#CanadaWAITS For Single Payer Healthcare

This is for all those people who just love the idea of single payer healthcare. They believe having the government take over a country's medical system is the right thing to do because, well, healthcare is a human right and thus should be free. Well, let's just go back to kindergarten and relearn the concept that nothing is free in this world. Not even your parents'or your government's love.

A new hashtag was created called #CanadaWAITS by a Canadian author, André Picard. He wanted to hear how Canadians fared with their government run healthcare. And did he get an earful. His twitter page is filled with hundreds of people's stories who waited months, even years to be seen and treated by doctors.

Total time from referral to OR: 2.5 years in which every step patient takes is in excruciating pain; rationing of ORs means #CanadaWAITS https://t.co/XeXRvky91k

— Deepa Soni, MD (@drdeepasoni) November 4, 2017

In the meantime, over in the UK, where they are so proud of their single payer system that they featured it in the opening ceremonies of the 2012 London Olympics, the government is starting to play its inevitable role as rationer in chief. The National Health Service has decided that patients who are obese or actively smoking cannot have elective surgery unless the patient fixes these defects in their personality. Granted this will take place in only one small district. However, the district is expected to save £68 million. And if you're the government who is paying everybody's medical bills, you're going to try to find savings anywhere you can, even denying healthcare for people who are less desirable because of their social habits.

So next time you attend a Bernie Sanders rally, just remember that single payer healthcare sounds great on paper. But you totally lose control of your medical care to some faceless bureaucrat who couldn't care less if you don't get timely care as long as it saves them money.

Socialized Medicine Is Inevitable

It's over. The U.S. Senate has failed to pass any reform to Obamacare tonight. The promises the Republicans made to overturn the ACA ever since it became the law of the land have proven to be illusory. When they finally controlled both ends of Pennsylvania Avenue, they embarrassingly shrank from all their grandiose talk. They meekly succumbed to liberal pressure and lost the number one item on their agenda after the election.

But it really isn't that surprising that Obamacare will continue to survive. Throughout these few months of debate, it seemed the only thing that mattered about healthcare in America was how many people would have insurance coverage. Every bill was meticulously reviewed by the Congressional Budget Office and its findings breathlessly announced. No matter how the Republicans tried to ease the phaseout of the ACA, the only thing the news media cared about was how many million fewer people would have health insurance.

It was rarely stated that hundreds of counties in the country currently have only one insurance company to choose from because insurance companies were losing money from so few healthy people willing to buy their plans. Little was mentioned of the double digit price increases in premiums that were taking place. And if it was brought up, then the burden was supposed to be eased by increased government subsidy payments to help people pay for the insurance. It was always about more and more government money being used to pay for this "right" to healthcare. In other words, socialism. There was no debate about how this is ultimately unsustainable and will eventually bankrupt the country.

So now we careen headlong into the final solution. Universal socialized healthcare fully funded by taxes to the government is the endgame here. After years of propaganda to convince the American public that the only metric that matters is the number of people with health insurance, they have now fully embraced that notion. Any new healthcare plan that is devised will need to cover the last ten percent or so of the population who still don't have it. Anything less will be seen as unacceptable, no matter how expensive it may be. American medicine as we know it is dead.

Medicare For All?

President elect Trump has stated that his plan to replace Obamacare would allow everybody access to health insurance. While the Republican Congress struggles to decide what to replace the PPACA with, perhaps Trumpcare would be another version of the old public option, a Medicare for all.

It doesn't sound as preposterous as it seems. What are some of the advantages of allowing universal access to Medicare? First of all, it would have almost immediate bipartisan Congressional support. Universal Medicare was championed by Bernie Sanders during the primaries. Much wasted bloviating on both sides of the aisle would be eliminated by implementing universal Medicare instead of arguing about tax credits and and pandering to the wealthy.

Medicare is also widely accepted throughout the country. Virtually every hospital and physician already accepts Medicare. There would be far less concern about narrow hospital and physician networks. You can just go to your old doctor and the plan will be accepted. The claim that you can keep your doctor if you like your doctor will finally be true.

Universal Medicare is portable. Change jobs? Keep your Medicare. Move across state lines? Same Medicare in all fifty states. Universal Medicare would also drive competition in the health insurance market. Already hundreds of counties have only one choice for health insurance. Universal Medicare would give these companies more competition to lower prices and allow people to buy insurance if the private companies don't offer any plans. In essence, the entire country becomes one giant risk pool for health insurance, which was one of the goals of Obamacare.

Don't forget people actually like Medicare. It's one of the untouchable pillars of the federal government. It would have immediate mass appeal. Intuitively it makes sense to most people. This is what people think of when they talk about universal health insurance in other industrialized countries. Its appeal would make the legislation much easier to pass.

How to pay for it? People will buy into it just like they purchase any other health insurance plans. Unlike regular Medicare, people will buy the insurance, with the premiums based on income. The more money you make, the more you pay for Medicare plans.

