Now at Reason.tv: Is Single-Payer Healthcare the Trabant of Medicine?

Nick Gillespie | November 7, 2007

Over at reason.tv's rough cut blog, I've posted an interesting take on single-payer health care from Stuart Browning. From his materials:

The Lemon demonstrates how single-payer health care systems have a lot in common with the failed economic systems of Soviet-era eastern Europe.

Written, Directed, Produced, Edited and Narrated By:
Stuart Browning

About the Video: 

The Lemon is part of the Free Market Cure Video Series created by filmmaker Stuart Browning to inform Americans about the dangers of collectivized medicine and the benefits of free markets in health care.

The filmmaker has received no funding from the health insurance industry or the health care industry.

More info here.

Info on the East-German Trabant, a.k.a. "the car that gave communism a bad name."

Click below to go to the vid at reason.tv:

Comments

|11.7.07 @ 12:00PM|#

We may not tolerant the Tribuant (sp?) but I find it amazing we continue to suffer Big Shitbox (aka General Motors).

|11.7.07 @ 12:05PM|#

You know that's a commie car when it looks like it's out of a Bond movie...

Jay D|11.7.07 @ 12:11PM|#

"Single-payer health care" is a misnomer. When I think "single-payer", I think, cool. That's something I can get behind.

I think of a person who goes in for health care and a "single-payer" pays the bill. Probably the person himself or the person's parent or guardian.

"Single-payer health care" actually means something closer to "millions-payer health care". A person goes in for health care and millions of people pitch in for the bill.

|11.7.07 @ 12:16PM|#

Put her in "H"!

Wikinger Elch|11.7.07 @ 12:27PM|#

Go Trabi go! :)

Alice Bowie|11.7.07 @ 12:55PM|#

1 If we simply Mind our own business and didn't have 2 pay for the War in Iraq, Afghan, africa, etc., etc., etc. ... That is, change our foreign policy ... we would have TONs of Money for Healthcare.

2 A single-payer provider would also work if EVERYTHING was covered by that single-payer (The Government). If the government plans to do the same thing that Met-Life, State Farm, and Aetna is doing...paperwork, paperwork, paperwork, paperwork, paperwork, paperwork, paperwork, paperwork to determine eligibility...then DON't BOTHER.

Alice Bowie|11.7.07 @ 1:00PM|#

The reason healthcare cost so much is because when ONE AMERICAN CITIZEN (or eligible National) goes to the Dr...there are about 50 people involved:

1. The Dr.
2. The Nurse
3. The Secretary
4. The Billing Clerk
5. The Insurance specialist in Dr.s Office
6. The Insurance Claims department
7. The Adjudicator
8. The people involved in the eligibility process
9. The adjusters
10. The people that deny
11. The customer service people managing all of this
12. The people in the insurance companies that make get reports from people, so that they can make a report, to give to other people, so they can make a report.

If the Dr charged $200 per visit...and the Payer (private, public, single payer, or whatever) Just paid it...it wouldn't cost so much.

|11.7.07 @ 1:07PM|#

A single-payer provider would also work if EVERYTHING was covered by that single-payer (The Government)

Wrong!

When the government, by law, is obligated to pay for whatever procedure, the provider can charge whatever they want.

There is no downward pressure on cost and would cause the Universal Healthcare price tag to skyrocket.

If this is taken into account in the legislation, providers will be driven out of business when real costs for production increase and the Gov't doesn't follow suit.

Either way, the bloated bureaucracy is the least of the worries...

|11.7.07 @ 1:16PM|#

Costs don't change because the government is paying for it. A single payer plan that paid for everything would cost as much as the price of everything.

Health care costs are so high in America because we consume the most health care

derrrrrrrrrr

|11.7.07 @ 2:00PM|#

Aaaah the Trabi. What other car could you install a sunroof in by with the application of a box cutter and some plexiglass.

|11.7.07 @ 2:05PM|#

TakTix, obviously you don't know the Canadian healthcare system. Here, the provincial governments negotiate a fee schedule with physicians so they don't "charge whatever they want". The same goes for hospital fees and prescription drug prices. That's one of the reasons why Canadians enjoy longer life expectancy at a lower cost than Americans with no medical bankrupts.

