Health Care

Medicare for All Is Bad Medicine

A better prescription would be to get government entirely out of health care.

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Opponents of choice in medicine are at it again, promoting Medicare for All with the U.S. government as the single payer and private alternatives outlawed. The push comes as health care systems around the world try to catch their breath from the stress test inflicted by the pandemic—and by normal demand for expensive services. While American medicine has its share of problems, single-payer supporters would take all of the flaws in the system and make them universal and mandatory.

"Everybody in! Nobody out!" protesters chanted in Toledo, Ohio, this week in an attempt to pressure Rep. Marcy Kaptur (D-Ohio) to sign on to H.R.1976, the Medicare for All Act of 2021. They should have added "or else," since the bill, with 115 cosponsors at the moment, makes it "unlawful for … a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act" or for employers to offer alternative coverage.

Providers wouldn't be forced to participate; the proposed law lets Americans pay non-participating physicians out of pocket for services—subject to regulations. Why would Americans pay for services covered by a hypothetical Medicare for All? To answer that question, look north of the border, where Canada's single-payer system, commonly called Medicare, struggles to meet patients' needs.

"With COVID-19 fuelling a surge in hospitalizations, the latest data provided by the Ministry of Health shows that as of December 31, 2020, there were 29,650 people on a waiting list for surgery" in Saskatchewan, the Canadian Broadcasting Corporation (CBC) reported earlier this month. The CBC noted similar delays in other provinces.

"Specialist physicians surveyed report a median waiting time of 22.6 weeks between referral from a general practitioner and receipt of treatment," which is the longest wait recorded, according to the free-market Fraser Institute.

As of 2020 only 62 percent of Canadians told Commonwealth Fund pollsters that they "waited less than 4 months for non-emergency or elective surgery after they were advised they needed it," compared to 92 percent of Americans. Only 38 percent of Canadians were able to see a specialist (who might recommend such surgery) within four weeks, compared to 69 percent of Americans.

Such waits cost more than money—although they cost plenty of that. "[T]wice as many Ontarians with heart ailments passed away waiting for surgery during the pandemic than before COVID-19 hit," according to the National Post.

To relieve the backlog, Canadian provincial governments, which manage the single-payer system, are turning to private clinics. In Quebec, "without the private sector contracts, a region like Laval would have delayed 76 per cent of surgeries instead of 31 per cent," the CBC noted in February.

As the data suggests, though, the public sector in many places had trouble delivering as advertised long before anybody had heard of COVID-19. In Germany, where those making less than €64,350 per year must participate in the government health insurance system which is funded on a quarterly basis, the system runs out of money on a regular basis.  

"State health insurance patients are struggling to see their doctors towards the end of every quarter, while privately insured patients get easy access," Deutsche Welle reported in 2018. "The researchers traced the phenomenon to Germany's 'budget' system, which means that state health insurance companies only reimburse the full cost of certain treatments up to a particular number of patients or a particular monetary value … Once that budget has been exhausted for the quarter, doctors slow down — and sometimes even shut their practices altogether."

The "budget" acts as backdoor rationing, limiting costs by choking off access for publicly insured patients to all but emergency medical care once the magic number is hit. Single-payer advocates often criticize private medicine for being cost-conscious, but government systems put at least as much emphasis on the bottom line as any corporate accountant.

That's especially obvious in the United Kingdom, where the National Health Service has a cult-like status. During the pandemic, this took the form of a "Stay Home. Protect the NHS. Save Lives." campaign. "The NHS is under severe strain and we must take action to protect it, both so our doctors and nurses can continue to save lives and so they can vaccinate as many people as possible as quickly as we can," Prime Minister Boris Johnson scolded the public

The campaign worked. Even people with medical concerns stayed home, resulting in a drop in doctor visits and a 90 percent plunge in hospital admissions.

"We are sadly seeing the fallout of people not getting cardiovascular care during this pandemic – with thousands of excess deaths caused by these conditions," Dr. Sonya Babu-Narayan, the associate medical director at the British Heart Foundation, told The Telegraph in October 2020.

Even that wasn't enough. Britons staying at home were advised to refrain from home repairs and gardening that might result in injuries burdensome to the government-run health care system.

"It suggests our treatment of the NHS as a religion has reached such a dizzying level that the government thinks the best way to secure our obedience during this lockdown is by telling us we'll be helping to Save the NHS," objected Brendan O'Neill in The Spectator.

It's difficult to imagine Americans venerating government bureaucracy (although feelings about Social Security come disturbingly close). But it's impossible to pretend that Medicare for All could escape the concerns that plague all tax-paid medicine. "A doubling of all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan," the Mercatus Center's Charles Blahous pointed out about an earlier Medicare for All proposal.

That's not to say that American medicine couldn't be improved; it suffers from cost and access problems of its own. Much of the problem comes from previous government interference in what is no longer even close to being a free market. Under the Affordable Care Act, federal regulators deliberately pushed previously independent physicians and small clinics to consolidate out of a smug belief that the health care industry would operate better in the hands of fewer operators. 

Those remaining operators are heavily regulated, and at great expense. "Providers are dedicating approximately $39 billion per year to comply with the administrative aspects of regulatory compliance," warned a 2017 American Hospital Association report.

Health care in the United States requires reform, without doubt. But rather than emulate the heavy state involvement that evokes headaches elsewhere in the world, a better prescription would be to get government entirely out of medicine and encourage more competition and choice.

NEXT: A Town in New Jersey Tried To Seize This Property To Block a Housing Development, Which Has Still Not Been Built

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  1. Didn’t Reason lambaste the Republicans for attempting to roll back some of the Democrat’s roadmap to Medicare For All a couple of years back?

    1. It’s the Reason rope-a-dope. They talk libertarian when there is zero chance it will derail the plans of the Democrats.

      1. Conversely, when anyone attempts any sort of reform that might begin to untangle the Gordian knot of government and healthcare Reason finds some excuse for opposing it.

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    2. That was right around the time that Reason morphed into Emote!

  2. I changed insurance carriers recently, and my eye doc and gp both mentioned that they hate dealing with private insurance because the companies are so picky and require extra effort to convince that procedures are real and worth paying for, while Medicare is easy-peasy, a breeze, so delightful in comparison.

    And all I could think was, “I guess that explains the $100B a year of fraud that the government admits, which in reality is probably double.”

    I do confess I had never thought of Medicare from the doctor point of view. I don’t think either of these docs submits fraudulent bills, both seem honest as you could want. But it does point out how easily they could cheat, and I don’t doubt there are doctors who shade the truth, exaggerate, or outright lie.

    1. First off doctors and medical providers don’t have to really lie because Medicare does make things easy and people exploit this fact. Just look at the commercials that are directed to Medicare patients. Look near the end of the pitch where the advertisement notes that these products or services are free to you if you are on Medicare. In many cases the company themselves will take care of all the paper work. Now if you an older person you are going to be especially pleased that these nice people are helping you get the care you need, whether you need it or not.

      1. “”Look near the end of the pitch where the advertisement notes that these products or services are free to you if you are on Medicare””

        Which products? If you are on Medicare you really need to buy a supplemental insurance to cover the 20% of outpatient visit costs Medicare does not pay for.

    2. And that’s why they audit and find that fraud…that’s the whole point.

      You do realize the private insurance companies find fraud as well right? Each place has entire departments related to “compliance” on each end which searches for fraud and the providers also double back over their paperwork to make sure they are not committing fraud.

      Your worry about medicare being defrauded happens whether it’s public or private. People will try to cheat and game the system. Do you think there is no car insurance fraud for instance? And yet you and I both pay for that as we are also clients of the insurance company. Same thing.

      1. You are a fucking moron. These reports of $100B fraud are the paid and unpunished fraud that the GAO reports precisely because it is unpunished and paid without question.

