The single payer healthcare system, as seen in Canada today, is a system where the government acts as the sole insurer for all of its citizens. The actual practice of medicine remains a private enterprise. It should be noted, to quell any conservative fears, that a single payer system is not socialized medicine, as one would find in Great Britain. A socialized system distributes salaries to doctors directly from the government, effectively making them government employees. A single payer system differs in that it distributes funds either directly to doctors on fee for service basis or by distributing lump sums to hospitals, which then distribute salaries to physicians as they see fit. Another possible avenue is, as seen in Germany, the distribution of funds to private insurance companies, which then use these funds for financing care private physicians provide. Allowing the government to act as the “middle man” proves to be an interesting intermediary between government control of healthcare finance and government ignorance of healthcare finance.

A single public plan would provide a comprehensive benefit package to cover all Americans. The exact contents of such a package would be of considerable debate, and will not be discussed here. Assume, for these purposes, that a comprehensive benefit entails the provision of what is reasonably required for the preservation of good health in an individual, such as access to a general practitioner, emergency coverage, prescription drug coverage, and so on. Wholly privatized and free-market engaging insurance providers would likely be eliminated, with the exception of those that provide coverage for that which is not covered in the government’s plan—coverage which can be referred to as “supplemental insurance”.

An important question asks how such a system would be funded. The money for a government program such as this has to come from somewhere, which will inexorably lead to taxes being raised. Compared to the dollars the American public is paying private, commercialized insurance providers, the amount they will be paying out to the government in lieu of this will seem trivial. To ensure that the funds are used for healthcare purposes, it is important to earmark those taxes for their use in healthcare.

Administrative costs are not factors of concern in single payer systems, since there is an easily definable population that is eligible for coverage. No selective process is needed to determine eligibility, considering the whole nation qualifies for benefits. There would also be no threat of a discontinuity in coverage when one changes jobs as is seen currently with employer-based insurance coverage. The system will no longer be employee based—even the unemployed will have coverage afforded to them. Spending can be controlled in various ways through a government regulatory agency.

from http://dispatchesfromnowhereland.blogspot.com/

  The United States system of providing healthcare and financing the care provided is quite simply, broken. In 2005, nearly one out of every six Americans had no health insurance , and by 2008 that fraction had risen slightly to just over 1/6(http://www.census.gov,www.google.com/publicdata). This would entail that nearly one out of every six Americans are not going to see physicians when needed, are not afforded the chance for the early discovery and subsequent treatment of potentially fatal but otherwise easily treatable diseases, are not being administered vaccinations against easily communicable diseases, are not being educated about various health risks, and so on. What is important to draw from this is that one out of every six Americans, which is just over 50 million people (US Census Bureau), are not getting the healthcare they need. Private insurers, operating as a for-profit industry, inevitably couple healthcare with free-market capitalism, the end result of which is 50 million Americans not being afforded basic medical coverage.

Even with this significant lack of coverage, healthcare spending is accelerating at a startling pace (Fuchs, Emanuel), due to a variety of reasons, including high administrative costs  caused by the need for assessment of whether or not to cover individuals and to what extent they are to be covered. Physicians, too, serve as causal agents for the skyrocketing health costs, as is evidenced by the McAllen, Texas region. This area, on the US-Mexico border near the Gulf coast, is the most expensive region in the country when it comes to healthcare spending. Surprisingly, this was not caused by McAllen’s hospitals providing any better service, nor was it caused by the population in the McAllen region deviating any more than the rest of the United States from the general standard of good health. In fact, what was causing the region to be so expensive was the “across the board overuse of medicine”. Many physicians, acting as businessmen, had a habit of ordering tests that may not have been entirely necessary, but generated a respectable sum to be paid out to them. McAllen, although perhaps the most obvious example, was not alone in its overuse of medicine. Across the nation, patients in more expensive areas were less likely to receive low cost preventative procedures, and the more money spent per person on healthcare in a given state, the lower that particular state’s quality of healthcare ranking tended to be. It seems that the former president George W. Bush’s assertion that “the best healthcare decisions are not made by government and insurance companies, but by patients and their doctors” may not have been wholly accurate. The commercially oriented care being provided is not a part of the solution, but a part of the problem. This is not to say that all physicians are acting in a profiteering manner when ordering certain tests that may be both unnecessary and costly—malpractice lawsuits are growing out of control, and consequently the insurance physicians must pay to protect themselves from these lawsuits is also growing out of control. Additionally, physicians must be sure to order certain tests for certain conditions to protect themselves, a practice known as defensive medicine. To be fair to the liability concerns of physicians, tort reform must be present in any sort of reform legislation proposed.

The situation in place now is far too complicated and extensive to be explained in the confines of this post; however it is clear that reform is needed. Considering the recent acceleration in healthcare spending, the urgency of fixing a system that constitutes such a large portion of our national economy cannot be understated. This reform will need to bend the long term cost curve the opposite of the direction it’s currently headed. As well as being economically sound, the solution must also be ethically just.

In case you've been living under a rock for the past few days, a historic election just took place in Massachusetts, where the people voiced their opinion on the health bill that was making its way through Congress. By choosing Scott Brown, they had the opportunity to tell Washington that they did not approve of the way the situation was being handled. This healthcare bill, without the 60 senate votes needed, will now likely die.

