Why I am for a single party payor system.

As I have been watching this thing unfold, my opinion on having a public options is changing.  Let me explain.

As a health care provider and a STRONG advocate of personal responsibility you would think I would be an aponent of a government run health insurance right?

Over the past 20 years, I have witnessed first hand the problems with the currrent disease care system.

Depending on a third party payor system always increases costs to the consumer without adding to the quality of goods, all in the name of being prepared in case “something bad” happens.

Since human beings are like water in that they will predictably flow towards the path of least resistence.  Providing safety nets allow for, and indeed encourage, irresponsible management of the one thing of true value in this life, namely your fleshy body.

Maintaining the well being of your fleshy body is a full time job, that frankly most Americans are too busy trying to pay the bills to keep up.  This is a problem with priorities.

But, if you do not spend some of your time and talent maintaining your fleshy body it will get sick, and you will be needing expensive intervention at some point.  Diabetes, cancer, and heart disease are very good demonstrations of this phenomena.

So when you apply the above knowledge of human behavior to the situation created by eliminating the unneccesary health insurance middle man and increasing the required effort to obtain help from the “system” you will see a behavioral adjustment towards the easier route of just taking care of yourself.

This will drastically reduce the cost of health care in this county allowing more of the wealth generated on the backs of the good people of this land to be channeled directly to the bankers.

Thoughts?

DrD

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10 thoughts on “Why I am for a single party payor system.

  1. A single-payer health system would not decrease costs… unless it creates those savings by rationing care. By removing the physician’s and patient’s choice from the priority position. The need for care will be based on what will cost the system the least amount of money… because it won’t be able to afford extraneous costs… like your non-tax-paying, non-producing grandmother who is now a drain or negative affect on society.

    The true salvation of our health care system will lie with removing the employer from the equation and removing over-regulation of insurance providers. We must encourage personal responsibility. Allow insurance companies to compete nationwide which increases the risk pool, encouraging the insurance company to lower premiums to compete for business while remaining profitable. Also, encourage patients to carry catastrophic coverage only and pay for the majority of their health care out of their pockets. Setup tax-free health savings accounts to cover these costs so there is no barrier to getting the care early when one needs it.

    This will create more personal responsibility for one’s health choices, diet, exercise, etc… because patients know if they develop problems, the first several thousand will be out of their own pockets. This will cut down on health expense-related bankruptcies because they will have coverage if they develop serious illness. This will encourage spending health care dollars wisely because money spent on preventative health care will decrease one’s tax liability.

  2. Awesome post Doc. Did you know the Republicans have offered an alternate plan that goes right down the line with what you said accept the government will provide every citizen with $3,500 credit on it to be used only at approved health care costs. Then they purchase major medical plans from the insurance industry to cover expenses beyond the first $3,500.00. This plan only cost about $100B for the cards, plus the major medical insurance costs which can be competitively bid for.

    This will give the choice of health care directly to the consumer and promote procedures that actually work.

  3. hey big guy…I agree with the comment above mine..however, my husband the extremist…says just what ronnie reagan says..all communism and or socialism needs to get a foot in the door is social medicine..its the back door way of getting this country to be what it fought for so many years…and that is a government controled police state..where we have no freedoms…now..on another note…there has to be a change in our health care system…we DONT NEED ANOTHER INSURANCE TO CHOOSE FROM…but..I believe…we need help with changign our insurance system..I also believe…we all need to have insurance….we need insurance to drive a car..I think it should be the same way…and …no FREE RIDES…no illegals get insurance…becuz if I were president..there wouldnt be any illegals…they would all be deported and anyone hiring them arrested for a long time…I feel disgusted at people who are not even citizens getting a free ride on the backs of our dollar bills and we are being rejected and we belong here..so, I believe we have to all be insured..no such thing as having no insurance..think abt it..you cant drive unless you have insurance..if everyone paid insurance then we wouldnt have a shortage of money…cut taxes and pay for insurance for health care…when my husband worked at MD ANDERSON…a month his taxes were I think and Im hoping I am thinking correctly…abt 4grand a month…that was taxes…he brought home…abt 2700 twice a month…he paid as much tax as his pay..Im not sure on this but..I remember being totally upset..screaming upset…cut taxes so people can pay for healthcare..help drs get help paying for thetir education….also have a really good checks and balances..and give bonuses to drs who save lives and do the best for their patients in preventative measures…also..no free abortions..Im a prolifer….and we dont pay for women to have babies without fathers…no more welfare for women who choose that as a way of life…I can list a few ways of cutting costs…

  4. Vickie,

    Auto insurance is to protect other people that you may hurt. That is a good idea.

    Health insurance is optional. If you decide not to have health insurance then you must pay for all your health related expenses on your own.

