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ehrnst

(32,640 posts)
Thu Oct 27, 2016, 08:50 AM Oct 2016

Which Countries Have Single-Payer Health Systems?

There seem to be many here who are under the impression that "all other developed countries" have implemented Single Payer or some form of it. That misconceptin seems to be the a basis for the claim that "single payer" the only model which could possibly manage health care costs and coverage in the US.


Which Countries Have Single-Payer Health Systems?

There are fewer than many people might think. Most European countries either never had or no longer have single-payer systems. "Most are basically what we call social insurance systems," says Gerard Anderson, a professor at Johns Hopkins Bloomberg School of Public Health who has studied international health systems. Social insurance programs ensure that almost everyone is covered. They are taxpayer-funded but aren't necessarily run by the government.

Germany, for example, has 135 "sickness funds," which are essentially private, nonprofit insurance plans that negotiate prices with health care providers. "So you have 135 funds to choose from," said Anderson.

Nearby, Switzerland and the Netherlands require their residents to have private insurance (just like the Affordable Care Act does), with subsidies to help those who cannot otherwise afford coverage.

And while conservatives in the United States often use Great Britain's National Health Service as the poster child for a socialized system, there are many private insurance options available to residents there, too.

As far as countries that have true single-payer systems, Anderson lists only two: Canada and Taiwan.
...............................................................................................................................................

Are Single-Payer Plans Less Expensive Than Other Health Coverage Systems?

Not necessarily. True, eliminating the profits and duplicative administrative costs associated with hundreds of different private insurance plans would reduce spending, perhaps as much as 10 percent of the nation's $3 trillion annual health care bill, says Anderson. But, he notes, once those savings are achieved, there wouldn't be further reductions afterward.

More important, as many analysts have noted, is how much health services cost and how those prices are determined. In most other developed countries, even those with private insurance, writes Princeton health economist Uwe Reinhardt, prices "either are set by government or negotiated between associations of insurers and providers of care on a regional, state or national basis." By contrast, in the U.S., "the payment side of the health care market in the private sector is fragmented, weakening the bargaining power of individual insurers."

Would Medicare For All Be Just Like The Existing Medicare Program?

No, at least not as Sanders envisions it. Medicare is not nearly as generous as many people think. Between premiums (for doctor and drug coverage), cost-sharing (deductibles and coinsurance), and items Medicare does not cover at all (most dental, hearing and eye care), the average Medicare beneficiary still devotes an estimated 14 percent of all household spending to health care.

Sanders' plan would be far more generous, including dental, vision, hearing, mental health and long-term care, all without copays or deductibles (which has given rise to a lively debate about how to pay for it and whether middle-class families will save money or pay more).




http://www.npr.org/sections/health-shots/2016/01/22/463976098/debate-sharpens-over-single-payer-health-care-but-what-is-it-exactly

72 replies = new reply since forum marked as read
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Which Countries Have Single-Payer Health Systems? (Original Post) ehrnst Oct 2016 OP
Single-payer was always a compromise for me. LWolf Oct 2016 #1
Then this post isn't referencing you. Many others here on DU, yes. ehrnst Oct 2016 #2
+1 NCTraveler Oct 2016 #8
And I would like every house in the country to be fitted with Solar Panels or wind turbines. ehrnst Oct 2016 #13
ok. nt. NCTraveler Oct 2016 #16
It does however, allow us a collective and efficient goal to reach... LanternWaste Oct 2016 #20
Yes, the goal of universal health coverage doesn't need to require single payer ehrnst Oct 2016 #30
No. A single payer system is essential. Anderson agrees. kristopher Oct 2016 #36
Anderson was talking about the "medicare for all" proposals of 2016 ehrnst Oct 2016 #39
I let him speak for himself - in context. kristopher Oct 2016 #40
Again - this is from 2011. ehrnst Oct 2016 #45
"Because, in most other countries they have a single purchaser, which is a very tough negotiator" kristopher Oct 2016 #48
This message was self-deleted by its author ehrnst Oct 2016 #53
You can paste the same thing again and again until you are blue in the face... ehrnst Oct 2016 #54
"Because, in most other countries they have a single purchaser, which is a very tough negotiator" kristopher Oct 2016 #57
What part of that refutes what I said? ehrnst Oct 2016 #58
And just that one thing LWolf Oct 2016 #66
It would be huge. NCTraveler Oct 2016 #67
Me too tazkcmo Oct 2016 #55
What right-wing garbage is this? BlueStreak Oct 2016 #3
Well first off - it's not garbage, and it's not right wing ehrnst Oct 2016 #5
Here is Anderson in an interview saying single payer is how to reduce costs kristopher Oct 2016 #29
That's from five years ago. The OP article discusses "Medicare for All" proposals in this election ehrnst Oct 2016 #31
The point of your article is the same as it always is, to misrepresent the idea and role of SP. kristopher Oct 2016 #33
I guess that's one way to try discredit something that you don't agree with ehrnst Oct 2016 #34
You are misrepresenting the meaning of Anderson's writing. kristopher Oct 2016 #37
What part of "not all nations in Europe have or have had single payer" ehrnst Oct 2016 #41
The posters you are arguing with are arguing for exactly what Anderson endorses. kristopher Oct 2016 #46
That's where you are misunderstanding. ehrnst Oct 2016 #51
"Because, in most other countries they have a single purchaser, which is a very tough negotiator" kristopher Oct 2016 #56
What part of that refutes what I said? ehrnst Oct 2016 #59
Screaming that something is right wing garbage doesn't make you right mythology Oct 2016 #23
There is not a shred of evicence that our private insurance system contributes one iota BlueStreak Oct 2016 #25
You have to be aware of terms: single payer is not necessarily universal health coverage mnhtnbb Oct 2016 #4
Good luck. You're guilty of "sophistry" now, like me. ehrnst Oct 2016 #42
Mere sophistry whatthehey Oct 2016 #6
Not everybody here "knows" And are you accusing me of lying or the NPR reporter?(nt) ehrnst Oct 2016 #7
Please cite the accusation of lying. whatthehey Oct 2016 #9
"Mere Sophistry" ehrnst Oct 2016 #11
Read deeper whatthehey Oct 2016 #18
Why don't you 'splain it to me. ehrnst Oct 2016 #19
Seems accurate. LanternWaste Oct 2016 #21
It may be ignorance from the NPR reporter or those spreading this stuff. Or BlueStreak Oct 2016 #26
Or you may simply think that anything that doesn't validate a particular veiw ehrnst Oct 2016 #32
I consider to be 'single payer'.. sendero Oct 2016 #10
You can make up your own definition for any word. But that doesn't change the reality of it. ehrnst Oct 2016 #12
Well if someone is controlling... sendero Oct 2016 #15
And to a Tea Partier, if something is federally regulated.... ehrnst Oct 2016 #17
Sender's point is correct. The author of the OP snip agrees... kristopher Oct 2016 #44
From 2011, and not addressing the points that the OP made ehrnst Oct 2016 #47
"Because, in most other countries they have a single purchaser, which is a very tough negotiator" kristopher Oct 2016 #49
I guess that means you're done copying and pasting the same thing that doesn't address my post? ehrnst Oct 2016 #52
"We're done" I suppose that's a 'mic' drop... ehrnst Oct 2016 #61
we need accessible, nonprofit, universal health care at little or no direct cost to patients.... mike_c Oct 2016 #14
I think universal healthcare is THE goal ismnotwasm Oct 2016 #22
Apparently to believe this = "sophistry" ehrnst Oct 2016 #38
True. There is not a magic way to universal healthcare ismnotwasm Oct 2016 #62
Tempting to simply declare that there is one simple answer to a complicated issue ehrnst Oct 2016 #63
The USA is the only country in the western hemisphere without a single payer Warpy Oct 2016 #27
Actually no. According to the OP Canada is the only country with true Single Payer ehrnst Oct 2016 #50
Canada is unique in how it set was up. roamer65 Oct 2016 #69
Arguments about language and definitions are a very deliberate distraction. hunter Oct 2016 #28
this ^^^^^^^^^^ Grey Lemercier Oct 2016 #43
Words mean things. Specific things. If you want to discuss them, you should know what they mean. ehrnst Oct 2016 #60
Where did I say Obamacare was socialism? hunter Oct 2016 #64
That was an analogy. ehrnst Oct 2016 #65
The article is FUD. It's not reporting "debate" about Single Payer at all. hunter Oct 2016 #68
To start with - You have made a major mistake in which foundation your are talking about ehrnst Oct 2016 #70
Ooops. Me, off on a wild google chase again... hunter Oct 2016 #71
Good to see that you now have the correct foundation ehrnst Oct 2016 #72
Dec 1969 #