        1. And further to your moronity, even a halfwit would understand that if the government were punishing $100B of fraud every year, the fraudsters would go elsewhere. The very fact that the government admits there is $100B of fraud is clear proof that the fraud continues, year after year, and if that is the case, even with the government prosecuting fraudsters, then there must be many times more $100B of fraud that the government doesn’t know about.

          Criminy you are stupid.

          1. The key thing is: a developed country has health care for ALL. Not just for those who can afford it, else it’s not a developed country. The US has a gaping hole in its essential infrastructure with the current hotch-potch system. The basis for any improvement, whatever shape that takes, is that everyone is covered – and I mean covered without fearing huge bills, without large co-pays and deductibles (that is insurance in name only). Any procedure costs many times more in the US than overseas, because of the inherent fraud in the current insurance-based system. For example, President Trump tried to force hospitals to publish their pricing as it was obvious that it was all manipulated depending on who is footing the bill – that’s a form of fraud. An operation costs what it costs, not how much that can be screwed out of someone. The hospitals refused, of course. The best way to fund healthcare is through public taxation. If the best way to run it is privately, perhaps there’s a clever blend of the two. I’m sure we have people smart enough to figure it out. The essential thing is that everyone is covered and no one gets financially punished for needing treatment.

            1. Any procedure costs many times more in the US than overseas, because of the inherent fraud in the current insurance-based system.

              If this were the case then the operational margins at play would be absurd, especially for the government payers that are comparatively easier to defraud. Somehow the opposite is true.

              it was all manipulated depending on who is footing the bill – that’s a form of fraud.

              Insurers negotiate rates in advance, and the hospitals demand more from commercial payers because the payers can afford it (especially since their client base demands the coverage), and because the hospitals need to offset the losses they take from government payers. This isn’t fraud; it’s a natural response to the incentives within the system.

              An operation costs what it costs

              Get 4 hospital execs in a room and you will get 4 different definitions on what constitutes an operation. It’s a bit more complicated than you think.

              not how much that can be screwed out of someone.

              “How much can be screwed out of someone” = “however much the consumer is willing to pay.” Getting the third parties out of the way would necessarily put downward pressure on prices, especially if coupled with repeals of the PPACA and the Stark Laws that limit how creative hospitals can be about commercial arrangements. And these are all commercial arrangements, regardless of how that might disgust you.

            2. Universal coverage is not a sign of development. If anything, it’s a signal of slavery and shortages.

              And huge medical bills are mostly due to government interference in the first place. Get government out of the healthcare industry entirely, and you’d see prices fall. (Nor should most healthcare require insurance).

              Insurance should be a hedge against a catastrophic event, not how you pay for routine care. And it should be private, because individuals have their own risk tolerances – government overlords don’t know better.

            3. I had a triple bypass for from over $75,000 to less than $25,000 when they realized they had to bill my Plan C insurance.

      2. Difference is incentives. Government has no incentive to root out fraud because it’s not going to go out of business. Whereas insurance companies can’t operate with even a fraction of the fraud that is considered normal in government, because they’d go bankrupt if they did.

        1. Exactly. And this is because insurance companies do not have a monopoly, and if one decides to experiment, to see if saving money on investigations and precautions outweighs the expected increased losses, the market will ruthlessly tell the tale.

          If you could legitimately call markets an invention, they rank right up there with money and prices, but in reality, they are as natural as gravity. All governments really do is distort them, much like building a dam distorts how gravity affects water drainage. Markets adjust, just as drainage adjusts.

          1. Spontaneous order is a creation of human action, not human design.

        2. I find the idea that government accepts fraud and the insurance companies don’t absurd. Insurance companies consider fraud part of the business and work into into their equations for cost. When an insurance company goes to court, they rarely ask if the plaintiff is correct, but rather what is the least expensive way to settle this case. If the insurance company is makin money they will keep going. If there is fraud they will track it down till they get to the point where it cheaper to ignore it.

          Part of the problem government has is that it is obligated to try to eliminate fraud. If it has a program that serves 99% of people honestly and has a 1% fraud rate, some Congress man is barking about the 1%. I think we should go after that 1% but not if it cost more than to let it lay.

          1. Part of the problem government has is that it is obligated to try to eliminate fraud.

            How do they measure it? No price signals. No profit. No loss. I don’t see how they can.

            1. It is not a question of profit but of cost. Say you have a $10M program that is helping 99% of people with 1% fraud. That means your losing about $100K to fraud and you look to see what can be done and minimize the fraud, but you don’t spend more than $100K on the effort. You acknowledge that you have a good program and unfortunately $100K is lost to fraud that is difficult to control.

  3. Just more bullshit about “choice.” The choice Americans had before the ACA, which is clearly flawed, was die or go broke, sometimes both. That’s no choice you dunce. Healthcare is not an elastic market genius- you WILL get sick and you WILL pay whatever to stay alive. How does the free market solve these issues?

    “To answer that question, look north of the border, where Canada’s single-payer system, commonly called Medicare, struggles to meet patients’ needs.”

    Pretty fucking rich to say that when we have the most medical bankruptcies in the world.

    But hey, keep licking the boots of your master- the Koch fucks – so they don’t have to pay more in taxes to have healthcare like any other first world country (doesn’t even have to be single payer- just has to be not shit like it currently is.)

    1. So set up a two tier medical establishment, as exists in a few countries. Use government money to set up ‘free’ medical care, limiting it to a set percentage of the federal budget to avoid creep. Allow free market for the rest.
      Many people will flock to the free government care, which will then be overloaded, making many leave it for something for which they must pay.
      There is no limit to what people will demand in health care so long as someone else pays.

      1. See Australia’s health care system, one of the top-rated systems on the planet, which operates about 50/50 private/public. Universal? Yes. Complex? Yes. A political “football? Sure, but then healthcare always is. Yes. Efficient? Yes,about 30% less expensive than our own (according to WHO).

    2. “Healthcare is not an elastic market genius- you WILL get sick and you WILL pay whatever to stay alive.”

      That’s completely untrue.

      1. Depends. You may put off a knee replacement but you have no choice if you show up with appendicitis. You could also just decide not to do anything about your glaucoma but the consequences are severe.

        Consumer preference hardly applies in medicine. To have that you need to know what are your options and have a number of alternatives to choose from at different prices. That requires knowledge you generally don’t have.

        You can choose between insurance plans which was what Obamacare was supposed to allow for but it is difficult to find out what is actually covered and providers you can use.

        In employer based insurance the employer makes those choices.

        Even in outpatient medicine people consider a “good” doctor to be someone who listens to their needs and concerns and prescribes treatments to relieve the symptoms. They don’t really think about what the doctor charges very much.

        Also doctors themselves generally don’t want to think about cost. They will try to use lower cost alternatives if something would be a financial hardship but most try to avoid the business end of things. They are not really interested in competing on price.

        Hospitals have to watch the bottom line but they are mostly competing with each other. Nobody is going to advertise the cheapest knee replacement in town.

        To make it more complicated there is no set reimbursement rate so costs for those paying little or nothing get passed on.

        So it ain’t a box of cornflakes.

        1. “Depends.”

          IOW, what Jeff said is indeed completely untrue.

        2. “To have that you need to know what are your options and have a number of alternatives to choose from at different prices. That requires knowledge you generally don’t have.”

          That’s simply not true in any meaningful way.

          You can’t say that, on the one hand, it’s totally ok for people to wait 27 weeks for treatment in a socialist medical system, and then say, on the other hand, no one has time to find out what their choices are.

        3. “They don’t really think about what the doctor charges very much.”

          When efficiently allocating resources, “not caring about price” is a bug, not a feature.

          “Also doctors themselves generally don’t want to think about cost.”

          Citation needed. I know doctors who own their own practice. And they have to care about costs or their business collapses. Who are these doctors who work for an annual salary of love in our cruel private healthcare system where that works out?

          “It ain’t a box of cornflakes”

          Believe it or not, we don’t need a socialized system for everything except cornflakes.

