Do we really want Socialized medicine

... about wanting it? We already HAVE socialized medicine in the USA, albeit in a particularly hidden form that combines dishonesty and necessity. It is supported on 3 great pillars of our society:

Toledo can't afford the co-pays!

No one in the US political system is seriously promoting a strictly-defined socialized medical system (a sytem in which the hopsitals are government owned and doctors and nurses are employees of the state). An example of that is what is found in the National Health Service in Great Britain. NHS is a failure and has spawned a private health system for those that can afford it.

There are people promoting a single-payer system like Canada has. While this is more socialist than what we have now, it isn't, technically speaking, socialized medicine. Medicare/Medicaid/Tricare are very similar to this but obviously don't cover 100% of the population.

The US is currently somewhere in this great abyss between government run healthcare and completely capitalistic healthcare. To be honest, that's part of our problem. We would be better going to one system or the other instead of trying to sit in the middle and play with both.

There are some great things about the Canadian system, and there are some very bad things. Likewise, there are some great things about our system, and there are some very bad things about our system. My hope is that we can take the good parts of their system and the good parts of our system and merge them together.

There's also a fundamental problem that all of the Western world has regardless of the type of healthcare system. That's the fact that we can provide more care than we can really pay for at this point. That's why we see healthcare spending increasing at 6-8% a year. That number is increasing at a similar rate in Canada (the prototype many people want).

If we suddenly go to a Canadian-style system, we're going to be disappointed because it won't solve all of our problems. One of the immediate problems is that of healthcare workers. One of the realities of the Canadian system is that physician reimbursement is significantly lower. That's one of the reasons there is an influx of Canadian-trained doctors to the US. Physicians are already limiting the number (or completely rejecting) Medicare and Medicaid patients because it isn't personally profitable for them. If the single-payer system puts wages in the similar range of the Canadian system then we're going to see major physician shortages because many over 50 will simply retire, and many of those younger than 50 can do a couple of things. One is that they simply leave medicine altogether. The other is that they go completely private (meaning pay for service) and simply not accept government reimbursement (this is happening in Canada more and more every year). If the government would guarentee that reimbursement would stay where it is now the I think physicians would largely support a single payer system.

More on this later, but it's late now.

I see it as a lack of responsibility on the part of a lot of citizens and no creativity to fix this problem using private companies.

However, shit happens. Car accidents, broken bones, gall bladder (sp.) that people can't predict. They need some type of coverage. What if the job does not provide coverage and something happens? That person/ family is screwed on medical bills 4 life.

GZ, hasn't there been a lot of change in Bankruptcy laws/requirements that that pillar is at least trying to get broken down?

I would support socialized medicine if it guaranteed a few things. First, doctors would need to be paid reasonable rates. I know when the government controls professionals, ammenities and pay tend to be significantly worse than that of private companies. For example, from a legal perspective, a prosecutor is a professional and could make a shitload of money in private practice, but instead is viewed as an hourly worker by the mayor and others, mostly because the mayor and council don't understand the importance of the judicial system and the law. I fear that if the healthcare system were to become public, doctors would be viewed the same way by an arrogant mayor and any other government official who thinks they know better. The fact is that these prosecutors are underpaid, but still choose to do what they do because they see their work as necessary, or a stepping stone to become judge. However, there will come a point when incompetent lawyers become prosecutors because the pay is so low. I fear that the same thing may happen for doctors if the system becomes public. The government will treat them as hourly employees and not understand the importance of their work. And like many canadian doctors, they will flee to a markey like the current US to make the money they think they deserve to make.

...first, thanks for reading my blog and for a thoughtful response. To register, you need a blogger or google account and those are free. Under the 'choose an identity' there is a link to get an account.

And you should know that I often post columns and items I find interesting even when I don't agree with everything stated.

I agree with HeyHey's comments that we don't have a true market system in health care, nor do we have a socialized system right now. I see the benefits of Canada's system, but I don't want to duplicate here. The fact that many Canadians come here for treatment speaks volumes to me.

Likewise, the fact that many Americans are going elsewhere for medical treatment should be sounding alarms for us.