LWolf

(46,179 posts)
1. Single-payer was always a compromise for me.
Thu Oct 27, 2016, 08:55 AM
Oct 2016

Let me state the goal clearly:

I want universal, not-for-profit, free at point of service, high quality and easily accessible health CARE funded 100% by taxes.

And let me be especially clear: What I want has nothing to do with health insurance or how health care is delivered in any other country. It has to do with recognizing health care as a right, and providing it free from all obstacles.

 

NCTraveler

(30,481 posts)
8. +1
Thu Oct 27, 2016, 09:48 AM
Oct 2016

"I want universal, not-for-profit, free at point of service, high quality and easily accessible health CARE funded 100% by taxes."

 

ehrnst

(32,640 posts)
13. And I would like every house in the country to be fitted with Solar Panels or wind turbines.
Thu Oct 27, 2016, 10:04 AM
Oct 2016

But that doesn't make the problem of global warming go away in the meantime.

 

LanternWaste

(37,748 posts)
20. It does however, allow us a collective and efficient goal to reach...
Thu Oct 27, 2016, 11:51 AM
Oct 2016

"that doesn't make the problem of global warming go away in the meantime..."

It does however, allow us a collective and efficient goal to reach. You see, to reduce or overcome a problem, a solution (or "goal&quot is first necessary and from that, appropriate and effective steps are then taken.

 

ehrnst

(32,640 posts)
30. Yes, the goal of universal health coverage doesn't need to require single payer
Thu Oct 27, 2016, 03:26 PM
Oct 2016

any more than concrete steps to reduce global warming requires all home being fitted with solar or wind in the next four years.

kristopher

(29,798 posts)
36. No. A single payer system is essential. Anderson agrees.
Thu Oct 27, 2016, 03:47 PM
Oct 2016

You cherry picked a discussion where he's looking at "pure" systems. However his writings are crystal clear - the transactional process must imbue primacy in the hands of the payer. Such systems are, correctly, commonly referred to as "single payer".

The medical industry must be changed into price takers, not price setters. Single payer is the way to do that.

'It's the Prices, Stupid': An Interview with Health Policy Expert Gerard Anderson

By Gerard Anderson, Elizabeth Palmberg
Sojourners, June 2011

Sojourners: What are some of the most important causes for why the U.S. is paying a lot more than other wealthy countries for health care without getting improved results?

Anderson: A higher health-care cost is pretty much because of what I call, “It’s prices, stupid.” We just pay approximately twice as much for each good and service that we utilize in the U.S. vis-a-vis other industrial countries. In fact, for a hospital visit it’s about three times more than other industrialized countries for a similar visit — in a shorter period of time that you’re in the hospital, we still spend about three times more. So it seems to be that we just pay more for identical services compared to other industrialized countries.

Sojourners: Why?

Anderson: Because, in most other countries they have a single purchaser, which is a very tough negotiator, whereas in the United States we have so many different purchasers that nobody has a lot of power.

Sojourners: If you didn’t have to think about political realities at all, what health-care policies would you suggest the U.S. adopt?

Anderson: Basically, that everybody has the same health care and access to the same health care.

Sojourners: Through a single-payer system?

Anderson: Well, that’s the payment side. And then access to the same delivery system as well.

Sojourners: So, both single-payer and a standardized quality of care?

