And many developed countries have multi-payer systems with universal coverage. The continued demand for "single-payer" precludes the option of building on the system we already have in place, which remains by far the most realistic possibility. There's no switch we can flip to overhaul the cost structure of our system--one that's developed over more than half a century. We could transition to single-payer but, unlike in other countries where it exists, it will have to cope with the cost structure of the American system.
The government "flipped a switch" to increase the cost of drugs. Government has provided drug companies with legislation that allows them to call all those ads you see for drugs on TV and elsewhere, “R&D”. When you buy a prescription drug, you are paying for those ads, and one way of bringing down the high cost of prescription drugs is to ban advertising of them to the public. That would be "flipping a switch" to reduce drug costs. Prescription drugs should never be advertised to the public anyway. It's completely inappropriate.
We don't need a single payer in order to regulate direct-to-consumer advertising. These aren't related concepts. Your example implies people are asking for and thus receiving drugs they shouldn't--probably true! As it is, the only ways to influence or determine which drugs people get are via (1) coverage by an insurance plan (public or private), (2) cost to the person vs. alternatives (including no drugs at all) within the context of coverage by their insurance plan, or (3) direct decision by a doctor or an official as to whether they may have that drug. There are things people will find unpalatable about any of those options.
I agree that building on the system we have is by far the most realistic possibility. Problem of course is no ideas have been seriously considered to do that which will have any significan impact on total healthcare spending. There are of course ideas that would work like lifetime caps for individuals, or doctor assisted suicide, or cost/ benefit analysis on reimbursable treatments but they all get called death panels and never get serious consideration.
It is not at all "irrelevant." Surely you do not consider it a matter of no consequence whether we have Big Government coupled with expansive services, or small government coupled with limited services...
Please do not suppose that I support a single-payer system--I emphatically do not!--but I am just weary of those people who pretend to support ObamaCare, who would really prefer UHC--but are unwilling to say so...
By the same thinking,- & I happen to agree with your point - Class Actions shouldn't be advertised to the general public either. Loads up the pool often times, with "Hopers" , those hoping their issues make the cut, or are overlooked by investigators, & they get a warm slice of SettlementPie.
You said "I 'believe' --and it is really not a subject amenable to debate--that those other 'developed' countries have much higher taxes than in the US" when we were discussing healthcare in "those other developed countries". In such a context objecting to high taxation which is used for many different programs is pretty irrelevant to the discussion of healthcare. And now you show that you had hoped to spin the conversation to big government vs. small government. What DO YOU really want to discuss?
Wow! I am really not sure just what your objection is! How is "objecting to high taxation" in other countries, in order to cover the cost of UHC, actually "irrelevant" to the discussion? Anyway, just why would the American middle class wish to subsidize the underclass (who often do not get needed medical care--and therefore, drive down the average "outcomes")? I would imagine that the American middle class receives medical care that is not at all inferior to that of people in other countries--and probably at a lesser cost, when taxation is considered.
The high taxes to which you refer are used to pay for many things. You can't usually break out the amount dedicated to healthcare, so objecting to a healthcare system on the basis of high taxation is illogical and impossible to justify. Because it is proven to work in every other country that has adopted the system. That's a bit like objecting that you really can't complain about the high price of electric rates because the price of gasoline has come down. It makes little sense. But our medical care is, indeed, inferior to that of several countries with national healthcare systems. https://www.linkedin.com/pulse/world-health-organizations-ranking-worlds-systems-abo-khadra-asmsy
But then you have to add back in the govt cost over runs and new administration costs. So add back 20%
Let me just say that I would far prefer a low-tax system, coupled with meager government benefits (and no UHC) to a high-tax system, coupled with generous government benefits. Is there something about that that you just do not understand? It all depends, I suppose, on your definition of "work." Does it "work" better for the middle class (who pay much more in taxes to support UHC, as well as other government "benefits")? I am not sure I understand your simile. The price of electricity and the price of gasoline would (in most cases) apply to the same people; whereas the middle class and the underclass are quite different people. Is it "inferior" for the middle class, however?
Yes. I don't understand how anyone can come to such a conclusion. Apparently. https://www.numbeo.com/quality-of-life/rankings_by_country.jsp http://geography-resources.wikispaces.com/file/view/Satisfaction+with+Life+Index.pdf The metric makes no such distinction, so I would say "yes".
Do you imagine that the underclass is not lumped in with the middle class, in coming to this conclusion?
Well then, you have your answer. I am interested in what is best for the middle class--not for what is best other Americans.
A plan that picks and chooses who to benefit on the basis of income is a bad plan. I'm surprised anyone would admit what you did.
I, myself, am middle class; so it should probably not be especially surprising that I would prefer a plan that chiefly benefits the middle class. (I am guessing that most members of the underclass would prefer a plan that benefits the underclass; and that most members of the upper class would prefer, say, tax policy in general that benefits the upper class.)
Doctors really like to catch a problem early and treat accordingly .. instead of not seeing a patient until they are really sick of have a huge, expensive problem. I have known many, many doctors.. and every internist I have ever know prided him/herself on keeping patients out of the hospital.
Any plan is going to favor one group over another, according to the terms of redistribution. And I am really not a redistributionist, at all.
But that is the system we already have. Health outcomes in the US do correlate with wealth. The only real issue is do we favor continuing the current wealth based system or do we want to change to a system that provides greater equality of outcomes. Once that decision is reached then a serious discussion of possible approaches can follow.