          1. Increasingly docs are opting to be part of a large group or employee because it is not worth the hassle.

            I am not advocating for any option in particular. It doesn’t seem that there is a consensus now anyway. I do keep an open mind about the proposals out there but anything is going to have downsides.

            1. “Increasingly docs are opting to be part of a large group or employee because it is not worth the hassle.”

              Is that because caring about prices has gotten even more complicated as we’ve socialized more and more medicine?

                1. Is that cultural or is that te result of an ever increasing, and continuously harsher burocracy

                  1. The latter has an effect, but I’d put most of it on the former, especially after watching the reaction to the pandemic.

                    The younger generations are extremely risk-averse. It doesn’t bode well for American society.

            2. They were compelled into joining larger groups by incentives in the ACA. Private practices were common before the ACA.

        4. Consumer preference hardly applies in medicine. To have that you need to know what are your options and have a number of alternatives to choose from at different prices. That requires knowledge you generally don’t have.

          In a competitive market area there is an obsessive focus on consumer preference, especially for outpatient services, and especially for those services which affect younger patients (read: women’s cancer).

          There are plenty of consumers that need to purchase expensive, specialized goods and services in other industries. In those there’s an ecosystem of intermediaries to guide the customer along instead of one being paid to simply provide liquidity.

        5. Echospinner….you’re a doctor, right?

          What would Echospinner do if he had a magic wand to fix healthcare?

    3. … you WILL get sick and you WILL pay whatever to stay alive.

      Just think how much you will spend if it’s not your money.

    4. Now do food.

      1. Clothing, shelter, transportation, etc…

    5. The choice Canadians have is . . . Wait and anyway.

    6. Keep licking Nancy “The requirement regulates activity that is commercial and economic in nature: economic and financial decisions about how and when health care is paid for, and when health insurance is purchased” Pelosi’s booty.

      If you think government ought to regulate your economic decisions, you just might be a damned fool, or a marxist.

    7. raspberry boy with their daily boot licking, just tax everyone more and it fixes everything

  4. I don’t think we are going to get to Medicare for All (M4A) unless SCOTUS invalidates the ACA. Then all bets are off. Nor do I think that we are going to private sector medicine soon.

    The problem is we really have is that no one wants to work together to solve the problems. Either your in one camp or other and their is no working together. Flaw in the ACA are a direct result of a failure of the Republican to provide any support at all for a model based on conservative design. It was more important to oppose President Obama, than to get conservative ideas into the ACA design.

    Right now M4A is in the better position to succeed. There is no model in the world for a private totally free market health care system. The best pro free market health care advocates can do is support the ACA and reform it to a better system.

    1. I find Switzerland’s approach to be compelling, but realize we’re not Switzerland. That country is wealthier (per capita income and accumulated wealth), much smaller, culturally cohesive, and their military budget relative to their GDP is smaller. Still – they have excellent health care – with an individual mandate for a “basic” plan. Low income citizens get help paying for the basic plan. Insurers don’t make profits selling the basic plan (by regulation) – they make profits selling the optional supplemental plans. Doctors are in private practice. Consumers have skin in the game. It’s highly regulated – but it seems more free market than our multi-tiered inefficient system.

      1. Even that is a relatively new phenomenon. Switzerland used to simply have fully private, free market healthcare, and it was working fine.

        1. if you could afford it…it was extremely expensive

      2. You beat me to it. = Swiss system

      3. Our military budget is like 50% of our medicard/caid budget (and also about the same of SS). People spend way to much time focusing on that red herring. And the military budget benefits alot more people that the healthcare budget. All of the employees of manufacturers, all military personell, contractors at military bases, europes dead beat governments like switzerland, etc.

        Too large of a portion of the healthcare budget is going to god knows who. Doctors may make a lot of money, but based on my experiences, they arent getting more than 10% of what the hospital is sending in the bill. For example, I get a bill for a regular GP appt saying the original total is $450. My doctor sees 10 people an hour, 7 hours a day, 5 days a week. Assuming he is fully booked (and he always is), that’s 8.2 million a year.

        We really need to address whats going on with prices to address getting healthcare for everybody.

        Also, the training program to become a doctor is retarded. 1, you dont have to be a GD genius to be a doctor, especially a GP. If you can take apart an engine or a transmission and put it back together, you are smart enough to refer to diagnostics manuals and memorize parts of the body and how they interact with people. Further on this point, APNPs and LPNs are already allowed to diagnose and prescribe medication without having to go through all of the shit doctors do. 2, what is the point in making med students work grueling hours for next to no pay once they prove that they can meet the educational requirements? 3, why does med school cost so fucking much?

  5. “A better prescription would be to get government entirely out of health care.”

    Yeah, short of burning the existing government to the ground and starting over from scratch, that’s not going to happen.

    1. No, that will not work either. There is very little desire in the electorate to get government out of medicine entirely. Unless that changes, the Government will never be entirely out of healthcare.

      1. Government can’t get out of healthcare in the US; any free market in healthcare has been destroyed, and it would take decades to rebuild it. Furthermore, most younger Americans simply don’t know how to even exist in a free market environment or take responsibility for their futures.

  6. Progressives obsess over universality of care to the exclusion of all other concerns, which is irrational. Their idea of public healthcare is a fantasy where nothing changes except you send your medical bills to the government.

    Once you tell all health providers that you will pay for all medicine anyone wants no matter how expensive it is, they want to start charging an infinite amount of money. And of course, the government doesn’t have an infinite amount of money (I’ll start believing in magic MMT when England stops having healthcare shortages. Until them, scarcity still exists). So the government has to engage in price controls and rationing, resulting in the shortages and surpluses that socialism always causes.

    People who think there are no choices in healthcare must have very simple experiences, undoubtedly the young and naive who think you just pay for whatever the doctor tells you. So, your knee hurts? Do you want an X-ray or an MRI? Do you want surgery, tearing your knee down and building it up again, with all the risks of complications and side effects, or just leave it as-is? If you want surgery, who’s your surgeon? The old man who’s performed thousands by hand, or the young guy with the robot who’s only done 50?

    People who think “medicine is medicine and you need it or you die” are living in an over-simplified world so their over-simplified policies actually work: a fantasy land. You should never put them im charge, because they never learn from their mistakes: Look at the NHS.

    1. But tough choices, and the adult realization that some things can’t be made perfect, deny the child fantasy of a perfect life, and the progressive fantasy that a big enough government can provide it.

      1. Several generations of Americans have grown up ignorant, with insane wealth, privilege, and safety, largely because the rest of the world was in shambles after WWII and the USD has been the reserve currency.

        Don’t worry, that’s coming to an end. Americans will get a good dose of reality as the dollar tumbles, European-style social unrest will grip the US, and the American standard of living plunges.

  7. Didn’t many health systems have patients stay home during covid because of…Covid? They were predicting hospitals full of Covid patients. Also, many clinics and hospitals in the US stopped seeing patients for a time due to the pandemic, not because of how the system was financially structured. And wait times in Canada may be longer because all people have access. You don’t wait so long in the US because poor people don’t bother getting in the line. Geez this is some bad journalism. Weak propaganda Reason.

    1. “And wait times in Canada may be longer because all people have access.”

      That’s totally untrue.

      About 95% of Americans have health insurance. So, of the 99% of people not in the 1%, about… 95% of them have health insurance. And some of those 5% don’t want insurance max pay out of pocket.

      The wait times in Canada aren’t due to the 5% of people having health insurance.

      This is why progressives can’t be in charge. They make up reasons to excuse their policy failures, so they never learn. You can’t have leadership forcing policies on all of society that ignores facts and can’t learn.

      I swear, if this country collapses, it won’t be from too much freedom. It will be from progressives intellectual enough to ignore facts and convince themselves or horrible policies, and then being unwilling to learn from the results as they drive over a cliff.

  8. Just as an aside, my brother-in-law used to work maintenance at a small hospital. A few years back, they installed a software system to track everything they did because Medicaid pays a portion of the overhead costs and they wanted to squeeze every penny they could out of Medicaid. He spent more time filling out the documentation than he did actually fixing shit.