Anderson: Correct.


https://sojo.net/magazine/june-2011/its-prices-stupid-interview-health-policy-expert-gerard-anderson
 

ehrnst

(32,640 posts)
39. Anderson was talking about the "medicare for all" proposals of 2016
Thu Oct 27, 2016, 03:50 PM
Oct 2016

And stated that Single Payer is not the only way that Europe has dealt with universal health care.

Is that incorrect?

kristopher

(29,798 posts)
40. I let him speak for himself - in context.
Thu Oct 27, 2016, 03:51 PM
Oct 2016
'It's the Prices, Stupid': An Interview with Health Policy Expert Gerard Anderson

By Gerard Anderson, Elizabeth Palmberg
Sojourners, June 2011

Sojourners: What are some of the most important causes for why the U.S. is paying a lot more than other wealthy countries for health care without getting improved results?

Anderson: A higher health-care cost is pretty much because of what I call, “It’s prices, stupid.” We just pay approximately twice as much for each good and service that we utilize in the U.S. vis-a-vis other industrial countries. In fact, for a hospital visit it’s about three times more than other industrialized countries for a similar visit — in a shorter period of time that you’re in the hospital, we still spend about three times more. So it seems to be that we just pay more for identical services compared to other industrialized countries.

Sojourners: Why?

Anderson: Because, in most other countries they have a single purchaser, which is a very tough negotiator, whereas in the United States we have so many different purchasers that nobody has a lot of power.

Sojourners: If you didn’t have to think about political realities at all, what health-care policies would you suggest the U.S. adopt?

Anderson: Basically, that everybody has the same health care and access to the same health care.

Sojourners: Through a single-payer system?

Anderson: Well, that’s the payment side. And then access to the same delivery system as well.

Sojourners: So, both single-payer and a standardized quality of care?

Anderson: Correct.


https://sojo.net/magazine/june-2011/its-prices-stupid-interview-health-policy-expert-gerard-anderson
 

ehrnst

(32,640 posts)
45. Again - this is from 2011.
Thu Oct 27, 2016, 04:00 PM
Oct 2016

And the points that he makes about how people seem to think that "single payer" is common, and that the "medicare for all" proposals proposed in 2016 covered far more than medicare covers are well within context.




As far as countries that have true single-payer systems, Anderson lists only two: Canada and Taiwan.


Are Single-Payer Plans Less Expensive Than Other Health Coverage Systems?

Not necessarily. True, eliminating the profits and duplicative administrative costs associated with hundreds of different private insurance plans would reduce spending, perhaps as much as 10 percent of the nation's $3 trillion annual health care bill, says Anderson. But, he notes, once those savings are achieved, there wouldn't be further reductions afterward.

More important, as many analysts have noted, is how much health services cost and how those prices are determined. In most other developed countries, even those with private insurance, writes Princeton health economist Uwe Reinhardt, prices "either are set by government or negotiated between associations of insurers and providers of care on a regional, state or national basis." By contrast, in the U.S., "the payment side of the health care market in the private sector is fragmented, weakening the bargaining power of individual insurers."

Would Medicare For All Be Just Like The Existing Medicare Program?

No, at least not as Sanders envisions it. Medicare is not nearly as generous as many people think. Between premiums (for doctor and drug coverage), cost-sharing (deductibles and coinsurance), and items Medicare does not cover at all (most dental, hearing and eye care), the average Medicare beneficiary still devotes an estimated 14 percent of all household spending to health care.

Sanders' plan would be far more generous, including dental, vision, hearing, mental health and long-term care, all without copays or deductibles (which has given rise to a lively debate about how to pay for it and whether middle-class families will save money or pay more).



kristopher

(29,798 posts)
48. "Because, in most other countries they have a single purchaser, which is a very tough negotiator"
Thu Oct 27, 2016, 04:03 PM
Oct 2016
'It's the Prices, Stupid': An Interview with Health Policy Expert Gerard Anderson

By Gerard Anderson, Elizabeth Palmberg
Sojourners, June 2011

Sojourners: What are some of the most important causes for why the U.S. is paying a lot more than other wealthy countries for health care without getting improved results?

Anderson: A higher health-care cost is pretty much because of what I call, “It’s prices, stupid.” We just pay approximately twice as much for each good and service that we utilize in the U.S. vis-a-vis other industrial countries. In fact, for a hospital visit it’s about three times more than other industrialized countries for a similar visit — in a shorter period of time that you’re in the hospital, we still spend about three times more. So it seems to be that we just pay more for identical services compared to other industrialized countries.

Sojourners: Why?

Anderson: Because, in most other countries they have a single purchaser, which is a very tough negotiator, whereas in the United States we have so many different purchasers that nobody has a lot of power.

Sojourners: If you didn’t have to think about political realities at all, what health-care policies would you suggest the U.S. adopt?

Anderson: Basically, that everybody has the same health care and access to the same health care.

Sojourners: Through a single-payer system?

Anderson: Well, that’s the payment side. And then access to the same delivery system as well.

Sojourners: So, both single-payer and a standardized quality of care?

Anderson: Correct.


https://sojo.net/magazine/june-2011/its-prices-stupid-interview-health-policy-expert-gerard-anderson

Response to kristopher (Reply #48)

 

ehrnst

(32,640 posts)
54. You can paste the same thing again and again until you are blue in the face...
Thu Oct 27, 2016, 04:25 PM
Oct 2016

But you seem to have ignored my original post - because your rants aren't in response to it.

Here it is again, because it seems to be the one thing you haven't actually addressed with all the pasting:

There seem to be many here who are under the impression that "all other developed countries" have implemented Single Payer or some form of it. That misconception seems to be the a basis for the claim that "single payer" the only model which could possibly manage health care costs and coverage in the US.



Perhaps that will clear up what I meant or inferred, or didn't infer or made me guilty of "sophistry."

Or perhaps not, judging by your repeated copy and paste of something that doesn't refute it at all.