Business deductions for health insurance could also be eliminated to help pay for universal Medicare. Right now this sweetheart deal brokered in the early 20th century gives unfair advantage and income to people who work for companies that offer health insurance. Small business owners, private contractors, part time workers, and millions of others don't get this deal. Removing health insurance deductions for businesses would free up billions of dollars and remove price distortions in the health insurance markets.

So could Trumpcare be a form of Medicare for all? It's hard to fathom what goes on under his orange hair every day but who knows? He is not beholden to either political party and can put forward his own plans without worrying about appeasing the right or the left. He just might do something this bold and Big League.

Single Payer Healthcare Is Almost At Hand

Take a good look at the above chart. It's a breakdown of the different entities who purchase insurance in the United States. It clearly shows that privately purchased insurance now covers just a small portion of the country's population. Health insurance received from private employers are available to about 117 million Americans, or only 36% of the total population. Nearly everybody else in the country receives their insurance from the government.

The federal government is responsible for everybody who gets their insurance through Tricare (military health insurance), Medicare, Medicaid, or Obamacare. The private individual market for health insurance has pretty much disappeared thanks to the Affordable Care Act. The ACA has been responsible for slowly pushing people off their previous insurance plans and into the arms of the feds. This is contrary to what President Obama promised during the debate over passage of the ACA and what I personally had to endure.

Because of the massive presence of the government in the health insurance business already, some people think that a Bernie Sanders proposal for a single payer Medicare for all system may not be that far fetched. According to a study from the City University of New York School of Public Health, the American government in all its entities currently paid around 64.3% of all healthcare spending. That number is set to rise to 67.1% by 2024. The American system will then be very similar to the Canadian single payer program where their government paid for 71% of all healthcare expenditures.

By doing away with the taxpayer funded subsidies granted to private companies for providing health insurance to their employees, hundreds of billions of dollars could be returned to the government to provide insurance for universal coverage. At this point, the Bernie dreamers will realize their vision at last.

So whether you like it or not, universal health coverage is almost at hand. The ACA has effectively squeezed the private insurance market to the point where it is not economically feasible for more and more individuals and companies. Government run health insurance will very shortly be the law of the land without Congressional debates about its merits. Physicians better stop moaning about the low reimbursements provided by the government programs and learn to live within their means.

The Public Option--It's Heeere!

Remember all the angst and handwringing from liberal Democrats when ObamaCare did not include a public option to compete against the insurance companies?  Well fear no more.  The Obama Administration has announced a new program that is a public option in all but name.  The Dept. of Health and Human Services will start a program to allow people with preexisting medical conditions who have not been able to buy health insurance for at least six months to purchase from a high risk insurance pool being set up by the federal government.  The program is intended to be "temporary" until January 1, 2014 when insurance companies are supposed to accept everybody, regardless of their medical conditions.

The program will start with $5 billion to pay medical claims for people in this high risk pool.  The premiums are supposed to be based on "standard rate" which are supposed to be no higher than somebody without preexisting conditions.  Plus the total out of pocket expenses is to be no more than $5,950 per individual. 

If this is not a public option, I don't know what is.  It sounds like an act of compassion to allow people to buy into a high risk pool now until the insurance companies have to accept them in three years.  But my hunch is that by 2014 this program will be so popular that it will be impossible for the federal government to withdraw the program.  This in essence will be Medicare for people with preexisting conditions.  Even though ObamaCare states that insurance companies have to accept everybody who applies for insurance, which in fact is everybody thanks to the individual mandate to buy insurance, the very crafty people who work there will figure out a way to dump patients into this new program.  The nationalization of the medical industry has already begun.

Another administration, another health care debate

Some of you reader(s?) may have wondered why I haven't mentioned anything about the health care debate raging in Congress right now. First of all, it is hard to debate a health bill that changes every day. As soon as you argue one point, the language of the bill changes and the argument is moot, a lot of wasted hot air. Then there is my conflicted opinions about what I want from all this. My doctor brain wants to have universal care, to make sure everybody in this country has health insurance. My taxpayer brain wants to limit how much money I want to spend for other people's health care, especially people who have abused their bodies with alcohol or drugs or people who just refuse to buy insurance just to save money, like people who don't buy car insurance.

And this is where the debate usually bogs down. We want universal health care, which everybody is for. But we don't want to acknowledge that the price will be astronomical. So now we need price controls, which is where the lobbyists take over to protect their turf. It would be much easier to pass into law if we can say we want universal health care and screw the costs or control health care inflation but screw the people.

We can have a socialist system like the Europeans. But nobody seems to want to face the fact that they face far higher tax rates and they don't seem to mind health care rationing. Can anyone imagine telling an American that their 89 year old Alzheimer's grandmother is not allowed to have state paid dialysis three times a week, ICU bed with full code status, while under ventilatory support? They would trot out a 60 Minutes reporter and some media hired gun ethicist to say how cruel this system is to the most vulnerable. Rationing will never work in this country but that is where we are headed.

There are so many facets to this debate and each and every side has a valid point. So somebody will get screwed if and when this passes (most likely doctors and hospitals. No unions, no clout). I will talk more on this subject in the future.