Let's consider things from THIS angle.
Supreme Irony: Would a 'single payer' health care plan be less vulnerable to the court than the Affordable Health Care Act?
Better yet, why get the government involved even more than it is? Think of the millions saved in legal costs alone.
This is an opinion piece, but…
Gosh. A great idea. Medicare is bankrupting the country, so let’s expand it to cover, however briefly, everyone. :rolleyes:
As someone (fast) approaching medicare age, I’m still trying to figure out where in the Constitution, the enumerated powers, it is?
I read this earlier in the week, and considered it to be highly unlikely.
Three words: Republican Controlled House.
No Medicare isn’t bankrupting the nation, that’s a straw dog argument those on the extreme right use, that is, until they need medicare for themselves or their parents.
However back to the article. Yes, the Court could rule Obama Care mandate as unconstitutional, because it has to do with private insurance companies profiting from the mandate.
A single payer universal system, would be run by the government, with government taxes so it would be constitutional.
Fact is, it’s what we should’ve gone with back when Hillary proposed it. Guess who opposed it and paid for the propaganda against it? The insurance companies who supported Obama Care.
But when Obama care came into being, it was a Democrat Controlled House and if the SCOTUS kills Obama Care, people may end up giving control back to the dems, as they see their kids being kicked off their insurance plans, and people being treated for cancer and other illnesses, find they’ve been dropped from coverage by their insurer.
Obama wanted single payer, but the Democrats in the Senate wouldn’t do it.
Trouble with single payer in this country is that it would become as politicized as SS and Medicare are, and likely just as overtultilized and insolvent. There is no question that Medicaid and Medicare are overutilized, and a single payer for everybody would undoubtedly be over utilized as well.
One could give some thought to the French system, which is about 2/3 public and 1/3 private. Overutilization had been a serious problem with the public part, but they more or less solved it by requiring that patients pay up front, then bill the government for reimbursement. There are deductibles similar to the deductibles in American insurance plans. Local plans deal with the indigent who can’t pay up front. Illegals can get care, but they have to pay for it 100%. The government reimburses nothing.
Doctors’ education is paid for by the government. So is malpractice insurance. Malpractice cases are always court-tried by specially educated judges. Malpractice attorneys can only charge hourly fees. They don’t get a piece of the judgment.
That’s in the public sector.
In the private sector, doctors can charge what they want to charge. People pay in cash or with private insurance. Those doctors pay their own malpractice insurance. Not too surprisingly, some of the highest skilled doctors are in the private sector.
Hospitals alone directly bill the government, but that has led to ER overutilization. The French were working on fixing that, but I don’t know if they ever did.
Doctors in France in the public sector make about 40% what American doctors do and, of course, taxes in France are considerably higher than here. So, being a doctor in France is a cornbread living unless you’re in the private sector. One has to wonder whether the public sector doctors are the 'best and the brightest", but when wages are controlled, that’s always a risk in anything. France contracts or expands the number of medical students based on perceived need, and obviously that affects admission standards.
Something our own country could do with some good effect without going “all French” is to curb malpractice suits in a manner similar to that of France, aid medical education and require more openings in medical schools if the universities are receiving federal money at all…which all do. Presently, universities control the number of physicians. Medical schools are money losers, and the other students subsidize them, particularly the law schools, which has led to ever-expanding numbers of lawyers who don’t know anything and can’t get a job even if they do. But even so, universities are profligate with money; something else that ought to be addressed by government, but isn’t. It really is a government problem because now that the government has taken over student loan programs and because there seems to be a serious overhang of people unable to pay their student loans, the government ought to get serious about requiring better results for the money it hands to universities.
Medicare, too, needs reform. In some places (like here) medicare is highly profitable for hospitals and clinics, both of which “gold plate” their facilities and compensation packages shamelessly. Medicare reimbursement is political in the sense that providers are allowed to “build in” their costs into the reimbursement formula; something that encourages “gold plating” in the places where it can be made to pay. Being well connected matters in that game.
Finally, I would like to see NPs allowed to have their own practices nationwide. It would also help if NP programs were “decoupled” from aspects of Masters’ degree programs that are actually geared to teaching nurses. There is, for instance, no point at all in requiring that NPs publish theses. It could be helpful as well if NPs could transition into special MD programs with less difficulty. Some NPs do that,but it helps little to have been an NP, essentially practicing medicine for perhaps years, if one is going to complete a medical education. Allowing for easier transition would allow them to make some money as they went along to aid in their own educations, instead of taking them right out of college, often penniless, so they can graduate from medical school owing $300,000 that has to be paid later in their charges.