    The final straw came for him one day when he had clocked out for the day and, on his way out the door, one of the ladies at the front desk stopped him and told him one of the toilets in the lobby ladies’ room was running constantly so he decided to take a quick look at it. Turns out it just needed a quick adjustment to the flush valve, took him literally just a minute to diagnose and fix the problem. The next morning he got called into the office and reamed out by the boss because the lady at the front desk had thoughtlessly mentioned to the boss how helpful my brother-in-law had been – and that’s NOT how things are done. The lady at the front desk should have filled out a Request For Service ticket, had it signed by her supervisor, submitted it to Maintenance where they would have produced a work order and assigned somebody to fix the problem and documented everything that was done. The problem was my brother-in-law had done a one-minute undocumented fix to a problem when it easily could have been turned into a one-hour documented fix. He was costing the hospital money by fixing shit.

    He put in his two-weeks notice that afternoon and the hospital was glad to be rid of him because they had frequent problems with him not filling out the paper work correctly.

    1. LOL. Thirty years ago I had the same experience working in a hospital. One of the hinges to a set of Dutch doors was loose, so the next day I brought in a screwdriver, and first thing proceeded to tighten them up.

      Just as a big wig walked by.

      Got called to a sit down with my own department head over it.

    2. The problem was my brother-in-law had done a one-minute undocumented fix to a problem when it easily could have been turned into a one-hour documented fix. He was costing the hospital money by fixing shit.

      You sure? Could be that he got in trouble because Medicaid would have reimbursed the hospital for the full hour of overhead cost, but couldn’t because they didn’t have the paperwork.

      1. Isn’t that what JerrysKids said? Medicare would have reimbursed for an hour overhead, but there was no overhead without all paperwork. You’d be filling out an hour of paperwork to get paid for an hour of paperwork. The cost of the actual fix wouldn’t factor into it

  9. I am a physician and I have a side job reviewing the billing of Medicare clinics looking for fraud.
    One day a month I go down to Miami and review five to 10 random Medicare bills from four different clinics.
    It takes me six hours to go from one clinic to another and sit and review the bills.
    I check for an intake form, signed by a licensed provider, with a diagnosis code.
    I check the progress note, signed by a licensed provider, that clearly states the treatment provided. I check that that treatment is consistent with the original diagnosis.
    I then review the actual Medicare form to see that they are only billing for that treatment and no others.
    I also check the signature logs, or during the pandemic, photographs of the zoom screen, (mental health counseling can be remote) to prove that the patient was indeed present and receiving the treatment.
    Of course there are probably 100 ways that the clinic could be cheating Medicare other than by simply sending false bills.
    But I can only look for false bills as I I have a full-time job in Fort Lauderdale and can’t be there in Miami during the day.

    I am doing my best to combat medical fraud. If there are any licensed physicians reading Reason who live in Orlando or South Florida, they are welcome to contact me as we need many more doctors to review these bills.
    Any specialty is OK as long as you have a Florida medical license.
    The clinics pay excellent money for one day of work per month, as this kind of review is required by the Medicare program.
    Contact me at Docduracoat@gmail.com

    1. You’d think they would employ someone slightly less expensive for the on-site/initial screenings. e.g. medical transcriptionists, or even nurses. They could then flag issues for review by a licensed physician working out of some centralized location.

      Eyeballs being the rate limiting step it probably would not reduce your workload. More likely it would enable the identification of more issues at a greater overall cost efficiency.

  10. Yeah, but what if like, hear me out on this, what if I want something but, guys listen, what if I want something and I don’t want to pay for it? Shouldn’t, like, someone buy it for me?

    1. /thread

  11. this is epically stupid for so many reasons.

    1/ your health, in part depends of the health of perfect strangers around you…you know…epidemics…
    2/ second, yes you are usually in good health, but when Cancer strikes…..well it’s like insurance…..what works is mutualizing the risk …..and that is “socialized medicine” ….either through private insurers or (better) the government

    The idea of being self responsible of one’s health is a pure fallacy.

    1. Private insurance is not socialism. Nor is it even ‘socialism.’ It is free association and right to contract.

      And, as to ‘you know… epidemics’ FUCK OFF collectivist slaver.

      1. “collectivist slaver” ..usually resorting to insults show the lack of arguments.

        And your description of insurers is ….cute.

        It’s like saying there is a meaning difference between Lockheed and the Pentagon…or that the SLS is a “private” enterprise versus government NASA,

        1. “Fuck off slaver” is the laconic method of noting that you think you have some claim to the interests and actions of other people. You do not.

          Adding in ‘collectivist’ is merely a way of making your the effect of your statements more clear.

          Not sure why you think it’s an ‘insult’ unless you are a self loathing sort of collectivist. Seeing as how you are fine with imposing these things using government force, ie. actual socialism, it really is what you are, so you might as well embrace it.

          I really am telling you to fuck off.

        2. And your description of insurers is ….cute.

          Well, that’s better than your description of insurance, which is economic nonsense. Since you don’t know what insurance is, it’s not surprising that you reach wildly incorrect conclusions about how it should be provided.

          1. Notice how he went from talking about “insurance” to trying to tie it to the specifics of certain “insurers.”

            Mendacious little fuck thinks he’s clever.

    2. Three are four ways to spend money.

      1) You can spend your own money on yourself. When you do that, why then you really watch what you’re doing, and you try to get the most for your money.

      2) You can spend your own money on somebody else. For example, I buy a birthday present for someone. Well, then I’m not so careful about the content of the present, but I’m very careful about the cost.

      3) I can spend somebody else’s money on myself. And if I spend somebody else’s money on myself, then I’m sure going to have a good lunch!

      4) I can spend somebody else’s money on somebody else. And if I spend somebody else’s money on somebody else, I’m not concerned about how much it is, and I’m not concerned about what I get.

      Tell me, which one of these describes government? Which is the least efficient means of spending money? I’ll give you a clue. It starts with an ‘f’ and ends with an ‘r’.

      1. actually, no.

        For example vaccination is more efficient when generalized.

        Plus private insurance is here to maximize its profit, not the health of its customers.

        Private health profits are just another type of waste

        1. Private health profits are just another type of waste

          Spoken like the economically ignorant socialist you evidently are.

        2. “vaccination is more efficient when generalized.”

          What do you mean by ‘efficient’? And for whom is it more ‘efficient’?

          1. that’s the point : for everyone

            1. Non responsive.

            2. Funny, isn’t it, that US vaccination rates are higher than those in Europe.

        3. Profit margins for insurance companies are around 3%.

          Depending on who you ask, Medicaid loses from 8% to 27% to “waste, fraud and abuse.”

          And that doesn’t take into account the sheer laziness of federal employees.

          1. you assume there is no waste, fraud or abuse in the private health industry.

            Ok sure.

            1. I assume they have an incentive to root it out, which government does not have.

    3. your health, in part depends of the health of perfect strangers around you…you know…epidemics…

      That has nothing to do with health insurance.

      second, yes you are usually in good health, but when Cancer strikes…..well it’s like insurance…..what works is mutualizing the risk …..and that is “socialized medicine” ….either through private insurers or (better) the government

      Insurance is neither “mutualizing the risk” nor “socializing the risk”. Insurance is simply a trade of a high unlikely loss for a low certain loss. People can, and do, insure others without risk pools or “mutualizing” anything.

      Insurance is a red herring anyway; the problems with the US healthcare system have nothing to do with insurance, they have to do with government regulations keeping prices for services, devices, and drugs at 10-100x the level they should be. In a free market for healthcare, you wouldn’t need insurance at all because decent healthcare just isn’t very expensive.

