I respectfully disagree. There are other solutions, just none as seductively "simple" as single payor, which is anything but "simple."

There is little doubt that our insurance-driven health system is broken, but taking the path of least intellectual resistance is not the way to "fix" it - it will only substitute a whole bunch of new, more structural & intractible, problems for the old ones & it will just take another generation or two to figure out it was a mistake, when it will be damn near impossible to undo. It'll end up like social security or Medicare - "untouchable" politically.

Already, the single largest category of healthcare expenditures in the US is administration, overwhelming all other categories of actual health care combined. We already have way too many Chiefs and scarcely enough Indians. To think that giving over all our resources and control of all healthcare transactions to a centralized faceless bureaucracy, one whose only interest is in "properly husbanding taxpayer dollars" and which contributes absolutely nothing to anyone's health in any way shape or form, would be foolish at best, catastrophic at worst. None of the incentives built into our current financing system encourage efficiencty in health care. Quite the opposite - we hand over huge sums of money to huge companies whose sole objective at that point is to keep as much of it as they can, backed up by the law firm of Delay, Deny, Deny Again.

A mixed system of healthcare financing is what most Americans would prefer, according to the data I've seen. A great deal of what is broken about our employer-based and commercial health insurance system could be fixed rather easily by making fraud the only acceptable reason to refuse coverage to a customer and truly spreading the risk the way "insurance" was intended in the first place. What we have now is a bunch of companies in the "premium sales" business, each trying to cherry-pick their way to profits by excluding anyone with so much as a hangnail. Requiring availability of major medical (catastrophic) coverage and returning to the practice of community rating to determine premiums would finally put some real competition back in the insurance industry. Then all the companies would have to focus on managing their investment portfolios instead of trying to nickel & dime us to death. They'd save a ton just in the elimination of their "Pre-Existing Condition Investigation" Departments. The pooling of insurance underwriting information, except for cases of fraud, should be banned. We should also quit subsidizing the qualified Medicare plans when there's no evidence they provide better, let alone cheaper, services.

We could have an affordable multipayor system, with freedom of choice and incentives for real efficiency, with just those few changes. I doubt there are any politicians brave enough to do the right thing, unfortunately. It sounds so easy: simply create the US Ministry of Health & all our problems go away. If it sounds too good to be true, it usually is.

You are both right and wrong, Dr. Guy. Right in the sense that there is no real crisis of insurance coverage, but wrong about the erosive effects of our increasingly convoluted and micromanaged systems, both private & public. The Personal Physician, as the role was understood in 1980, is on the endangered species list. More later.

The Personal Physician, as the role was understood in 1980, is on the endangered species list.

I have a damnably good personal physician and I'm under Medicare!

There is not, nor will there ever be as long as any solution is devised and run by man and bureaucracies.

Yeah, like 400,000 insurance employees designed to nickel and dime or just plain reject health insurance claims.

Yeah, like 400,000 insurance employees designed to nickel and dime or just plain reject health insurance claims.

Replaced by a million government bureacrats with no incentive to get anything right.  At least those 400,000 have an incentive.  It is called profit, as there is more than one player in the game, so we can take our business to another one.  Not so when the government is the only game in town.

A mixed system of healthcare financing is what most Americans would prefer, according to the data I've seen. A great deal of what is broken about our employer-based and commercial health insurance system could be fixed rather easily by making fraud the only acceptable reason to refuse coverage to a customer and truly spreading the risk the way "insurance" was intended in the first place. What we have now is a bunch of companies in the "premium sales" business, each trying to cherry-pick their way to profits by excluding anyone with so much as a hangnail.

A fine statement that seems unwittingly to favor a fair system such as we now have with Medicare.

Employers now are already standing in line to unload this mess[think GM & UAW] in order to compete with foreign companies that do not carry health insurance. "Government requirements" are not as much a hindrance as private insurance.

By "profit" I trust you mean reasonable gain, but insurance is notorious for profiteering and rejecting legitimate claims.

Yes, and part 2 of that statement was why they can try to gouge, but will lose out in the end.  If a company is incompetant and rejecting claims just because they can, find another provider.

With the government, you dont have that choice.  Indeed, the only good thing about the government program is that it has spawned a whole industry of lawyers who do nothing but specialize in those type of cases.  And the money those lawyers get do nothing for treatment or for the patient, just fatten their pockets.  And that is on top of the inherant waste of a monopoly/government program.

If we didn't word our narratives just right, the government wouldn't pay.

A simple universal magnetic card swiped with the data of services is all that would be needed in single payer.

One would think, but the government doesn't work that way. For example, in one service I worked, if the patient was given oxygen, we had to write, "oxygen administered for patient's shortness of breath." If we wrote, "Patient had shortness of breath, so we gave him oxygen" medicare wouldn't pay. In the other service we didn't have to write out our reasoning for giving oxygen if it was to treat the chief complaint. In actuality, since administering oxygen is standard medical procedure for patients with shortness of breath, the only thing you would have to justify is if you decided not to administer it.

In othe words, nothing about the government requirement were based on medical standards or even logic. They were completely arbitrary requirements that did nothing more than increase the cost of doing business... and justify some government workers' jobs. Jobs that obviously don't need to exist, since they serve no real purpose.

Governments. Can't live without them, can't satisfy their intense need for paper.

Yes, and why the maritime Commission is located in WVa. Which has a Very LARGE coast I have been told.

Is this any way to treat an "honorable" senior citizen?