single payer treats individual irresponsibility no differently than a true victim of unforeseen catastrophe.

Who pays? In our current tax system, 36% of filers in 2008 didn’t pay income tax (going from memory) - so it wouldn’t be “single payer” until each person paid into the pool. But, we won’t have that - we will continue to have an entitlement-consuming class of citizens that has zero incentive to reduce consumption of health care (they don’t have to pay for it, someone else is, so why bother?). Basic laws of supply and demand will push the costs out of orbit, and at some point, the wealth being used to pay for the entitlement can’t sustain the rising costs forever. Getting something for nothing is impossible - there will always be consequences.

[/quote]

Well, couldn’t the typical standards for determining your payment (smoker, drinker, obese, etc) still be used under single payer?

And I can see what you’re saying about who pays, but don’t we do that already? If someone can’t afford there medical bills, ultimately aren’t those passed onto us (why hospitals charge such high rates)?

From an economic standpoint a single payer would be the worst system imaginable, just think of the abuse that the system would have.

Think of it this way, look at how many people abuse title 19. Now expand that to everyone.

[quote]thunderbolt23 wrote:
What incentive under a single-payer system do you have to take individual responsibility for your health? An individual who eats right, doesn’t smoke or overindulge in alcohol, doesn’t do drugs, and exercises “pays” the same as someone who eats like crap and does other assorted things to destroy their health. Single payer treats individual irresponsibility no differently than a true victim of unforeseen catastrophe.

Who pays? In our current tax system, 36% of filers in 2008 didn’t pay income tax (going from memory) - so it wouldn’t be “single payer” until each person paid into the pool. But, we won’t have that - we will continue to have an entitlement-consuming class of citizens that has zero incentive to reduce consumption of health care (they don’t have to pay for it, someone else is, so why bother?). Basic laws of supply and demand will push the costs out of orbit, and at some point, the wealth being used to pay for the entitlement can’t sustain the rising costs forever. Getting something for nothing is impossible - there will always be consequences.

[/quote]

I’d like to see companies that produce cigarettes, fast food, sodas, cars that do 200mph, motorcycles that do the same, booze and so forth get taxed up the fucking nose to pay for this healthcare reform.

[quote]BackInAction wrote:

Well, couldn’t the typical standards for determining your payment (smoker, drinker, obese, etc) still be used under single payer? [/quote]

Sure, in theory, but that isn’t what it is about. Single payer is designed to “level” and make access to health care “equal”. If someone has to pay more, they are officially “un-equal”.

Insurance companies already price this risk. If there was a “national” insurance company that included, as its risk pool, all American ciztiens, and each covered citizen got “priced” accoridng to their risk and paid into the pool accordingly, I’d have less of an issue.

But that isn’t the goal of single payer and would never occur.

Single payer does not simply simply cover those who can’t pay - it is an entitlement enjoyed by many people who can pay, but simply now will not under the entitlement. In essence, we’d be foisting the costs of health care of a huge swath of people completely competent to pay for their own health care onto the narrowing pool of wealth we are drawing all of our government expenditures from.

If we were simply paying for those that cannot pay for themselves, it would be essentially what we have now - Medicare/Medicaid or something similar - and there would no need for single payer.

[quote]John S. wrote:
From an economic standpoint a single payer would be the worst system imaginable, just think of the abuse that the system would have.

Think of it this way, look at how many people abuse title 19. Now expand that to everyone.[/quote]

It’s a shame people in this country don’t look down on people more who cheat these systems. I don’t know how to resolve these types of issues without more regulation (which will end up costing more).

[quote]DBCooper wrote:

[quote]thunderbolt23 wrote:
What incentive under a single-payer system do you have to take individual responsibility for your health? An individual who eats right, doesn’t smoke or overindulge in alcohol, doesn’t do drugs, and exercises “pays” the same as someone who eats like crap and does other assorted things to destroy their health. Single payer treats individual irresponsibility no differently than a true victim of unforeseen catastrophe.

Who pays? In our current tax system, 36% of filers in 2008 didn’t pay income tax (going from memory) - so it wouldn’t be “single payer” until each person paid into the pool. But, we won’t have that - we will continue to have an entitlement-consuming class of citizens that has zero incentive to reduce consumption of health care (they don’t have to pay for it, someone else is, so why bother?). Basic laws of supply and demand will push the costs out of orbit, and at some point, the wealth being used to pay for the entitlement can’t sustain the rising costs forever. Getting something for nothing is impossible - there will always be consequences.

[/quote]

I’d like to see companies that produce cigarettes, fast food, sodas, cars that do 200mph, motorcycles that do the same, booze and so forth get taxed up the fucking nose to pay for this healthcare reform.[/quote]

That doesn’t seem very fair.

[quote]thunderbolt23 wrote:

[quote]BackInAction wrote:

Well, couldn’t the typical standards for determining your payment (smoker, drinker, obese, etc) still be used under single payer? [/quote]

Sure, in theory, but that isn’t what it is about. Single payer is designed to “level” and make access to health care “equal”. If someone has to pay more, they are officially “un-equal”.