      1. lol, funny then how medicine prices are much lower in the heavily regulated European States (including for older standard drugs like insuline…in case you were about to whine about research costs)

        1. go take a long vacation in Cuba, and you will learn how your marxist dreams work out in real life

        2. lol, funny then how medicine prices are much lower in the heavily regulated European States (including for older standard drugs like insuline…in case you were about to whine about research costs)

          I don’t see what you think is “funny” about it. Europe heavily regulates the healthcare market to keep prices down, while America heavily regulates the healthcare market to keep prices high. The reason for that is that the primary proponents of regulation in the US, namely the Democrats, are also in bed with the medical lobby.

          Another reason for why prices in Europe are lower is because large parts of the healthcare market are actually less regulated than in the US. For example, many drugs that are expensive, prescription only, and reimbursable in the US are over the counter and non-reimbursed in Europe. For example, contraception is over the counter and out of pocket in Europe, while it is covered under Obamacare.

          The European model is indeed better than the American one. It’s unfortunate that Democrats are the primary obstacle into bringing that model to the US, instead telling US voters lies about what happens in other countries and how it is paid for. As you illustrate, large numbers of Americans are ignorant enough to believe those lies.

        3. Nominal currency prices aren’t the only price. Europe pays for their healthcare in shortages, rationing, and wait times.

    4. 1) If you wanna use COVID as a worthy excuse of communism in medicine I’d just like to remind you that it is a completely negligible risk to 90% of the population. It’s only a risk to the old, sick or frail who are already at high risk of dying soon from a thousand other natural causes that are simply more common.
      And also a reminder that those who lock themselves up in their houses like moles are not at risk from contracting COVID. That’s your own prerogative as long as you have a source of income that doesn’t require leaving the house or a nice chunk of savings.
      So because you fail to understand statistics or are a paranoid risk-averse coward you are entitled to steal other people’s property to pay for your healthcare? Yet you are unwilling to drastically change your life to make your personal odds of catching COVID negligible. Is that about the gist of it?
      2) That’s totally different because you had the choice to participate and purchase health insurance or take your chances. Of course this isn’t true either nowadays thanks to Obamacare individual mandates and communist bullshit of hospitals being forced to treat patients that can’t afford to pay.
      Typical leftist unwilling to assume any personal responsibility whether it’s financial or risk mitigation of their own health.

  12. Profits are the cost we pay for efficiency. There’s a shitload of profit in medicine here in the US, and compared to anyplace with socialized medicine it’s orders of magnitude more efficient.

    1. you do realize that life expectancy is lower in the US than in Europe (where various forms of socialized medicine exist).

      I don’t know what better measure of “efficiency” in health is there than…well ..health
      https://ourworldindata.org/life-expectancy

      1. Oh I’ve heard this stale argument before.

        Check out the differences in how infant mortality are calculated. Exclude gang-related murders from life expectancy. Socialized medicine doesn’t make much of a difference when you’ve got hot lead poisoning. Then there’s also lifestyle related conditions, like obesity, that reduce lifespans no matter how much medicine you throw at them.

        Apples and oranges.

        1. He sounds like a Suderman sock.

        2. you are beautifully undermining your own argument.

          In Europe, there is no first amendment….hence less “hot lead poisoning”

          and in Europe as well, lifestyle conditions (alcohol, tobacco use, obesity) are actively fought against especially by the State and health authorities.

          but hey, if you are happy to turn into a third world country where “dog eat dog” in the name of “liberty”,,,all the more power to you i guess !

          1. I’ll keep my 1A and my freedom to live an unhealthy lifestyle, fuck you very much.

            1. I think he’s trying to refer to the 2A. His ignorance is proving epic.

              1. Prince Harry was dissing on the 1A, calling it “bonkers.” So who knows?

              2. yes sorry, i meant indeed the 2nd, regarding the right to bear arms. Slip of the keyboard.

                the first is of course regarding freedom of expression

                1. What’s wrong with the 2A?

            2. no need to “fuck anyone”.
              Next time you visit Europe, wonder how free we are.

              For example , in my country, women are FREE to abort…how about yours?

              1. In my country men own as many guns as women do shoes…. how about yours?

                1. in my country people are free to have guns for sport and hunting.

                  We don’t need to own 10 guns, our cities are not overrun by zombies (though i guess yours aren’t either)

                  maybe you need all those guns to compensate for tiny cocks?

                  please enlighten me

                  1. Why? They’re fun. Making a soda can dance in the middle of a field is fun. Putting holes in innocent pieces of paper is fun. Hearing the clink of hitting a steel target is fun.

                    Some days I want to plink with my .22, while others I want to feel the blast of my .357 Magnum in my face.

                    That and they hold value. Not like cars.

                    Why do people own multiple cars, shoes, watches, or anything else?

                  2. “free to have guns for sport and hunting.”

                    LOL

                    …for…

                    Permission ain’t freedom. But you knew that. That’s why you are here isn’t it? You know deep down that you will never have even a taste of freedom, and you resent us for it.

                    1. “Political tags — such as royalist, communist, democrat, populist, fascist, liberal, conservative, and so forth — are never basic criteria. The human race divides politically into those who want people to be controlled and those who have no such desire. The former are idealists acting from highest motives for the greatest good of the greatest number. The latter are surly curmudgeons, suspicious and lacking in altruism. But they are more comfortable neighbors than the other sort.”

                      ― Robert A. Heinlein

                      There are people who are hostile to freedom because freedom is a lack of control, and a lack of control is anarchy.

                      Worldwide they are the majority.

                      Liberty is an aberration. These last few hundred years of freedom (and the resulting prosperity) are a blip in the history of man.

                      https://youtu.be/ixth_kYzF9c

                  3. Get thrown in a cage for using “naughty” words, yeah faggots like you are so “free”. Fuck off slaver and go lick boots elsewhere.

              2. LOL

                I’ve been to Europe plenty. You are not free in any meaningful sense of the word. Fascism, other than the genocide and wars of territorial aggression, won decades ago. Both the right and the left in Europe are committed statists. Maybe that’s why you cannot even see what you really are.

                BTW

                Women in the US are more “free” to murder their unborn children than most of Europe.

                1. ah yes “the killing of unborn child”.

                  funny how you hate abortion, but do nothing to reduce its occurence or to take care of the child once born.

                  Hypocritical assclowns

                  1. You demand I prove something yet have the gall to accuse me directly of something with which you cannot possibly have any direct knowledge.

                    And then you call me names?

                    Pissed you off a bit did I?

                    Maybe you really should have already fucked off already.

                    Slaver.

                  2. You argue like a smug sophomore who has just heard ridiculous ad hominem cliches for the first time and cant wait to regurgitate them

          2. In Europe, there is no first amendment

            Get up off of your damn knees.

          3. In Europe, there is no first amendment….hence less “hot lead poisoning”

            Average number of murders by years in the US: 15000. Number of deaths in WWII in Europe: 20 million, or about 200000/year when spread over a century. Europeans binge-kill, and in a bad way.

            and in Europe as well, lifestyle conditions (alcohol, tobacco use, obesity) are actively fought against especially by the State and health authorities.

            And yet, obesity rates have doubled in Europe over the past couple of decades and smoking rates are 50% higher than in the US.

            but hey, if you are happy to turn into a third world country where “dog eat dog” in the name of “liberty”,,,all the more power to you i guess !

            Europe is turning into a an impoverished, authoritarian continent. And, sadly, the US is following suit, by adopting the same idiotic progressive policies as Europe.

        3. and one can always massage numbers.

          But ultimately, Americans DO live shorter lives , in poorer health, than socialized Europe.

          1. We’re fat and lazy. How’s socialized medicine gonna fix that?

            1. By denying you care while excluding your morbidity and mortality from the stats.

              IOW the socialist way.

              1. you will have to prove that.

                And spare me the “do your own research bullshit”.

                You said it, own it.

                1. Prove it? Unpossible.

                  I get that English is maybe not your first language. Why don’t you look up the concept of “future tense.”

                  1. Here’s a clue: My reply was to a question using “gonna” which is American slang for “going to.”

            2. i don’t know..maybe by not treating the tomato sauce on the high school pizza as a vegetable?

              by educating your youth?

              by discouraging people from eating stuff filled with salt, sugar and grease?