It should.

To pass a bill so flawed just for the sake of passing it doesn't solve any problems at all. Truth be told, it may create many more problems down the road. This bill needed to die for the sake of the American people. While reform is important, it would be irresponsible to try and pass a bill that affects the entitlement to health for the entire American population. The election of Scott Brown should be seen as an opportunity for health care reform- for us to develop a bill that respects both those with low income and those with pre-existing conditions, and one that isn't politicized. While the healthcare reform bill is dead, healthcare reform it's self isn't. For lack of a better example, healthcare reform is taking a little nap. It will come back, refreshed and ready to go later.

You deserve better. It's your health that's at stake here.

veritas vos liberabit

Is there any party that conducts surveys regarding council's approval ratings? Also, if you would like to comment on what you think the results of such a survey would be, please feel free. I'm curious.

It goes without question that these are trying times for our country, both at home and abroad. When faced with such circumstances, it is the nature of the young and newly empowered eighteen to twenty-four year old demographic to question and protest the government. With these new issues at hand, especially the war in Iraq, the protest and distrust in government by the nation's younger demographic is comparable only to that of the youth of the 1960's and 70's. With a pivotal upcoming election, one that many feel will be one of the most important in our nation's history, the youth of this nation are presented with a chance through the democratic process to make a decision that will unquestionably shape the rest of their lives. It is still yet to be seen whether they will make a sound, conscientious decision based upon what is good for the continuity of the nation and for the preservation of its morals and institutions, or will we make an immature decision that wraps itself in our instinctual fear of that which represents power?
 

This period between the ages of eighteen and twenty-four in one's life is filled with uncertainty, invoking the instinctual need for reassurance of safety. In pursuance of this safety, one attacks anything and everything that may be of some threat to their still limited power. This leads to the distrust and attack of that which holds the greatest power relative to them, shown in history to be the government. Such instances as the French Revolution and the American Revolution proved to be well-founded revolts based upon gross exploitations of political power that were of a self-serving nature. Contemporary youth, ranging from the hippies of the sixties and seventies to today's modern protesting generation have seemed to protest not which could cause the most damage to the well being of the country, but that which most threatens their own self interests. These interests range from the preservation of their own lives to their financial standing.
 

Nobody wishes for war. It is the most ugly, primal quality of man that we have witnessed throughout history. Never is it "acceptable" for a man to kill another man, not even in war. However, when the safety of one's country is in jeopardy, it is necessary to act in this manner in order to ensure peace. With the threat of nuclear holocaust ever present, any suspicion that someone who wishes death to America is in the possession of weapons of mass destruction must be pursued. If peaceful means of resolving the issue are exhausted, one is left with no choice but to resort to the use of military force in order to maintain and ensure the continuity of the safety of the world as we know it. Although poorly executed and grossly mismanaged, and also based on faulty information, it was absolutely necessary to enter Iraq, and usurp a brutal regime that was well known to be in opposition to the values this country stands for. This, in conjunction with the looming possibility that this regime was also in possession of weapons that would cause mass death and destruction to America or it's allies, it was best to be proactive and ensure the safety of the country. War is protested because everyone naturally fears death. It is both the greatest certainty and uncertainty in life. Nobody knows when their time of death will come, how it will come, and nobody can be certain what happens to one's soul after one dies. It is certain, however, that it will come. It takes a special person to think that the collective life of the country, and the safety of its citizens, is worth the sacrifice of their own life.
 

The other most important and unfortunate quality of this generation is that they expect everything to always be fair and balanced. This, in such a dynamic world, is a nice ideal, but one that is impossible to ever attain. It does not behoove the well-being of the country to nationalize health insurance, or hand out welfare checks. John F. Kennedy said it best: "Ask not what your country can do for you, but ask what you can do for your country."
 

Nothing in this life should ever be socialistic in nature, because that would eliminate the human nature to compete. If everyone received the same thing regardless of how much money they made, or how much work they put forth, the nation would without doubt become extremely lethargic and the economy, sluggish. Nobody would ever hope to become anything better than average, because that's all they would receive in the end- guaranteed mediocrity. Although the gap between the wealthy and the poor is growing, it is not the fault of the federal government. Matters must be resolved by the wish of the wealthy to aid the poor, and for the poor to pursue a more affluent status. Handing out welfare checks without any questions as to whether or not the recipient is actively pursuing measures that will accelerate their accumulation of wealth is not going to be doing the recipient any good.
 

In hopes that the selection of our next president will steer our country in the right direction, it is necessary that the youth vote with careful consideration and truly know the issues at hand. We take our country into a brand new day, into uncharted territory with circumstances never seen before in history. We are at war with not a country, but with a loose affiliation of terrorist organizations. We are at war at home, growing increasingly divided as issues polarize into partisan issues. This is not the time to be arguing over such matters based on party lines. What this country is in need of is a strong, unified approach at addressing the issues. All we have to do is make the right choice- a choice based on sound contemplation, and hopefully for the betterment of the nation. We can no longer be divided into democrats and republicans, liberals and conservatives. We are all Americans, and we must make the right choice next November. Not a choice that will simply pull out of every military engagement, and socialize healthcare, but a choice that will carry our country further into the twenty-first century, while still holding true to its identity.