The WELL: inkwell.vue.273: Joe Flower, healthcare futurist: Should the U.S. have a single-payer plan? (2006)

#99: rebarebar (rebarebar) Sun 1 Oct 06 09:52

Sun, 01 Oct 2006 09:52:00 PDT

The next part of this discussion is how to get there. The recent Massachusetts legislation is flawed in many ways and may not work ultimately because its compromise was caving to the insurance and drug industries. As long as the model is to accommodate these profit making entities as they wish, no real change can happen.

BUT! If the discussion in the media, in legislatures can ever get framed properly, it might include: 1--Access to health care is as important to our economy and democracy is access to education. Why do we not treat it the same way? 2--Access to health care for all will go farther to ensure our general wellbeing by better controlling communicable diseases. Think of another flu outbreak, SARS, and so on. [Read entire topic]

#98: Jonathan David Haskett (jhaskett) Wed 21 Jun 06 11:32

Wed, 21 Jun 2006 11:32:00 PDT

S.F. unveils universal health care plan - Yahoo! News

http://news.yahoo.com/s/ap/20060621/ap_on_he_me/san_francisco_health_care

A better model than Massachussetts? [Read entire topic]

#97: Jonathan David Haskett (jhaskett) Wed 21 Jun 06 10:42

Wed, 21 Jun 2006 10:42:00 PDT

Time to take some of these ideas to a more political venue.

Two new websites reported in today's Washington Post both of which aim at boosting progressive/democratic idea generation.

www.democracyjournal.com www.thedemocraticstrategist.org/premiere/

Democracy Journal has an article illustrating how the deductability of coporate health insurance amounts to a govt. subsidy of the current broken healthcare system.

These are the kinds of policy forums in which single-payer needs to presented and support for it solidified so that it becomes part of the Democratic party idea bank.

For those who don't like Dems I would be happy to know where an althernative forum exists to present this idea with any viability to the Repubs, or a policy alternative that provides the potential for 100% coverage for all Americans, at equivalent high standards and low costs. [Read entire topic]

#96: Jonathan David Haskett (jhaskett) Wed 14 Jun 06 13:12

Wed, 14 Jun 2006 13:12:00 PDT

Meanwhile, I had to take my stepson to Kaiser yesterday evening for a cat-scratch that had gotten infected. Got through to an actual human advice nurse (as opposed to an automated AI go - to - the - Emergency Room, telephone button decision tree like at Amerigroup). She had all his records available electronically, was able to hunt me up an appointment at the nearest urgent - care facility and send them a note electronically that I couldn't find his Kaiser card (no problem). Waited 15 minutes at the urgent care facility got to see a doctor who, again, had all Sebastian's records online, got a prescription filled at the inhouse pharmacy and got home in like 1 hour and 45 minutes.

Saved Kaiser a boatload of money by A) not deferring treatment until the infection was severe because of fear of costs and B) not going to the emergency room.

This could be everybody. [Read entire topic]

#95: Stephanie Vardavas (vard) Tue 13 Jun 06 14:45

Tue, 13 Jun 2006 14:45:00 PDT

That absolutely sucks, jhaskett. It makes me so angry. [Read entire topic]

#94: Jonathan David Haskett (jhaskett) Tue 13 Jun 06 14:33

Tue, 13 Jun 2006 14:33:00 PDT

A personal note. What a diconnect. It is hard to keep this discussion going because in open discussion the consensus comes to single payer and then what more is there to say.

Meantime my housemate was sitting at the dinning room table in tears yesterday because she has no insurance and routine medical tests, yes all those recommended tests that save money in the long-run are going to cost her $500 which she is hard pressed to come up with. As an uninsured person she has had years of people implying that her lack of insurance is due to a lack of motivation, drive, will to get ahead and essentially her own fault. [Read entire topic]

#93: Robin Podolsky (podolsky) Mon 5 Jun 06 17:20

Mon, 05 Jun 2006 17:20:00 PDT

"Wow. I wonder what the chances of that passing are, Imagine that you are an executive for United or Aetna. Here is a bill that proposes to take away your largest market. What would you do?"

Well, all of us are still alive and unharmed--and this bill that wasn't supposed to make it out of its first committee is alive and well also. Thing is, almost any business that now offers health benefits (most of the large ones) would save money due to this bill--corporations, like individuals would be assessed on the basis of means, not what a monopolized industry could squeeze out of them. As to small businesses--the benefits/pension crisis doesn't only threaten big corps like GM--if they fail and their workers lose jobs, every dry cleaner, hair dresser and realtor who depends on them loses income too. Further, the costs of underinsurance drain small businesses in ways that are hard to measure--lost hours, lost efficiency, low morale, etc; in addition to ways that can be measured, such as higher local fees from governments that need to pay for their own benefits packages.

So, it's not even us vs. big business--it's a certain kind of big insurance vs. everyone else. Companies like Kaiser, on the other hand, would do great with our bill. They could negotiate a yearly budget that would allow them to provide healthcare efficiently without dangerous corner-cutting. [Read entire topic]

#92: Dennis Wilen (the-voidmstr) Sun 4 Jun 06 18:58

Sun, 04 Jun 2006 18:58:00 PDT

Thanks <bbear>! Great thinking! [Read entire topic]

#91: Carl LaFong (mcdee) Sun 4 Jun 06 18:40

Sun, 04 Jun 2006 18:40:00 PDT

My solutions would only overload the morgue. Just buy another fridge or two and you're fine. [Read entire topic]

#90: Joe Flower (bbear) Sun 4 Jun 06 15:46

Sun, 04 Jun 2006 15:46:00 PDT

There you go again. one thing your solutions would do is overlaod the already overloaded ERs.

Here is an article from the Economist reviewing Michael Porter's new book "Redefining Healthcare," which argues that 1) competitive forces used so far in healthcare have been 'introduced piecemeal, in incoherent and counter-productive ways that lead to perverse incentives and worse outcomes: "health-care competition is not focused on delivering value for patients."' But 2) 'a redirection of competition from the level of health plans, doctors, clinics and hospitals, to competition "at the level of medical conditions, which is all but absent" could bring quality up and costs down.

http://www.economist.com/business/globalexecutive/reading/ displaystory.cfm?story_id=6999160

I have not read the book yet. I have the book right here. It is one of several that I am to write an essay on for Strategy + Business over the summer. I must say that as far as I understand the book, I agree with Porter - and I also see no conflict between competition in the marketplace and a single-payer system (as I said in the article that framed this conversation). But I am less sanguine that the powerful forces looking to make money from healthcare could let the necessary reforms come through that would shape the competition around bringing true value to the customer. Those forces are having a fine time with the present system skimming off the value for themselves, and would surely strive to skew any reforms to benefit them even more, at the cost of any benefit to the individual consumer or the society as a whole. [Read entire topic]