Mansplaining is the same no matter what your gender.

kristopher

(29,798 posts)
57. "Because, in most other countries they have a single purchaser, which is a very tough negotiator"
Thu Oct 27, 2016, 04:39 PM
Oct 2016
"Because, in most other countries they have a single purchaser, which is a very tough negotiator"

Anderson's comments in both articles are consistent (note the tough negotiator part of the message). Your position arguing against those here who espouse the same thing as Anderson show clearly that you are either trying to distort his message or don't understand what you are reading.
 

ehrnst

(32,640 posts)
58. What part of that refutes what I said?
Thu Oct 27, 2016, 07:47 PM
Oct 2016

And I thought "we were done."

I guess I should be flattered....

 

NCTraveler

(30,481 posts)
67. It would be huge.
Fri Oct 28, 2016, 02:46 PM
Oct 2016

I really thought the story of the decade with respect to healthcare was "we just didn't realize how sick people without health insurance were."

That statement is something most of us knew.

 

BlueStreak

(8,377 posts)
3. What right-wing garbage is this?
Thu Oct 27, 2016, 09:05 AM
Oct 2016

The fact is that single payer is a very well used solution world wide. Here is a partial list:
https://truecostblog.com/2009/08/09/countries-with-universal-healthcare-by-date/

And you will notice that every last single-payer country has better health outcomes and lower costs than the US.

 

ehrnst

(32,640 posts)
5. Well first off - it's not garbage, and it's not right wing
Thu Oct 27, 2016, 09:26 AM
Oct 2016

And the definition of what is considered to fall in the bounds of "single payer" is not included in your link, perhaps because the writer of that blog is a software engineer who studied economics in college, and not a health policy analyst.


"Gerard Anderson, a professor at Johns Hopkins Bloomberg School of Public Health who has studied international health systems."

"True Cost is written by Praveen Ghanta. I grew up in Louisiana (which explains the occasional La.-related post), studied economics and computer science at MIT in Boston, worked in New York for a while, and now call Atlanta home."





kristopher

(29,798 posts)
29. Here is Anderson in an interview saying single payer is how to reduce costs
Thu Oct 27, 2016, 02:42 PM
Oct 2016

'It's the Prices, Stupid': An Interview with Health Policy Expert Gerard Anderson

By Gerard Anderson, Elizabeth Palmberg
Sojourners, June 2011

Sojourners: What are some of the most important causes for why the U.S. is paying a lot more than other wealthy countries [in the OECD] for health care without getting improved results?

Anderson: A higher health-care cost is pretty much because of what I call, “It’s prices, stupid.” We just pay approximately twice as much for each good and service that we utilize in the U.S. vis-a-vis other industrial countries. In fact, for a hospital visit it’s about three times more than other industrialized countries for a similar visit — in a shorter period of time that you’re in the hospital, we still spend about three times more. So it seems to be that we just pay more for identical services compared to other industrialized countries.

Sojourners: Why?

Anderson: Because, in most other countries they have a single purchaser, which is a very tough negotiator, whereas in the United States we have so many different purchasers that nobody has a lot of power.

Sojourners: If you didn’t have to think about political realities at all, what health-care policies would you suggest the U.S. adopt?

Anderson: Basically, that everybody has the same health care and access to the same health care.

Sojourners: Through a single-payer system?

Anderson: Well, that’s the payment side. And then access to the same delivery system as well.

Sojourners: So, both single-payer and a standardized quality of care?

Anderson: Correct.

https://sojo.net/magazine/june-2011/its-prices-stupid-interview-health-policy-expert-gerard-anderson

 

ehrnst

(32,640 posts)
31. That's from five years ago. The OP article discusses "Medicare for All" proposals in this election
Thu Oct 27, 2016, 03:32 PM
Oct 2016

Are Single-Payer Plans Less Expensive Than Other Health Coverage Systems?

Not necessarily. True, eliminating the profits and duplicative administrative costs associated with hundreds of different private insurance plans would reduce spending, perhaps as much as 10 percent of the nation's $3 trillion annual health care bill, says Anderson. But, he notes, once those savings are achieved, there wouldn't be further reductions afterward.

More important, as many analysts have noted, is how much health services cost and how those prices are determined. In most other developed countries, even those with private insurance, writes Princeton health economist Uwe Reinhardt, prices "either are set by government or negotiated between associations of insurers and providers of care on a regional, state or national basis." By contrast, in the U.S., "the payment side of the health care market in the private sector is fragmented, weakening the bargaining power of individual insurers."

Would Medicare For All Be Just Like The Existing Medicare Program?

No, at least not as Sanders envisions it. Medicare is not nearly as generous as many people think. Between premiums (for doctor and drug coverage), cost-sharing (deductibles and coinsurance), and items Medicare does not cover at all (most dental, hearing and eye care), the average Medicare beneficiary still devotes an estimated 14 percent of all household spending to health care.

Sanders' plan would be far more generous, including dental, vision, hearing, mental health and long-term care, all without copays or deductibles (which has given rise to a lively debate about how to pay for it and whether middle-class families will save money or pay more).



And the point of my article was that there is a misconception that most countries in Europe have or did have single payer.

Is that clearer?

kristopher

(29,798 posts)
33. The point of your article is the same as it always is, to misrepresent the idea and role of SP.
Thu Oct 27, 2016, 03:40 PM
Oct 2016

You're a one trick pony.

"Sophistry" is precisely the correct word for your style.

 

ehrnst

(32,640 posts)
34. I guess that's one way to try discredit something that you don't agree with
Thu Oct 27, 2016, 03:43 PM
Oct 2016

This is like trying to argue with someone who is convinced that shutting down Planned Parenthood will reduce abortions, despite what health policy experts say, because they have this sacred cow of an idea that they won't turn loose of.

Or anti-vaxers.

I'll trust the healthy policy people, thanks.

I think I'll leave the "sophistry" to you.

 

ehrnst

(32,640 posts)
41. What part of "not all nations in Europe have or have had single payer"
Thu Oct 27, 2016, 03:52 PM
Oct 2016

and the "Medicare for All proposed in 2016 is more comprehensive and expensive than acutal medicare" was misinterpreted?

kristopher

(29,798 posts)
46. The posters you are arguing with are arguing for exactly what Anderson endorses.
Thu Oct 27, 2016, 04:01 PM
Oct 2016

With that piece you are promoting, you are attempting to make it seem he is not in favor of a single payer system. That is an exemplar for someone engaging in sophistry.