    You say no socialized medicine, then you contradict yourself by saying everyone should pay the middle man and have health insurance. You can’t have it both ways.

    Do you have haircut insurance? How about plumbing insurance? The health and well being of your body is your own business. If you choose to pay someone else to be responsible for it, that is your choice. But, you cannot force me to pay someone else to be responsible for my the health of MY body.

  5. Um, you know the US already has socialized medicine, right? 50% of all health-care cost is paid for by the government.

    Dr. Gray, if single payer health care doesn’t reduce costs why does France (which has measurably better health care than the US) have much cheaper health care? With greater personal access?

    I agree with deregulation of the health care industry, but think the personal responsibility argument is largely moot. Tobacco and obesity related deaths are the number one killer in the US. We have the most expensive health care per capita of the GDP on earth. But it’s still not enough to keep people from smoking and being inactive. So raising the price still further will help? Why?

    And if personal responsibility means the government shouldn’t provide health care, why police? I mean, you could have chosen a better neighborhood to live in. You choose to live in that part of town, why should my taxes pay for your irresponsibility, it was your poor life style choices that put you there. Everyone should have to pay for private security firms. Then there is a greater incentive for personal responsibility.

    And hell, why should the government pay for a military for everyone? Those people didn’t HAVE to work at the world trade center. They chose work for a symbol of American economic might. Their choices got them killed. The military shouldn’t protect everybody, that just encourages people to go about their daily business irresponsibly! Individuals, not the government, should fund their OWN protection. Competition among various mercenary bands will lower the cost of warfare for everyone.

    —or we can accept the fact that sometimes the government needs to provide a service because some services should be available to everyone, regardless of income.

  6. Truthwalker,

    I have walked in the path you now tread. I had the same questions about 18 months ago. To counter a couple of your points.

    The government is not suppose to provide security. A well armed citizenry provides that.

    Proper revenue to run government comes from merchants that obviously benefit from the stability government provides. Taxing individuals can never be adequately defended. Both the income tax and personal property taxes are completely illegitimate theft.

    The world is full of tyrants that strive to own and control the planet. A well informed well equipped military is put in place by a free people to protect our borders and defend our liberties from internal tyrants only. NOT to be used as the police department for the world, or as thugs for the expansionist tyrants we are trying to get rid of.

    Lastly, government never provides anything. It uses force to reallocate resources created or improved by natural born humans.

    Don’t even get me started on who benefited most from 9/11.

  7. “A well armed citizenry provides that.” Ah yes. Feudalism. Because which citizens do you think can afford the weapons and training it takes to secure security in this age? The wealthy property owners. So instead, the military provides it, and everyone gets the same military protection so that all people have the same protection and not just the wealthy.

    If government does not provide that, why do governments that do have better, more stable societies then places that don’t?

    “Taxing individuals can never be adequately defended. Both the income tax and personal property taxes are completely illegitimate theft.” That’s absurd. Individual citizens use government services and must pay for them. Putting the tax burden entirely on business is unfair.

    The proper use of the military has no bearing on who pays for it.

    “Lastly, government never provides anything. It uses force to reallocate resources created or improved by natural born humans.” You could say the same thing about churches, business, clubs. Any organization on earth. The people pay for certain services through taxes and the government provides them.

    • Now we are getting some where. I am from very poor background of oil well workers, roofers, and other laborers. The one thing everyone of my uncles (and aunts) had plenty of were guns and ammo. So your rich only argument does not hold up to reality on the land around here anyway.

      Posse Cumatatus (sp) and the third amendment insure the military has zero presences within the civilian world. They have one and only one job, defend the borders from ambitious tyrants. This can be paid for with excise taxes on inports and other business activities.

      “Putting the tax burden entirely on business is unfair” Come on, business doesn’t bear the burden, they pass it on to the consumer. The business community has to report its activity to the state anyway and therefor is the natural place to keep track of revenue collected for the state.

      Private property is not private if you have to pay to keep it. Why should anyone else know what I have already acquired?

      I agree, when individuals want to use services available from the company we call government, they certainly should pay for it. But, if I do not need or want the service then I cannot be “taxed” to pay for it anyway.

      “You could say the same thing about churches, business, clubs. Any organization on earth” Again, I agree completely! People pay for services as they need them. Stealing from one person in the name of helping another is socialism and has no place in America.

      The only difference between a company and a government is somehow a government thinks it can use force to accomplish its goals, where a business has to market its wares and will fail if the people don’t like what it is selling.

      Thanks for the intelligent conversation!

