Rush & Schakowsky Monday Opportunity to Vote for Single Payer

Speak out on healthcare in Aurora (0.00 / 0)

featuring:

Congressman Dennis J. Kucinich with Dr. Anne Scheetz, Dan Kenney, John Laesch, & John Wojcik

4 p.m. Sunday, August 2nd

Prisco Community Center

150 W. Illinois Ave. Aurora, IL  60506

$10 Suggested donation to cover costs

For more info, including an opportunity to lunch with Rep. Kucinich, go to http://docs.google.com/View?id...

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by: yinn @ Sun Jul 19, 2009 at 13:04:29 PM CDT

"Negotiating clout" (0.00 / 0)

I have never understood what people mean when they talk about the negotiating clout of a single-payer system or the public option. The example we have before us is Medicare. As you presumably know, Meciare does not in any way, shape, or form negotiate with vendors (mostly meaning physicians). It tells them, "Here is what we will pay you. Take it or leave it. Period. End of story."

I would expect national single-payer to operate the same way, although I haven't checked the relevant provisions of the Conyers bill. There's no reason why a state-level single-payer system couldn't do the same, although this would only apply within the state. Theoretically it could lead to physicians leaving the state, although I don't view that as particularly likely. It also raises the question of how people travelling outside their home state would be covered. I suspect they'd need supplemental insurance, the way Medicare recipients travelling outside the US need supplemental insurance.

The public option is different. According to the variant presently considered most likely, it would indeed negotiate with physicians the way private insurance companies do. But unless it becomes much bigger than I expect (i.e., bigger in a given area than the biggers private insurance company serving that area), it would have no more clout than they do.

Bill Thomasson

Permission to reprint explicitly granted

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by: wathomasson @ Sun Jul 19, 2009 at 15:48:15 PM CDT

So could this be a sleeper hit? (0.00 / 0)

So even if the regular final health reform bill, whether with a public option or not, is a dud, could this optioning of states with the ability to create their own single payer system really work?

I guess what I'm asking is if the Kucinich admentment becomes law is it a viable alternative for progressive states? Granted one still needs to get it passed locally and maybe Illinois isn't there yet.

When I go to another state my current health coverage works to at least some extent. Couldn't an Illinois state single payer plan work as well. Aren't we mostly talking about emergency medical treatment for the most part?


Jeff Wegerson

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by: wegerje @ Sun Jul 19, 2009 at 16:11:32 PM CDT

[ Parent ]

Could, maybe (0.00 / 0)

I expect the regular healthcare bill to fully address the structural problems with the current system. That's what I see as the main goal of current healthcare reform.

Costs are a hair-pulling conundrem, especially given the demographics of an aging population. Regular insurance is partially protected by the fact people over 65 go on Medicare, but we are very soon going to have to get serious about Medicare funding. Still, even people in their 50s and early 60s have greater healthcare needs than they did when they were younger.

The only way to keep total costs approximately constant in the face of rising demand is to decrease cost per unit of healthcare delivery. There are certainly savings to be had from improved efficiency and a greater emphasis on preventive care. That's what people mean when they talk about paying physicians for results rather than for the number of procedures performed. But I am sceptical about that being the magic bullet people are looking for. I think the sort of savings people are seeking is going to call for ratcheting US physician incomes down to something more like what they get in other countries. But even Gary can see the problems with that. You already have physicians complaining about what, not just Medicare, but private insurers have done to the incomes they expected when they graduated medical school.

And yes, the supplemental insurance I was talking about could in principle be part of the state plan. Just as Medicare could in principle pay for care outside the US. But it doesn't.

Bill Thomasson

Permission to reprint explicitly granted

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by: wathomasson @ Mon Jul 20, 2009 at 10:00:21 AM CDT

[ Parent ]