Insurance companies already price this risk. If there was a “national” insurance company that included, as its risk pool, all American ciztiens, and each covered citizen got “priced” accoridng to their risk and paid into the pool accordingly, I’d have less of an issue.

But that isn’t the goal of single payer and would never occur.

Single payer does not simply simply cover those who can’t pay - it is an entitlement enjoyed by many people who can pay, but simply now will not under the entitlement. In essence, we’d be foisting the costs of health care of a huge swath of people completely competent to pay for their own health care onto the narrowing pool of wealth we are drawing all of our government expenditures from.

If we were simply paying for those that cannot pay for themselves, it would be essentially what we have now - Medicare/Medicaid or something similar - and there would no need for single payer.[/quote]

Understood. Thanks for clarification.

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What I don’t understand is how single payer systems exist all throughout Europe and Asia without most of the issues were talking about? These people are also some of the healthiest in the world.

Why wouldn’t it work here?

[quote]BackInAction wrote:

It’s a shame people in this country don’t look down on people more who cheat these systems. I don’t know how to resolve these types of issues without more regulation (which will end up costing more).[/quote]

What we need is the free market solution. You see if we go back to real inurance which protects against catastrophic events then people would be forced to pay out of pocket for regular check ups. That will cause people to go to the doctor less causing the doctor to lower his rates to get more people to come.

This will then drive innovation, since people will have to spend most out of pocket they will look for the best cures.

This is how the free market has always functioned, look at HDTV’s. Look at how much the price has dropped, we can have the same thing in health care.

[quote]BackInAction wrote:
What I don’t understand is how single payer systems exist all throughout Europe and Asia without most of the issues were talking about? These people are also some of the healthiest in the world.

Why wouldn’t it work here?[/quote]

People are not a bunch of fat asses around the world, it has a lot to do with our lifestyle. Look at the rest of the world, they are all about to go bankrupt, and a major cause of this is the health care system. They can’t ration to much more or shit will hit the fan.

[quote]John S. wrote:

[quote]BackInAction wrote:
What I don’t understand is how single payer systems exist all throughout Europe and Asia without most of the issues were talking about? These people are also some of the healthiest in the world.

Why wouldn’t it work here?[/quote]

People are not a bunch of fat asses around the world, it has a lot to do with our lifestyle. Look at the rest of the world, they are all about to go bankrupt, and a major cause of this is the health care system. They can’t ration to much more or shit will hit the fan.[/quote]

Definitely agree.

I think for profit health care is flawed because there is no incentive to cure anything and further more there is an incentive to create illness when none exists

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ask someone from Romania how socialism is working out for them.

[quote]John S. wrote:

[quote]BackInAction wrote:
What I don’t understand is how single payer systems exist all throughout Europe and Asia without most of the issues were talking about? These people are also some of the healthiest in the world.

Why wouldn’t it work here?[/quote]

People are not a bunch of fat asses around the world, it has a lot to do with our lifestyle. Look at the rest of the world, they are all about to go bankrupt, and a major cause of this is the health care system. They can’t ration to much more or shit will hit the fan.[/quote]

You have it as cause and effect that the health care systems of the world have bankrupted them, then why are we bankrupt?

[quote]BackInAction wrote:

What I don’t understand is how single payer systems exist all throughout Europe and Asia without most of the issues were talking about? These people are also some of the healthiest in the world.

Why wouldn’t it work here?[/quote]

Differences in culture, for one. You are comparing apples to oranges. We have fantastic access to the best health care services in the world in the US (broadly speaking), and look around at obesity, etc. Despite that access, and despite the fact that if people were generally healthier they would save money, look around you at how individuals are treating their individual health.

We aren’t an unhealthy nation because we lack access to care - we are an unhealthy nation because we don’t take care of ourselves in the vast space before ever using the health care system, and then we overconsume health care resources once we decide we have a health problem. The most obvious example of overconsumption of health care resources: gastric bypass surgeries and the like for obesity.

My experience in Eurpoean cultures is that many of them are more active - for one, their cities are small and tight, lending them to walking and bicycling. But there is also more of a cultural approbation of gluttony.

Doesn’t mean that I think their health care system is great - it just means they think of health differently as an initial matter, and reap the benefits of that philosophy before they ever avail themselves of the health care system.

[quote]pittbulll wrote:

[quote]John S. wrote:

[quote]BackInAction wrote:
What I don’t understand is how single payer systems exist all throughout Europe and Asia without most of the issues were talking about? These people are also some of the healthiest in the world.

Why wouldn’t it work here?[/quote]

People are not a bunch of fat asses around the world, it has a lot to do with our lifestyle. Look at the rest of the world, they are all about to go bankrupt, and a major cause of this is the health care system. They can’t ration to much more or shit will hit the fan.[/quote]

You have it as cause and effect that the health care systems of the world have bankrupted them, then why are we bankrupt?[/quote]

Prepetual war and social programs.