'It's the Prices, Stupid': An Interview with Health Policy Expert Gerard Anderson

By Gerard Anderson, Elizabeth Palmberg
Sojourners, June 2011

Sojourners: What are some of the most important causes for why the U.S. is paying a lot more than other wealthy countries for health care without getting improved results?

Anderson: A higher health-care cost is pretty much because of what I call, “It’s prices, stupid.” We just pay approximately twice as much for each good and service that we utilize in the U.S. vis-a-vis other industrial countries. In fact, for a hospital visit it’s about three times more than other industrialized countries for a similar visit — in a shorter period of time that you’re in the hospital, we still spend about three times more. So it seems to be that we just pay more for identical services compared to other industrialized countries.

Sojourners: Why?

Anderson: Because, in most other countries they have a single purchaser, which is a very tough negotiator, whereas in the United States we have so many different purchasers that nobody has a lot of power.

Sojourners: If you didn’t have to think about political realities at all, what health-care policies would you suggest the U.S. adopt?

Anderson: Basically, that everybody has the same health care and access to the same health care.

Sojourners: Through a single-payer system?

Anderson: Well, that’s the payment side. And then access to the same delivery system as well.

Sojourners: So, both single-payer and a standardized quality of care?

Anderson: Correct.


https://sojo.net/magazine/june-2011/its-prices-stupid-interview-health-policy-expert-gerard-anderson
 

ehrnst

(32,640 posts)
51. That's where you are misunderstanding.
Thu Oct 27, 2016, 04:13 PM
Oct 2016

"you are attempting to make it seem he is not in favor of a single payer system."

No, I never did. You jumped to that conclusion.

Look at the title of my OP. OK?

Now, look at the actual text that I pulled from the article - it talks about Single Payer and that it would cost more than it would in the two other countries where it has been implemented. (I can copy and paste too!)

Which Countries Have Single-Payer Health Systems?

There are fewer than many people might think. Most European countries either never had or no longer have single-payer systems. "Most are basically what we call social insurance systems," says Gerard Anderson, a professor at Johns Hopkins Bloomberg School of Public Health who has studied international health systems. Social insurance programs ensure that almost everyone is covered. They are taxpayer-funded but aren't necessarily run by the government.

Germany, for example, has 135 "sickness funds," which are essentially private, nonprofit insurance plans that negotiate prices with health care providers. "So you have 135 funds to choose from," said Anderson.

Nearby, Switzerland and the Netherlands require their residents to have private insurance (just like the Affordable Care Act does), with subsidies to help those who cannot otherwise afford coverage.

And while conservatives in the United States often use Great Britain's National Health Service as the poster child for a socialized system, there are many private insurance options available to residents there, too.

As far as countries that have true single-payer systems, Anderson lists only two: Canada and Taiwan.



Are Single-Payer Plans Less Expensive Than Other Health Coverage Systems?

Not necessarily. True, eliminating the profits and duplicative administrative costs associated with hundreds of different private insurance plans would reduce spending, perhaps as much as 10 percent of the nation's $3 trillion annual health care bill, says Anderson. But, he notes, once those savings are achieved, there wouldn't be further reductions afterward.

More important, as many analysts have noted, is how much health services cost and how those prices are determined. In most other developed countries, even those with private insurance, writes Princeton health economist Uwe Reinhardt, prices "either are set by government or negotiated between associations of insurers and providers of care on a regional, state or national basis." By contrast, in the U.S., "the payment side of the health care market in the private sector is fragmented, weakening the bargaining power of individual insurers."


Is that clearer?

kristopher

(29,798 posts)
56. "Because, in most other countries they have a single purchaser, which is a very tough negotiator"
Thu Oct 27, 2016, 04:34 PM
Oct 2016

Anderson's comments in both articles are consistent (note the tough negotiator part of the message). Your position arguing against those here who espouse the same thing as Anderson show clearly that you are either trying to distort his message or don't understand what you are reading.

 

ehrnst

(32,640 posts)
59. What part of that refutes what I said?
Thu Oct 27, 2016, 07:48 PM
Oct 2016

And I thought you said "We were done."

I guess I should be flattered....

 

mythology

(9,527 posts)
23. Screaming that something is right wing garbage doesn't make you right
Thu Oct 27, 2016, 12:58 PM
Oct 2016

Likewise refusing to believe facts doesn't make you right.

Oh and most of of that lower life expectancy is related to factors outside of healthcare like car accidents and and gun deaths. We lead the world in 5 year year life expectancy for common cancers like breast and colon cancer. That costs money as it's high cost both drug and provider fronts.

 

BlueStreak

(8,377 posts)
25. There is not a shred of evicence that our private insurance system contributes one iota
Thu Oct 27, 2016, 01:53 PM
Oct 2016

to the fact that the US does well treating certain diseases. This is a tribute to the researchers, not the insurance system.

mnhtnbb

(31,319 posts)
4. You have to be aware of terms: single payer is not necessarily universal health coverage
Thu Oct 27, 2016, 09:21 AM
Oct 2016

Here is a list of countries which have universal health coverage --sometimes achieved by a combination of public/private coverage

https://en.wikipedia.org/wiki/Universal_health_coverage_by_country


And yes, Medicare can be very costly. Both my husband and I are on it and we have gap insurance provided by a BCBS Federal plan,
for which we pay substantial premiums. We also have premiums for Medicare Part A and B deducted from our SS monthly payments.

I just had $3,000. worth of dental work done--removing old fillings and replacing them with crowns--not a penny of it was covered by either
Medicare or our BCBS Federal plan. That's outrageous.