I'm a big fan of alternative medicines. I don't think they should be used solely, but my old doctor, who had a nice balance of traditional and alternative treatments, left Toledo for a state out west where he could focus more on the alternative side.

I wouldn't call our medical system in the states 'free market' due to the many onerous regulations and the over involvement of third parties (like insurance companies). A couple of years ago, I did some research on this topic and came across information about a growing number of doctors who were getting away from affiliations with insurance companies. Many of them were in rural areas, but some were in cities. They said that their patients could afford the $50 office visit cost several times a year, but couldn't afford to pay $500 a month for comprehensive health insurance. Many of their patients carried insurance for catastrophic or emergency illnesses/injuries, so they were covered in case of a gall bladder surgery or car accident.

Personally, I think the tax code has impacted the medical industry significantly. The tax code encourages your company to be your supplier of insurance - resulting in you 'paying' for services you don't need - again, a one-size-fits all type of scenario. If I were to purchase my own insurance, I wouldn't need well-baby care, maternity or fertility coverage...but I get those - and am paying for them - in my current package.

I believe that there is a lot we can do to improve the system - but I don't want to go the way of more regulation and government involvement to do so.

If you think health insurance is expensive now, wait till it's free!

Americans, on the whole, have a warped view of what health insurance should be. My father is in the insurance business and tells stories of people paying $100 more a month so that they don't have to pay a $15 co-pay. He says he tries to reason with them that they're losing money, but it doesn't work. We expect insurance to cover 100% of any healthcare we need, when it fact it should be there as a safety net to protect us in catastrophic cases.

If our healthcare insurance model were applied to car insurance we'd have oil changes, new tires, burned out lightbulbs, and the golf ball dent repair all paid for by insurance. Fortunately we all recognize that's not the purpose of car insurance. We only use car insurance when there is a major incident that would require a tremendous outlay of personal income to take care of. We don't use it for day-to-day maintenance.

In my way of thinking we should apply the same principals to health insurance. For example, any visit to your family doc (say $100) should be paid for out of pocket. A colonoscopy every 5 years (say $400) should be paid for out of pocket. If you have heart pain and undergo an emergent angiography plus battery of tests (say $5000) then that's when insurance picks up. I personally plan on taking out a high deductible policy with lower premiums. I'll tuck the deductible amount into a bank account (or HSA) and use it if it's needed.

There is a tremendous increase in expense when we tell our insurance company (or the government) to pay for routine healthcare. For one, every time an insurance company (or the government) pays for something they take a cut to pay for their overhead costs and also to make a profit in the case of private insurance. Either way, a $100 reimbursement to a physician will turn into maybe $120 of total cost paid for by either premiums or through taxation. It would be cheaper to keep the third-party (insurance or government) out of the equation. Secondly, when private insurance or the government is the payer physicians have to correctly bill and code for any expenses. While initially maybe a good idea, it has turned into a major headache and additional expense due to the complexity of the whole process. Physicians have now resorted to hiring personnel whose sole job it to deal with the insurance companies. Talk about a total waste of healthcare dollars! Instead of that money staying with the patient or physician, it is instead going to a person who makes sure the form (online or paper) is filled out correctly.

Another example of waste is the recent attempt by some University of Toledo students to get birth control covered by the school's insurance plan. I'm all for birth control, but I don't think that's something that should be paid for by insurance. Something as commonly used as birth control should be paid for out of pocket because there is no sharing of "risk." Likewise for the HPV vaccine Gardasil. It's a great breakthrough and will save thousands of lives in the years to come, but I think that financial outlay should be paid for by the individual. The fallacy in thinking comes when people believe having insurance pay for such things results in no cost to them.

In order for us to solve the healthcare mess we all need to understand that healthcare is a cost that we all have to pay for. Just like car payments and the mortgage, we shouldn't expect other people to shoulder our costs.

In my way of thinking we should apply the same principals to health insurance. For example, any visit to your family doc (say $100) should be paid for out of pocket
And if you don't have $100? If you have a couple of kids who all get sick and should be seenby a Doc but you don't have $200 (or more) or more to take them in?

Your plan may be fine for people with that type of income but there is a fairly large portion of the population who don't have that kind of money. Surely you're not suggesting that medical care is something only the well off should be able to have access to?

From Dr. Williams