  8. Regarding the replacement of the military with armed citizens, you miss my point. I grew up around shooting and I’m glad I did, but Sporting rifles and ammo are not even remotely sufficient. Looking back to the 1st Gulf War, the US beat the 5th most advanced military on earth in about 24 hrs. Going further back, the Mujaheddin were successfully beaten by the Soviets until Reagan authorized US built anti-aircraft missiles to be given to them. The Vietcong did not win the war, they simply waited until America lost interest. While the US lost 50K, the VC lost around 3 million. Remember the VC were not armed with sporting equipment, but with combat rifles, light artillery, light and heavy machine guns, and anti-tank weapons. Modern warfare simply stands against an armed populace defending the land, UNLESS the public is allowed to organize private armies of a battalion size and greater. If that is the case, then only the rich will be able to afford military protection, which was my point about feudalism.

    The 3rd Amendment does not ensure the military has zero presence in the civilian world. It ensures that the military must not use its monopoly on force to avoid paying rent.

    If consumers ultimately pay any tax placed upon business, then how is it wrong to tax the people directly?

    “Private property is not private if you have to pay to keep it” That’s simply not true, nor is it to the point. The private in property refers to the legal right to exclude others from using it, not the right to not pay anyone for it.

    “But, if I do not need or want the service then I cannot be “taxed” to pay for it anyway.” No. In a contract as simple as a cellphone contract, if you do not want or need a service which is inherent to the contract, you categorically CANNOT simply refuse to pay for the services you do not use. You must pay, or end the contract.

    Your citizenship is a de facto contract with your government. If the government charges you for services you do not need, you may end the contract by leaving the country, and legally changing your citizenship.

    Thankfully, since our country is not a business, you have third option of voting. (If, by the way, you don’t believe your vote counts, that is procedural problem with YOUR government and not implicit to all governance.)

    “Stealing from one person in the name of helping another is socialism and has no place in America.” No, stealing is stealing. Taxes aren’t. The only way all taxes can be stealing is if all government illegitimate. If that is the case, then you believe anarchy.

    “government thinks it can use force” Not thinks, CAN. That’s the whole purpose. Government IS a monopoly on force. Doesn’t that have enormous risk of abuse? Of course. So why do it?

    Because the market is amoral, where a (democratic) government is the moral temperature of the people. The market is neither good nor evil, but simply provides whatever people want at whatever price they will pay. In a totally free market, child pornography, for instance, would be legal because there is a demand for it. Thus, the people create a group to have a monopoly-on-force that can be stronger then force of the market.

    Though there would be advantages to government run on market principals (and we could use more market principals in the government we have) ultimately, the will of the people, as expressed through the administrative laws of the society, must through the government, be stronger then any market force within the country, or said market will simply bribe the government until it has a monopoly, destroying the free market.

  9. “UNLESS the public is allowed to organize private armies of a battalion size and greater. If that is the case, then only the rich will be able to afford military protection, which was my point about feudalism.”

    As a veteran of the 82nd Airborne, your point is well taken.

    “private in property refers to the legal right to exclude others from using it”

    Have you been keeping up with the immanent domain problems now that government can use force to take “private” land from one person and give it to another if the government thinks it will increase tax revenue? I hold to my point, private property is a kingdom unto itself. The sovereign (source of law) land owner owes nothing beyond contractual agreements that he willingly enters into.

    “legally changing your citizenship” this is a catch 22 effort. As a natural born creature of god I am endowed with inalienable rights not the least of which is the right to be left alone. Who would you file with if you are already sovereign? We do not live in a democracy. Thank God, America is a Constitutional Republic set up in such a way that natural born humans are the ultimate political authority over their own lives. The current de facto system has done a very good job brainwashing us to believe the artificial state has authority over us, but this simply is not the truth. I am not an anarchist, but I do trust people more than artificial constructs no matter what title they use.

    “Because the market is amoral, where a (democratic) government is the moral temperature of the people.”

    Very nice description of the market. However, again we do not live in a democracy. We are a republic, governed by the rule of law not the whim of a popularity contest. The rule of law breaks down when those in power refuse to follow the written law of the formative Constitution. Child pornography is an infringement of the natural rights of the child and therefor unconstitutional behavior and therefor illegal in our republic.

    “the will of the people, as expressed through the administrative laws of the society, must through the government, be stronger then any market force within the country, or said market will simply bribe the government until it has a monopoly, destroying the free market.”

    You are describing Roman Statutory law, not Constitutional law. The de facto legal system around here has spent the last 50 years at least trying to switch us from a country ruled by law, to a country ruled by arbitrary statutes that can flow with the whim of a majority. THAT is why we are in such a mess now. The statutory system is set up to accept bribes and is constantly for sale to the highest bidder.

    Thanks again for taking the time to discuss this with me, I really needed a different point of view to hon my opinion.

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