Our goal should be universal health coverage as defined by the World Health Organization

Universal health coverage (UHC) means that all people receive the health services they need without suffering financial hardship when paying for them. The full spectrum of essential, quality health services should be covered including health promotion, prevention and treatment, rehabilitation and palliative care.


http://www.who.int/mediacentre/factsheets/fs395/en/

whatthehey

(3,660 posts)
6. Mere sophistry
Thu Oct 27, 2016, 09:35 AM
Oct 2016

Yes yes yes another person rushing in to breathlessly tell us the "news" that most other industrialized democracies have health care funded from various sources by various mechanisms. We know. But what they almost all also have is coverage for everyone with nominal point of use costs, largely funded through taxation (for example those supposedly "private" German funds are 77% TAX-FUNDED). Don't give a flying fuck what somebody tries to twist that into as far as definitions go, let's get it here too.

 

ehrnst

(32,640 posts)
11. "Mere Sophistry"
Thu Oct 27, 2016, 10:02 AM
Oct 2016

the use of fallacious arguments, especially with the intention of deceiving. a fallacious argument.

 

BlueStreak

(8,377 posts)
26. It may be ignorance from the NPR reporter or those spreading this stuff. Or
Thu Oct 27, 2016, 01:57 PM
Oct 2016

ir may be the fact that the NPR / PBS system has moved far right over the past 20 years under incessant pressure from the biggest corporations and their friends.

There are still some worthwhile programs on NPR, but most of the news coverage has followed the money. Honestly, the news department of my local Fox affiliate is more balanced than NPR these days.

 

ehrnst

(32,640 posts)
32. Or you may simply think that anything that doesn't validate a particular veiw
Thu Oct 27, 2016, 03:37 PM
Oct 2016

is ignorance or "going Right."

Maybe the facts are somewhere that are not where you expect them to be.

This is like trying to talk to anti-vaxxers.

sendero

(28,552 posts)
10. I consider to be 'single payer'..
Thu Oct 27, 2016, 09:51 AM
Oct 2016

.... any system whereby the providers/doctors/pharma cannot simply name any price they want to, like they do in the US at present.

And yes, single payer is the only way to bring costs under control. Until we have it, we'll be paying $600 for a $20 epi pen, and other ridiculous prices as well.

 

ehrnst

(32,640 posts)
12. You can make up your own definition for any word. But that doesn't change the reality of it.
Thu Oct 27, 2016, 10:03 AM
Oct 2016

Republicans 'considered' the ACA to be "Socialism."

sendero

(28,552 posts)
15. Well if someone is controlling...
Thu Oct 27, 2016, 10:05 AM
Oct 2016

.. the prices paid, it is BY DEFINITION a single payer system.

 

ehrnst

(32,640 posts)
17. And to a Tea Partier, if something is federally regulated....
Thu Oct 27, 2016, 10:34 AM
Oct 2016

then by their definition, it's SOCIALISM.

Single PAYER is exactly that - all costs are paid by one entity.

kristopher

(29,798 posts)
44. Sender's point is correct. The author of the OP snip agrees...
Thu Oct 27, 2016, 03:57 PM
Oct 2016
'It's the Prices, Stupid': An Interview with Health Policy Expert Gerard Anderson

By Gerard Anderson, Elizabeth Palmberg
Sojourners, June 2011

Sojourners: What are some of the most important causes for why the U.S. is paying a lot more than other wealthy countries for health care without getting improved results?

Anderson: A higher health-care cost is pretty much because of what I call, “It’s prices, stupid.” We just pay approximately twice as much for each good and service that we utilize in the U.S. vis-a-vis other industrial countries. In fact, for a hospital visit it’s about three times more than other industrialized countries for a similar visit — in a shorter period of time that you’re in the hospital, we still spend about three times more. So it seems to be that we just pay more for identical services compared to other industrialized countries.

Sojourners: Why?

Anderson: Because, in most other countries they have a single purchaser, which is a very tough negotiator, whereas in the United States we have so many different purchasers that nobody has a lot of power.

Sojourners: If you didn’t have to think about political realities at all, what health-care policies would you suggest the U.S. adopt?

Anderson: Basically, that everybody has the same health care and access to the same health care.

Sojourners: Through a single-payer system?

Anderson: Well, that’s the payment side. And then access to the same delivery system as well.

Sojourners: So, both single-payer and a standardized quality of care?

Anderson: Correct.


https://sojo.net/magazine/june-2011/its-prices-stupid-interview-health-policy-expert-gerard-anderson
 

ehrnst

(32,640 posts)
47. From 2011, and not addressing the points that the OP made
Thu Oct 27, 2016, 04:03 PM
Oct 2016

As far as countries that have true single-payer systems, Anderson lists only two: Canada and Taiwan.

Are Single-Payer Plans Less Expensive Than Other Health Coverage Systems?

Not necessarily. True, eliminating the profits and duplicative administrative costs associated with hundreds of different private insurance plans would reduce spending, perhaps as much as 10 percent of the nation's $3 trillion annual health care bill, says Anderson. But, he notes, once those savings are achieved, there wouldn't be further reductions afterward.

More important, as many analysts have noted, is how much health services cost and how those prices are determined. In most other developed countries, even those with private insurance, writes Princeton health economist Uwe Reinhardt, prices "either are set by government or negotiated between associations of insurers and providers of care on a regional, state or national basis." By contrast, in the U.S., "the payment side of the health care market in the private sector is fragmented, weakening the bargaining power of individual insurers."

Would Medicare For All Be Just Like The Existing Medicare Program?

No, at least not as Sanders envisions it. Medicare is not nearly as generous as many people think. Between premiums (for doctor and drug coverage), cost-sharing (deductibles and coinsurance), and items Medicare does not cover at all (most dental, hearing and eye care), the average Medicare beneficiary still devotes an estimated 14 percent of all household spending to health care.

Sanders' plan would be far more generous, including dental, vision, hearing, mental health and long-term care, all without copays or deductibles (which has given rise to a lively debate about how to pay for it and whether middle-class families will save money or pay more).

kristopher

(29,798 posts)
49. "Because, in most other countries they have a single purchaser, which is a very tough negotiator"
Thu Oct 27, 2016, 04:06 PM
Oct 2016

That is Anderson referring to single payer (the purchaser pays).
You know the rest. If you can't recall, let me know.

We're done.