              1. These are problems created by government.

                More government is not the solution to too much government.

                1. But without more government how are we going to be able to go on the internet and lord our “superiority” over people who choose to have less government in their lives?

                  How else are we supposed to compensate for our deep seated insecurities?

                  1. funny. its actually the american tourists the flaunt their “superiority” ……they are kind of ridiculous tbh

                    1. We do not ‘flaunt’ it so much as we exert it. Which, I know, is infinitely more annoying to everyone else.

                    2. I imagine that people who carry themselves in a “I don’t need to obey commands or ask permission as long as I’m not fucking with anyone else” manner may be perceived as exerting superiority.

                      Or maybe they’re citizens in a sea of subjects.

                    3. Ah, I see, you are a European with an inferiority complex and massive envy of America. That explains a lot.

                    4. Yep Sarc, it’s what I call the Frederick Douglass attitude.

                2. no, it isn’t. It’s crap pushed by the food industry that the government should regulate :

                  because the industry doesn’t give a fuck about externalities : in this case YOUR FUCKING HEALTH

                  1. ^ Thinks government gives a fuck about your health…

                    1. He was probably part of the Anti-Monsanto crowd back in the day.

                  2. It’s crap regulations created by a government captured by the food industry.

                    More government is not the answer.

                  3. Your health is not an “externality”. Your health is something you yourself are responsible for, by choosing products, services, and lifestyles that keep you healthy.

                  4. Who do you think chose to count tomato sauce as a vegetable, exactly? I mean, this is in relation to regulations regarding school lunches, and what counts as a vegetable for such a regulation is also a regulation… it’s government all the way down! If government didn’t do this, who possibly could?

                    More government won’t escape the flaws of current government. Insanity is doing the same thing and expecting different results…

              2. by discouraging people from eating stuff filled with salt, sugar and grease?

                How? By saying “don’t eat this stuff”, or through coercive taxation (i.e., denying individual rights)?

                1. part taxation, part regulation part information part education

                  1. So force & cost, force & cost, cost, and cost?

                    Who owns you?

                    1. Not sure who exactly. But you gotta admit that, whatever they paid, they sure are getting their money’s worth.

                    2. and who owns you? do you know how much the private health industry pays its lobbyists?

                    3. ^Thinks government apparachiks are preferable to lobbyists

                    4. I own me, and I’d prefer to keep it that way. And any money I pay to the private health industry is voluntary. That some of that money goes to lobbyists is irrelevant. They don’t have a gun pointed at me.

                    5. @Leonremi and who owns you? do you know how much the private health industry pays its lobbyists?

                      A lot. And that is precisely why I want a free market in healthcare, instead of what we currently have in the US, namely a highly regulated market that drives up prices.

                      The European system would actually be fine with me, where morons like you who don’t know any better are on a cheap government plan and STFU, while people with money can buy as much high quality healthcare as they want.

                  2. So we are too free?

                    Is the freedom to choice what you eat a bridge to far?

      2. Asian Americans have a longer life expectancy than any European country (or any other country period, including Hong Kong). That illustrates what a deeper dive into the data shows you: life expectancy is largely unrelated to the healthcare system once minimum needs are met.

        So, your theory is b.s.

        1. He doesn’t have a theory. He has a list of bullet points that someone gave to him.

          1. Actually, as has become clear, @Leonremi is a gonverment-indoctrinated European with an inferiority complex. If there had been an Internet a century ago, young German brownshirts would have made the same statements that he is making today.

      3. You do realize this is mostly because Americans have significantly unhealthier diets? And because Amercians exercise less? The life expectancies have more to do with lifestyles than quality of healthcare.
        FYI, one of the reasons Europeans exercise more is that in most European countries personal transportation is too expensive/Europeans are too poor to make regular use of personal cars affordable so they are forced to walk and bike more.

    2. We pay more for worse outcomes and go bankrupt anyway.

      You have a very odd idea of “efficiency”.

      1. ww pay for the very best outcomes, its not even debateable. Check 5 year cancer survivability stats.
        Inputs are not outcomes.

  13. Medicare For All is dead. Biden won the Dem nomination by campaigning against it.

    1. oh wait, strike that. According to Wingnut.com AOC is the real POTUS and Biden has no say in the matter.

      1. Now do neonazis and white supremacy.

    2. Medicare For All is dead. Biden won the Dem nomination by campaigning against it.

      Oh, that’s cute: you think politicians actually keep their campaign promises! Even cuter that you think a senile, corrupt opportunist like Biden does!

  14. Medicare for All Is Bad Medicine. A better prescription would be to get government entirely out of health care.

    For the past few years, Reason stood on the sidelines with vague “on the one hand, on the other hand” articles and lambasting Republicans for not “providing a compelling alternative” when Republicans tried to repeal the ACA. Now we get vague articles about how nice it would be to have free market healthcare.

    Conclusion: Reason is a bunch of progressive establishment hacks.

    1. Remember this. Toosilly is not remotely serious about anything libertarian. All those “the Republicans need to come with a different government imposed solution if the want to eliminate Obamacare” articles went by him without so much as a peep in reply.

      Poseurs, the entire lot of them are poseurs.

      1. Yeh, I seem to recall Reason not liking Trump going after Obamacare because reasons.

        They should have been cheering on. Heck, they should had a glass of whiskey in one hand and handing a sledge hammer with the other.

  15. ship sailed 11 years ago.

  16. I’m just glad nobody linked to Bon Jovi.

    1. I was going to, you bastard!

      1. alright! one more time! with feeling!

  17. “Everybody in! Nobody out!” protesters chanted in Toledo, Ohio, this week

    1. A health plan so good, you have to be forced into it.
    2. Spoken like SS camp guards.

    1. Totalitarianism is as totalitarianism does.

      Another one of those “superior” ideas that our European “betters” unleashed on the world.

  18. Liberaltarians think free market health care is a real issue for voters. Nope. That is long over, and government health care won. Oh it’s gonna suck hard like Tony fellating his socks, but worrying now is like worrying about nuclear war and fallout.

    1. UK/French-style government healthcare would be a good thing: government run clinics with limited coverage, limited costs, and limited salaries.

      But that’s not what the US is getting. What the US is getting under Democratic leadership is fully private healthcare that robs the US taxpayer blind by charging whatever it wants to and whatever corrupt politicians are willing to give it.

  19. Jimmy Dore won’t like this.

  20. Once your healthcare is a matter of public concern any activities you undertake that are demeaned antithetical to that concern is open to government regulation. This isn’t new but we’ve seen signs of increasing acceptance of this stance and an increased willingness of governemtns to tax or prohibit everyday items and activities that could potentially be bad for your health.

  21. You forgot to explain how an unsubsidized market in healthcare will deliver universal affordable healthcare.

    If it won’t do that, then it’s not a better plan.

    1. And Tony proves my point from above.

    2. “If it won’t do that, then it’s not a better plan.”

      That’s a nonsense statement.

      1. Every other non-shithole country on earth has figured out how to deliver universality. So if we can’t do that, we’re not trying hard enough, and that’s just a plain fact.

        You can’t even begin to theorize about a system without government subsidy in some form that delivers quality, affordable healthcare to all Americans. If you can’t do that, then you have no objections to offer yet, you simply have more work to do to earn a seat at the table.

        1. >>universality

          not everyone believes this is cake and pie

          1. If universal health care meant everybody died at 30, Tony would be fine with it.

          2. We have universal health care. It’s just not expansive enough for Tony’s taste.

            1. Nor efficient.

              Doing bitch work for the status quo in profits is a terrible way to waste your life.

        2. See? He assumes that all healthcare quality is equal, so if you just create a government program, you’re done.

          It’s a perspective that over-simplifies and minimizes the issue so as to arrive at the preferred policy position the quickest, facts be damned.

          This is why these people can’t be put in charge of things. They’re not committed to facts or outcomes. They’re committed to policies.