The video is full of misinformation. We don't have a total government monopoly on health care, and neither do the Europeans. In Canada about 30% of health care spending is private, such as employer provided extended health benefits. It refers to rationing, but what do you call it when a private insurrer denies a claim forcing a policy holder to go without care? My wife is American, been treated under both systems, and prefers the Canadian model. At least hospitals here don't dump the uninsured in the streets like they do there.

Alice Bowie|11.7.07 @ 2:12PM|#

I agree Bill Pope. In the US, the Canadian Healthcare system is demonized ... and many things that are simply not true are stated.

The Government can use the SAME 'Usual and customary care' model used by private insurers today. The BEST insurers in the USA do the same as done in Canada...they negotiate with providers the 'Usual and customary care' fee before they can join a PLAN.

I b-lieve all of this can be done without TONs of Paperwork. A simple SSN and a Service Code and a Date of Service SHOULD B enough.

Alice Bowie|11.7.07 @ 2:16PM|#

Either way, the bloated bureaucracy is the least of the worries...

This is the MOST of our worries

People are denied healthcare b-cause of bureaucracy.

An insurance company can play games with u (while u r dying of Cancer) until u die.

The COST of the bureacracy ALONE is the BIGGEST cost in healcare

Alice Bowie|11.7.07 @ 2:20PM|#

I have an insurance Policy that convers me 100% for In-Plan and 80% out-of-Plan.

So,

The 1st Page of the policy states that I'm covered 100% in-plan.

The following 25 pages discuss all of the things that r not covered.

They r full-of-shit...and r completely PROFIT DRIVEN.

|11.7.07 @ 2:29PM|#

Further to this, it's about time intellectually honest libertarians recognize that healthcare represents a market failure because insuarance companies make money collecting premiums from health people rather than caring for the sick, and no one is in competition to cover the chronically ill.

|11.7.07 @ 2:56PM|#

..."it's about time intellectually honest libertarians recognize that healthcare represents a market failure because insuarance companies make money collecting premiums from health people rather than caring for the sick, and no one is in competition to cover the chronically ill."

There's the rub, insurance, by it's nature is profit driven, so insuring driving or a business is easy, it's all based on risks of behavior.

Health insurance companies needs healthy people to pay into a system which is based on healthy people betting that they are going to have a health problem and the insurance company is betting that they are not. The small amount of those who are a profit loss, the chronically ill or unfortunately injured are factored into the equation and paid for by the policy holders.

It will be interesting to see how the health insurance process evolves over the next decade or so. I do not see the current system working very well for anyone except the insurance companies and health care professionals.

Charles Hueter|11.7.07 @ 3:10PM|#

They r full-of-shit

Did you or did you not sign and agree to the terms? If so, then you've weighed your options and made your choice, haven't you?

...and r completely PROFIT DRIVEN.

So? Making a profit isn't immoral, provided it was done without fraud or force.

|11.7.07 @ 3:19PM|#

Especially when you factor in the merry-go-round with the insurance companies trying to get them to cover something that they suddenly have decided to not cover.

It's not "the small amount of those who are a profit loss, the chronically ill or unfortunately injured are factored into the equation and paid for by the policy holders." It's "the small amount of those who WOULD be a profit loss, chronically ill, or unfortunately injured we find reasons to deny paying out for them at all."

I still can't see why we can't go to a simple system: government provided, very basic health insurance, covers standard stuff. You present your card, you're covered. May not have all the latest bells and whistles, plus gov't gets to nag you about check-ups to try to catch stuff early. Anything else (latest bells and whistles, extreme treatments) is covered by private insurance.

I had a variant on this where anyone who wanted to could opt out of the gov't health insurance and get a reimbursement on his taxes. He could go back on at any point, but only after having had a full-body check-up and proving that his health was at least as good as the average person of his age on gov't health insurance.

Charles Hueter|11.7.07 @ 3:30PM|#

Further to this, it's about time intellectually honest libertarians recognize that healthcare represents a market failure

An intellectually honest libertarian would first tell you that what currently exists in the United States has little in common with an actual free market in insurance, health care, and medicine.

I think doctors, hospitals, specialists, nurses, technicians, and so on ought to be able to charge whatever they want for whatever procedures they wish to offer.

...because insuarance companies make money collecting premiums from health people rather than caring for the sick, and no one is in competition to cover the chronically ill.