 

ehrnst

(32,640 posts)
52. I guess that means you're done copying and pasting the same thing that doesn't address my post?
Thu Oct 27, 2016, 04:19 PM
Oct 2016

Because you clearly haven't understood a single thing I said about what I actually meant - due to your repeated 'splaining.

If you really need to correct someone, find someone who you actually understand enough to figure out if you actually disagree with them....

mike_c

(36,214 posts)
14. we need accessible, nonprofit, universal health care at little or no direct cost to patients....
Thu Oct 27, 2016, 10:05 AM
Oct 2016

Eviserating the greedy for-profit health insurance industry would be nice, too.

ismnotwasm

(41,921 posts)
22. I think universal healthcare is THE goal
Thu Oct 27, 2016, 12:27 PM
Oct 2016

But one that needs to be taken in steps. As I point out, but I don't argue enough to be heard, If we had single payer or universal payer tomorrow--there would not be enough providers for our population. We are facing a nursing shortage as well as a Physician shortage. Nursing leaders and unions are well aware of this, and are trying to fill the gaps in both areas by encouraging more Nursing practioners, as well as improving work conditions for nurses. Hospitals are working with the bundling programs to cut healthcare costs during hospital stays, the ACA has preventative healthcare incentives in place, as do many insurance companies-- Taking care of ourselves needs to be part of the bargain

While I believe healthcare is a right, I am also aware of relative and proportional costs within different situations of sickness and conditions. I am willing to pay taxes so someone can get that expensive life-saving stem-cell transplant, with possible subsequent multiple trips to the ER, someone has to be willing to pay takes for the expensive care of my husbands Multiple Sclerosis. we all have to be willing to pay taxes for reproductive care, including pre-partum, antepartum. And post-partum. Abortion as well.

Not here so much but elsewhere I see comments like "why should I pay for pregnancy when I don't get pregnant" --which is as dumbass as you can get.

The entire tax structure for healthcare--as I understand it, I am no tax expert here, would need a quite a bit of work, which is why I always felt the ACA was a starting place. We see how people either dislike it because it's not single payer, can barely afford it because of income, or hate it, because they think it is "socialism". The millions of newly, and sometimes first time-insured who have actually benefited from it are rarely mentioned.

 

ehrnst

(32,640 posts)
38. Apparently to believe this = "sophistry"
Thu Oct 27, 2016, 03:49 PM
Oct 2016

And 'deceit'

And supporting CEOs getting the big bucks.

"Single payer" and whatever it seems to mean to any individual that's talking about it is now the litmus test for being "progressive."

It's like anti-vaxxers on the left.

ismnotwasm

(41,921 posts)
62. True. There is not a magic way to universal healthcare
Thu Oct 27, 2016, 07:54 PM
Oct 2016

There is more going on in governmental medical reimbursement than the ACA--screaming "single payer" isn't getting the work we need done. We need a solid direction/pathway/plan that includes having enough providers to care to the poplace. Nursing leaders are very aware of this, and are doing a lot of work within the profession and Unions to accomplish part of what we need.

 

ehrnst

(32,640 posts)
63. Tempting to simply declare that there is one simple answer to a complicated issue
Thu Oct 27, 2016, 08:01 PM
Oct 2016

Like, "Global warming is a hoax invented by liberals" and "vaccinations are something that big pharma is telling us are necessary."

The confirmation bias here is very strong, and there are some serious sacred cows.

I'll think twice before poking that beast again.

Warpy

(110,913 posts)
27. The USA is the only country in the western hemisphere without a single payer
Thu Oct 27, 2016, 02:05 PM
Oct 2016

government health care system. Most countries are like Mexico, they've had it in place for decades but are too poor to make it universal although they're working on it. The US alone is where for profit insurance calls the shots enough to throw people who need care off the plans because they pose "risk" to profits.

Clearly, this is INSANE.

 

ehrnst

(32,640 posts)
50. Actually no. According to the OP Canada is the only country with true Single Payer
Thu Oct 27, 2016, 04:08 PM
Oct 2016

So there are degrees, and apparently wildly differing definitions

In any case, Mexico is a mix.

https://en.wikipedia.org/wiki/Healthcare_in_Mexico

roamer65

(36,739 posts)
69. Canada is unique in how it set was up.
Fri Oct 28, 2016, 03:40 PM
Oct 2016

Last edited Sat Oct 29, 2016, 11:02 AM - Edit history (1)

The Canada Health Act originally promised a 50-50 match on dollars to any province who would set up a universal single payor system like Saskatchewan's. The 50-50 match brought them all on board. Each single payor is a provincial entity, funded from the provincial and federal levels. Canada's approach had to be different because it is a confederation, not a federation.

In Ontario, private hospitals do exist, but they must accept OHIP reimbursement as full payment.

Since we already have Medicare setup, that should be our vehicle for universal single payor health insurance.

hunter

(38,264 posts)
28. Arguments about language and definitions are a very deliberate distraction.
Thu Oct 27, 2016, 02:38 PM
Oct 2016

In civilized nations everyone has access to effective and appropriate medical care. This is accomplished by many means, some nations entirely socialist, others by a byzantine mix of highly regulated private medical providers and government subsidies.

The U.S.A. is not a civilized nation.

 

ehrnst

(32,640 posts)
60. Words mean things. Specific things. If you want to discuss them, you should know what they mean.
Thu Oct 27, 2016, 07:49 PM
Oct 2016

For instance, Obamacare isn't "Socialism" even if you say that it is many, many times, and you say, "Well that's what I call socialism."

hunter

(38,264 posts)
64. Where did I say Obamacare was socialism?
Thu Oct 27, 2016, 09:18 PM
Oct 2016


Nations have accomplished universal health care in a variety of ways. That's what I said.

Yet for the unemployed and unemployable, and for those who are stricken with budget-busting catastrophic illnesses or accidents, there are elements of socialism in all these plans. So what?

The stink of "we can't do that here" is very strong in this article. Fear, Uncertainty, and Doubt.

Why can't we have a single payer here? It seems to work well in Canada, which is a nation very similar to our own.