          1. They’re committed to an ideology, Brian. A perverse and twisted ideology.

          2. What are you even talking about? I just said every country on earth that’s not a shithole has this figured out, and there is a different structure to each country’s system.

            It sure seems like the evidence is in, and it has delivered us two realities: universal healthcare is possible in a wealthy country, and the consensus of wealthy countries, minus this one, is that healthcare is a right to be guaranteed to all humans.

            If you can’t do better than that, why should anyone listen to you?

              1. So polling says Americans want the government to pay for a private health insurance system. America wants Obamacare.

                I’d design things differently, but all I’m advocating for here is universality, so whatever is cool. Every country has a different system. Ours will undoubtedly be a market-based one, but we have to get to the starting line of universality first.

        3. you simply have more work to do to earn a seat at the table.

          We know you’re all about top men, Tony.

        4. Many other countries may have universality – you can fiat that. But “deliver”? Lol. Tell that to Canadians who can’t get an appointment for over 5 months. They ‘have’ healthcare, but it’s really not delivering.

          1. Canada spends far less per capita than the US on healthcare for better overall healthcare outcomes. It’s pretty much the same story across the board. Copy and pasting one country’s system over our own would be a massive improvement, regardless of anything else.

            There is easily room for a tiered system that delivers basic healthcare services universally but subjects elective healthcare to the marketplace. Or whatever. The wait line thing is such bullshit. Nobody’s dying in line for healthcare. Maybe somewhere you have to wait longer for an elective or non-time-sensitive procedure. But the US rations in a far, far more brutal way: if you’re poor, fuck off and die.

            Let’s try to see the whole picture. It would be a tragedy to sacrifice a vast improvement on the status quo because we were trying to avoid a situation that may not even be relevant.

            And if you really want shorter wait times, advocate more taxes to pay for more hospitals and doctors. But you could just adjust your values to something resembling the humane.

            1. It’s easy to spend less money when people die waiting for treatment they never receive.

              1. Cite your claims. You’d hate to be caught repeating horseshit lies.

  22. Anyone who supports Mr. Tuccille’s option of “getting the government out of health care/insurance entirely,” what are some examples of countries around the world which have adopted a laissez-faire approach to health care and insurance, and have achieved the following three goals:

    1) Universal coverage
    2) Good quality of care
    3) Cost control

    Singapore and Switzerland, both of which have substantial government roles in their health care/insurance systems, do not count.

    Please reply only with examples of specific countries that meet the criteria I set out above.

    1. Unless you think waiting around half a year for treatment is good quality of care, then you can’t find a single payer system that satisfies your criteria, either.

      1. Waiting times for non-emergency procedures are a feature of all health care systems, including single-payer systems. That is a single element of health care quality. While the US is better than many countries in this one factor, it is poorer in others. Most international comparisons of health care show that other OECD nations have overall quality as good or better than the US.

        1. And most of those studies consider socialized medicine higher quality care.

          When you do that, you shouldn’t be surprised when the highest quality care turns out to be socialized medicine, but at that point, you’re just defining “socialized” as “good.”

          1. That is not correct about the OECD database on health care quality. They don’t consider whether a country’s health care system is “socialized,” by any definition, in comparing health care outcomes in different countries. They just look at the date. The same is true for other studies, like the Commonwealth Fund’s, which utilize the OECD data.

    2. There aren’t any countries that meet your criteria and have a completely private healthcare system.

  23. I would LOVE to see what medical services would cost if it really was a free-market system with actual price discovery. (It isn’t “healthcare” as our stupid politicians call it, it is medical care. No one can give you healthcare. That is something you do for yourself like lose weight, exercise, eat right, sleep enough, etc.

    When the republicans carp about “maintaining our free-market healthcare system” they are SOOOO full of shit it is unreal. There is nothing free-market about the system, nor has there been for the past 40 or 50 years. When I was in active practice, all anyone knew was their copay. In the vast majority of cases they didn’t give a f*** what was being charged to insurance because “I only have to pay $X.”

    We don’t even really have medical insurance any more – with premiums as high as they are, and deductibles as high as they are, it is nothing more than pre-paid medical services.

    Equally full of shit are the assholes who claim “healthcare is a right.” Bullshit. Because an actual right never confers a compulsion on another person to have to do anything. If you have a “right” to medical services, then it means someone is under compulsion to provide them.

    Americans are too damn stupid to connect the dots between the insurance, medical, and Big Pharma lobbies that run this entire medical services shit-show.

    Unfortunately, it is NEVER going to be a real free market in medical care until insurance is gone, and providers can set pricing. But now that there has been near total corporate capture of the whole system, with plenty of lobbyist cash lining the pockets of shithead politicians in both parties, we get what we have. And every intervention they make, whether it is Part D (thanks, republicans), or the ACA (thanks, democrats), only makes it more expensive and worse.

    Fuck America…after all, it’s fucking us.

  24. With private insurance, which pays providers a lot more, if I am sitting in teh ER or waiting room I go to the head of the line.
    Under single payer I will be sitting with an illegal on one side and a professional recipient on the other and have only a 1 in 3 chance of going first! Even though I paid into the system and they didn’t!

    1. That is all part of the corporate circle-jerk – there are no “providers” per se any more, or very few. Almost all doctors are nothing more than corporate employees with not near as much say about the services they dispense than the CEO and insurance company have. Private practice is fast becoming a thing of the past…and they will boring in as many foreign doctors willing to work for less as they can. And also, now you are as or more likely to see a PA as an MD, because they make less. In many simpler cases it doesn’t matter, but they have 2 years of post-grad training vs. 10.

      The actual clinicians are not raking in all this dough – it is the administrative parasites in these medical services corporations whose salaries have exploded. Doctor salaries are actually flat to down when adjusted for inflation.

      Trust me, the corporate takeover of healthcare is no better for the standard of care than the government taking it over.

      1. bring in – not boring in – fat fingers

  25. Firstly I want to know if J.D. Tuccille is on the parole of a company or companies in the medical or pharma field. If yes, turn the page. if no, then remember that every wealthy country in the world has medicare for all and it works. Only in America is what should be a human right treated as dangerous socialism, i.e. giving lazy blacks freebees.

    1. It’s not a human right – see my post above.

    2. Whip those *slaves* till they bleed-out “medicare-for-all” either by SLAVE-LABOR or SLAVE-WAGE-LABOR…

      Either way; You have a real problem feeling utterly entitled to what other people provide. The fact you want Gov-Guns to get pointed at them makes you the filth of society.

      You have a plan — go ‘start’ your plan. Advertise for membership to your ‘works’ plan. Prove to the people it works… Don’t pack around Gov-Guns *forcing* people — That’s a Dictator/Slave-Owner..

      That’s where your thinking makes you filth – and fits perfect as ‘slaver’.

    3. J.D. can’t be on parole if medical and pharma companies don’t have prisons.

      Do you also think “You Have A Right to Chicken Done Right?”

      Kentucky Fried Chicken (KFC) had that as a slogan on their TV commercials back in the Eighties. Having first learned about libertarianism and free markets and having just read Milton and Rose Friedman and Ayn Rand, I always screamed at the screen: “No you don’t! Not until you’ve first paid!”

      Then KFC actually tried to practice that slogan in the early 2010s (Twenty Teens? Sounds sick and wrong!)

      They offered a free rotisserie chicken sandwich to everybody who had a coupon printed from the Internet.

      It ended up all over the nation with lines of people and cars going around the restaurants, traffic in neighborhoods around the restaurants getting backed up for a quarter-mile or more, the restaurants ended up running out of chicken, people ended up trying to counterfeit coupons and pass them off as real, customers and employees and managers ended up getting in fist-fights, and eventually it all ended up ending.

      I don’t think the rotisserie chicken sandwich is even on the damn KFC menu anymore, probably because the whole scheme was an embarrassment that deserved the old “Memory Hole.” I haven’t been back but a couple times since and didn’t want to ask!