He or she might then point out that the prime responsibility for any particular individual's health care decisions lies with that particular invididual or their guardian. This could mean anything from studiously putting away some income into a personal savings account to be used in the event of a medical emergency, to joining a risk-sharing pool (e.g., buying insurance), to seeking the help of friends and family, to seeking a job with health care benefits, and etc.

Just as with the producer side of health care, patients and customers ought to be free to shop around and pay the price they think represents the best value. One of the most important points John Stossel brought up in his recent special on American health care is that too many people simply don't engage in price-comparisons. They have insurance and a fixed deductible, so they are significantly detached from the important informational signals inherent within prices. This is a valid and important criticism of health care insurance in general as it is usually practiced.

This isn't a market failure, because there's no real open market. It's a grossly inefficient, half-collectivized bureaucratic nightmare that satisfies some people some of the time.

|11.7.07 @ 3:58PM|#

I think the entire debate over healthcare suffers from terminology problems.

We don't really have health insurance in this country. Due to some perverse tax incentives, we have private health management. What we have is essentially the worst of both worlds: the a bloated bureaucracy rationing treatment combined with the private sector's drive to cut costs.

A real health insurance policy would read something like:

"The insurer agrees to pay all medical expenses beyond a fixed amount X incured over some period Y"

The cost of the policy would vary based on the age/health/habits of the person, the size of the fixed amount, the length of the period, and what sort of renewal options are available.

Under such a system I, for example, as a young person who is almost never ill enough to see a doctor, would want a high fixed amount of medical expenses that I am responsible for, since that would lower my premiums, and would probably pay a premium to have my policy renewable at my discretion over some term to hedge against the possibility of developing a chronic condition. Once I had my policy, it would be my responsibility to budget and save so that I could afford to pay up to that fixed amount should I become seriously ill. After that the insurer pays everything.

With private insurance like this, the cost of the bureaucracy is mitigated to some extent (insurance companies still need employees to make sure doctors aren't trying to pad the costs on the portion the insurance pays), and individuals, who are now seeing their medical bills at least for the first X dollars, have an incentive to hold down costs for routine medical treatment (check ups, etc ... ).

If the government wanted to get involved in health care, it would be easy under such a system to provide individual means tested subsidies in conjunction with a mandate that everyone purchase coverage. That would combine the cost reducing incentives of a proper market based system with a government assurance that everyone would have access to coverage.

Hell, slap on a government restriction that insurance companies can't get involved in the selection of doctors/specialists and you have a system that would be more equitable ( with respect to access to facilities and high quality doctors ) than the two tier system of gov care vs private care in the UK, Canada, et al.

Toss in tax free (or even negative tax) health savings accounts and you could get rid of our trade imbalance in the process (although the dollar's current freefall should fix that problem anyway). That would also mitigate, though certainly not obviate, the problem of how to deal with insurance for the elderly. Beyond some threshold, are guarenteed to have some chronic health issue, and beyond that threshold the insurance market is going to be non-existent. The remaining balance of one's health savings account would then be dedicated to purchasing health care in old age. After that we run into the basic fact that all people have to die. There is, of course, the age old difficulty that rich people can afford to put it off longer than poor people. Currently no system has managed to get around this, and nothing short of global public health care and a ban on private care will. I think the mostly private solution would, if in continuous effect over the whole of one's life, end up offering more care to all parties.

Of course, such a system would take some time to implement, and our government must meet its obligations with respect to the current mess of a healthcare market it has created with distorted incentives.

Just my off the cuff two cents.

Alice Bowie|11.7.07 @ 4:36PM|#

i like that Brian

Paul|11.7.07 @ 4:39PM|#

A person goes in for health care and millions of people pitch in for the bill.

Correction, Jay D, a few people end up paying for millions of bills. That's how it kind of ends up with that whacky healthcare system we call government.

Jay D|11.7.07 @ 5:49PM|#

I had to double-check. I heard it in the video. It is called the Ministry of Health in Canada.

Minihealth!

|11.7.07 @ 6:40PM|#

Why not government auto insurance? Imagine what would happen if people didn't have to pay to fix their own cars. "Free" oil changes but with a 9 month wait. "Free" tires with a 3 year wait. Seems about the same with health care to me.