I must make a confession, as others have above: I'm not a fan of NPR. They are bought and beholden to big money interests, much as U.S. politicians are. They can't afford to alienate their big donors, which is the same fix many politicians are in when it comes to campaign finances.

My favorite part was this:

Are Single-Payer Plans Less Expensive Than Other Health Coverage Systems?

Not necessarily. True, eliminating the profits and duplicative administrative costs associated with hundreds of different private insurance plans would reduce spending, perhaps as much as 10 percent of the nation's $3 trillion annual health care bill, says Anderson. But, he notes, once those savings are achieved, there wouldn't be further reductions afterward.


Well wait a minute, you just said Canada and Taiwan are the only nations with true single payer systems... Are they less expensive?

Here's a chart from the Organisation for Economic Co-operation and Development:



https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

It took me about 12 seconds to find that data. Canada looks like it's doing pretty good to me.

Worse, I followed the link provided to expert Uwe E. Reinhardt, and first thing you see is: Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.

Exploring further, He is currently a director of Boston Scientific, a medical device company, and a trustee for the Hambrecht & Quist Life Sciences Fund and Health Care Fund, which are closed-end mutual funds.

Dear God, is there anyone who doesn't have a finger in this pie?
 

ehrnst

(32,640 posts)
65. That was an analogy.
Fri Oct 28, 2016, 08:47 AM
Oct 2016

And where did I say that Canada and Taiwan were more expensive?

The snip you are "refuting" is about the savings that would be acheived in the US, not Canada and Taiwan.

Is that clearer?

hunter

(38,264 posts)
68. The article is FUD. It's not reporting "debate" about Single Payer at all.
Fri Oct 28, 2016, 02:52 PM
Oct 2016

It's meant to make readers nervous about making any fundamental changes to the predatory and obscenely expensive U.S. health care industry.

I don't know, maybe you posted the article because it starts off featuring Bernie Sanders. But then it goes off the rails presenting as fact the views of experts and institutions who have strong interests in keeping the U.S. health industry as it is, to the detriment of us all.

The article is biased reporting. Very obvious biases and conflicts of interest among its sources were not identified.

Is it possible that established journalists no longer recognize biased sources and corporate propaganda?

The reporter, Julie Rovner, after years of working at NPR, covering issues in NPR's more sophisticated version of Fox News "Fair and Balanced," now works for Kaiser Health News.

Kaiser Health News is supported by many of the same big money players who support NPR. But mostly it's George Kaiser and his BOK Financial Corporation.

Kaiser is not a bad egg so far as this world's wealthiest people go (he supports Democratic candidates 10 to 1 over Republicans, and he was a major Obama supporter). Nevertheless he's highly invested in business as usual, which means at best incremental Obamacare style tweaks to the existing healthcare system.

I don't know. Maybe it's impossible to accomplish any great improvements in U.S. health care without the support of big money players.

That makes the U.S.A. a plutocracy, not a democratic republic.

For all the money the U.S. spends on health care every resident ought to enjoy the best health care in the world. But the fact is that many wealthy people, and people with platinum health insurance plans, still suffer mediocre and inappropriate health care, sometimes more dangerous than an indigent person in a hospital emergency room might receive. The great rivers of money flowing through the U.S. health care industry are somehow more important than our actual health.

 

ehrnst

(32,640 posts)
70. To start with - You have made a major mistake in which foundation your are talking about
Sat Oct 29, 2016, 09:37 AM
Oct 2016

You seem to be confusing the "George Kaiser Family Foundation" (http://www.gkff.org/) with "The Kaiser Family Foundation" (kff.org) which self-supporting, self-funded foundation. That also goes for Kaiser Health News.

http://kff.org/about-us/

http://khn.org/about-us/

Is that clearer? It's helpful to have the facts before developing opinions or making claims about something.

The article is informational, it's not "meant" to make readers "nervous," and just because it does not confirm your bias, doesn't mean it is biased. I'm not sure what the "obvious biases and conflicts of interest among its sources" you are referring to. You didn't list them, let alone cite them.

Your characterization of NPR as a "more sophisticated version of FoxNews" is so off base, I don't think we have the same view of reality as pertains to "FUD."





hunter

(38,264 posts)
71. Ooops. Me, off on a wild google chase again...
Sat Oct 29, 2016, 01:05 PM
Oct 2016


How about this:

https://projects.propublica.org/nonprofits/organizations/946064808

I stand by what I said about plutocracy, the framing of the article, the biases of the experts consulted, and my generally low opinion of NPR.
 

ehrnst

(32,640 posts)
72. Good to see that you now have the correct foundation
Sat Oct 29, 2016, 03:54 PM
Oct 2016

The "donations" that top out at <5% of their budget come from partnerships and grants:

Such as:

http://www.greaterthan.org/campaigns/health-coverage-hiv-you/

http://kff.org/its-your-sex-life/
Those contributions are partnerships and grants for particular projects, including public ed.


http://kff.org/greater-than-aids/


And reporter education programs:

http://kff.org/other/kaiser-family-foundationglobalpost-partnership-and-global-health/

Grantors and partners have included:

The GroundTruth Project (previously with GlobalPost) and the Columbia University Graduate School of Journalism: http://kff.org/media-internships-fellowships/

MTV and the CDC: http://kff.org/hivaids/press-release/mtv-calls-on-audience-to-live-a/

Walgreens: http://kff.org/hivaids/press-release/walgreens-and-greater-than-aids-team-up-in-national-effort-to-encourage-hiv-testing-and-prevention/

UCSF Center of Excellence in Transgender Health: http://kff.org/hivaids/press-release/new-video-series-from-greater-than-aids-gives-voice-to-trans-women-about-high-rates-of-hiv-facing-their-community/

" a broad coalition of public and private sector partners, including: major media and other business leaders; Federal, state and local health agencies and departments; national leadership groups; AIDS service and other community organizations; and foundations, among others." http://kff.org/hivaids/press-release/somos-familia-campaign-brings-attention-to-impact-of-hivaids-in-latino-communities/

Kaiser Health News has partnerships as well: http://www.cjr.org/the_second_opinion/kaiser_health_news_expands.php

See what you can find when you know how to research correctly?


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