      The moral of the story is: So-called “free” shit, whether chicken or medical, is just that and worth exactly what you pay for it! And you never know you might get just damn shot, killed, or hurt! It’s not even worth it! Hey! You know!You know!You know! Hit it!

  26. I still remember the day Obama’s ACA(Obumercare) Nazi-Bill was going to FIX EVERYTHING!!!!!!!!!!!

    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.
    Just like the healthcare bill before it.

    Anyone who thinks another healthcare bill will fix it deserves a swift kick in the head for their undeniable stupidity.

    Not to mention it VIOLATES “The People’s” law over their government.

    1. Some people think the right use of Gov-Guns is to protect Individual Liberty and Ensure Justice.

      Some people think Gov-Guns should be used to *take* whatever their GREEDY self wants……. AND they’ll use every excuse-word written in the English language to justify their GUN THEFT…

      It’s pretty easy to determine which political party fits which description the best… If Democrats weren’t politicians they’ll all be in prison for armed robbery.

      1. In the cell next to the republicans.

        Cut the red-blue bullshit – they’re ALL fucking us, and the faux divide pitting the cultists of each party against the other is literally the life-blood of the whole stinking corrupt system.

        1. they’re ALL fucking us — Yes, yes they are for the most part… Some far far worse than others and collectively one party far worse than the other. Far too many Republicans acting just like Democrats.

          But that doesn’t change the fact that the two parties platforms are complete opposites.

          That one party is about upholding “The Peoples” law over their government (U.S. Constitution) and the other party doesn’t even mention the peoples law or mention the word in their platform but instead speaks entirely about how — You don’t own you; The [WE] foundation owns YOU.. (Still the Party of Slavery just cluttered with far to much BS)

          1. NFW – both parties have their lips wrapped firmly around corporate America’s pecker, because the money is just too good. Endless war. Endless deficit spending. All the “differences” are theater.

            If you think the republicans defend the constitution, then you haven’t read the constitution.

            It’s a choice between hippo shit and giraffe shit. And the red-blue game ensures that NOTHING will ever change or get better. Watch any kind of viable third option rise up and you’ll see them lock step to eliminate it. It’s a giant reality TV show, you we are the dupes.

            1. Like I said; What Republican Politicians do and what their Platform is; is often two different things.

              What’s your proposed solution to getting back to the USA’s foundation?

              1. Unfortunately, there is none. Heartbreaking, but it has gone past the tipping point and will never return. Things like rank choice voting and viable third parties might help, but I think the system is so corrupt that it cannot be saved.

                The USA is an empire in decline, with the best government money can buy. The politicians are totally in it for themselves, and they not only don’t care about us, they actively disdain the populace…all while telling us they are working on our behalf.

                And the red-blue cults ensure the system will remain this way until it consumes itself.

  27. Not mentioned at all in this insane screed is the fact that the USA has worse life expectancy than all of the other nations trashed here, while spending almost double what they’re spending per capita.

    1. That’s because life expectancy in the civilized world is more of a function of personal choices and lifestyle rather than health care.

      You can’t eat Burger King for dinner every night and expect the health care system to save you, no matter how much treatment you take.

      1. And that is because our food supply here in the richest country in the world is garbage, with corporations owning the FDA and getting regulations passed that allow them to process food in ways where it is unfit for human consumption. And even getting “organic” changed so they can increase their profits while marginalizing the quality and healthiness of the product.

        But hey, it can still be sold after sitting on the shelf for 6 months, and that’s what counts.

        1. Remember all those Gov-Gun that forced everyone to eat processed food “unfit for human consumption” instead of growing a garden thus using gov-guns to increase their profits??

          Ya; me neither. I’d rather eat “unfit for human consumption” than sell my soul out to enslaving dictators pointing gov-guns at me for not eating [WE] mob approved food.

          But hey, at least I won’t be imprisoned for buying a can of beans that have been on the shelf for 6-months at half-price. Ya; Individual Freedom IS WHAT COUNTS!!!

          Why don’t you go start an “MyCoolFood” label organization then you can get your cool food just the way you want it. Heck you might even prove to be of value to someone instead of a criminalistic thorn in the *ss.

          1. If you think the republicans are any less Gov-Gun pieces of shit than the democrats, then you are not very bright at all. Fawning over people bent on destroying you is the fucking stupidest thing ever.

            If the shoe fits…

        2. At some point, one would think you would give up trying to make the government solve problems when it only makes them worse.

          If they can’t do the FDA right, what makes you think they can do healthcare?

          1. Not saying they should, I am just pointing out how things are.

  28. Alright, for these statistics comparing Canada and the U.S. to actually make sense you have to include the number of people in the U.S. who forego health care due to the costs, because they are uninsured or the premiums are too high, they are basically on an infinite wait list
    The one thing this article actually taught me is that the excess deaths statistic which I previously thought proved beyond any reasonable doubt that the coronavirus pandemic was real could just be caused by the backup in health care caused by tons of ppl seeking hospitalization from the flu or the cold when they don’t really need it, and causing ppl with actual health care needs to get shut out, or sacrifice themselves for the greater good by waiting for “covid” patients to go first

  29. “Everybody in! Nobody out!” protesters chanted in Toledo, Ohio

    So “Medicare For All” is like a gangbang?

  30. And all I could think was, “I guess that explains the $100B a year of fraud that the government admits, which in reality is probably double.”

    I do confess I had never thought of Medicare from the doctor point of view. I don’t think either of these docs submits fraudulent bills, both seem honest as you could want. But it does point out how easily they could cheat, and I don’t doubt there are doctors who shade the truth, exaggerate, or outright lie.
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  31. This article is exactly correct. Medicare for all would be very bad for medical care. I am a Medicare patient. When seeking medical care from a specialist I frequently hear a background discussion of the number of medicare patients the practice has and whether or not they can accept another medicare patient. While physicians do serve medicare patients, their practice as a business limits the number of medicare patients to a low percentage of all current patients. I have had to wait to have elective surgery for my last three major surgery for from a low of 6 weeks to a high of 6 months. Waiting 6 months for back surgery to relieve a terrible pain problem when no treatment really works, is torture.

    That said, Medicare for All would see an exodus of physicians who accept medicare and medicaid patients from treating those patients. When Canada limited the salaries physicians could earn there was a large number of them who came to the USA, and a smaller but significant number who went into practice outside of government hospitals and outside of government payments to where the patients paid the doctors and hospitals cash out of their pockets before treatment. Now, where there is socialized medicine there are years long queues for patients to wait for treatment, and life threatening conditions frequently have the prospective patients die while waiting. Cancer patients go from early detection to stage 4 cancer waiting in the queues with aggressive cancers, and die, when early treatment would have added many years to their lives.

    Medicare for all is the end of medical care in this country. The queue will get really long, and you will have to pay for it outside of medicare and medicaid, and insurance before being treated. If you can not pay, then you will suffer and die. Actions have consequences, and bad actions have bad consequences.

    1. So refuse to use Medicare and buy a private plan.

      1. Correction: So refuse to PAY Medicare and see what happens.

  32. Intent matters not at all. These people want us dead twice over. First by aiming the long gun of the law at us to force compliance, and secondly for wanting to subject us to centrally planned healthcare. They need not be aware that their intent is murderous for it to be murderous. We should treat anyone who advocates this law as someone who is in the act of attempting mass murder.

  33. The problem I have with Reason.com articles like this one, is that they build straw men to tear down. There is NO CHANCE that Medicare for All with no private insurance will pass. And we WANT the government involved to keep costs from spiraling out of control. Reason.com should discuss the idea that a Medicare option be made available to Americans. Right now I would be happy for 55 and up.

    Economically, listen to Charlie Munger of Berkshire Hathaway. Get medical expenses out of companies and into the commons, and make American industry more competitive. We are competing against European companies that do not have to pay medical expenses.

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  35. Medicare for all, I have done my analysis and I do not think its the best idea

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