Other Questions
Still don't believe it? You've come to the right place. We've got questions on any topic, and answers to any question. Soon. Dig in. There's plenty of other great sites with answers to your single-payer questions as well.
- Canada
- Cost/Financing/Funding
- Current Health Care System
- Drugs/Pharmaceuticals
- Free Market
- Government Control/Socialized Medicine
- Great Britain/UK
- Malpractice
- Medicaid/Medicare
- Physician Income
- Research
- Taxes
- Technology
- The Uninsured
Canada
Aren't Canadians coming over here all the time to get MRIs?
Not really. In a study asking US and Canadian hospitals about Canadians coming to US hospitals from 1997-1998, 80% had seen fewer than 10 patients, and 95% of hospitals had seen 25 or fewer patients over the entire year. Extrapolating findings, the study found that 640 Canadians had come to the US for MRIs or CT scans; Canadian provinces averaged 80,000 MRIs during the same time period.
Aren't Canadian physicians leaving Canada in a mass exodus?
Not at all. While Canada does have more physicians that leave than enter, the number has been decreasing since 1996, and it's less than 1% of physicians. And while it's still a significant number, it's by no means an exodus. Canada does have problems keeping doctors in rural areas, but so does the US.
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Cost/Financing/Funding
Won't this bankrupt us?
Health care coverage is already subsidized heavily by federal, state, and local taxes. In fact, fully 64% of health care spending is already from taxes. Employers would pay a small payroll tax, but this tax would be instead of paying health care premiums like most employers pay now. Most employers that currently offer health insurance would actually save money. Small businesses will no longer be at a disadvantage in obtaining good health coverage for their employees and thus competing for the best employees.
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Current Health Care System
America has the best health care system in the world!
Only if you don't compare it to anything else. The US ranks 37th in a World Health Organization examination of the world's health care systems. Americans also live fewer years than people in other countries, and have higher infant mortality levels (more babies under the age of one die per year). And according to the Institute of Medicine, 18,000 die each year from having a lack of health insurance. And we've got 45 million people without health insurance, and the most expensive health care system and prescription drugs. The US does a good job with waiting times for elective surgeries, but doesn't do nearly as well as other countries in most measures of "best" or "quality," however you define it.
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Drugs/Pharmaceuticals
Bulk-purchasing of drugs is big government price control. Shouldn't the market decide that?
Virtually all other industrialized, capitalist countries have some sort of large-scale bulk-purchasing program. It's just like Wal-Mart using its purchasing power to buy in bulk, and provide cheap goods to customers. In fact, the reason many people are buying drugs from Canada is because they're much cheaper there. Insurance companies do this all the time--buy drugs for all of their members, and get cheaper prices, so would it really be that different to have the government buy for everyone? The VA and the Department of Defense already do this, but the current Medicare legislation does not allow the government to do so.
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Free Market
Government Control/Socialized Medicine
A national health service would have the efficiency of the Post Office, the bureaucracy of the IRS, and the compassion of the Army. You really want that?
Governments do some things better than others--so do corporations. Medicare is the most efficient health care system in the US, with administration costs about 20% of the average HMO's administration costs. And if you think there's no such thing as corporate bureaucracy, you've probably never had a problem with your HMO. Ask anyone who has. Any system is going to have some red tape. But it's a matter of having *one* system of red tape, or 50 different ones. And government's not all bad. Government has provided us with public libraries, the GI Bill, Social Security, police and fire protection, the Do-Not-Call list, emergency services, national parks... there's bad, sure, but that doesn't mean you can just ignore the good.
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Great Britain/UK
Doesn't it take months to get in to see a doctor in England?
There are definitely concerns with the UK's health system. But those are for another website. England has what's called a "national health service"--true "socialized medicine." In England, the government employs doctors and owns hospitals. In single-payer, doctors and hospitals are still privately owned and run. It's a completely different system. Apples and oranges.
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Malpractice
What's single-payer going to do about malpractice rates?
Malpractice is a complex issue, but it's clear that rates in Canada are pennies compared to what they are in the US. Part of the reason: different laws in Canada. But another part: everyone in Canada knows they have health insurance. Whereas Americans can lose their job (and their health insurance), and have a medical mistake turn into an uncoverable "pre-existing condition," Canadians know that they'll be able to receive care for any complications from medical mistakes. So they probably sue for less (if they sue at all), because they're not having to figure in future medical costs into their lawsuit amount.
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Medicaid/Medicare
What's so great about Medicare? Isn't it another government bureaucracy?
Sure, there are hoops to jump through in Medicare, and issues that need to be addressed, but on a whole, Medicare is an extremely efficient health system. (By efficient, I mean it spends very little money on administration of the program, and most of its money going toward health care.) Medicare spends about 2-3% of every dollar on health care administration, while most HMOs spend around 15%--some even high as 30%. That's 30 cents of every dollar not going toward health care.
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Physician Income
Wouldn't physicians make much less money in this system?
Most physicians would make less gross money, but the same net amount. Because the system would have much simpler billing (there's only one form to fill out), physicians would have much smaller costs, too. Canadian physicians make similar amounts to what US physicians make; specialists generally make less, but medical school is much less expensive and debt-ridden in Canada than it is in the US. Physician income is also much more stable in Canada, where the government is required to pay physicians within 30 days of the bill, or interest is charged to the government. (And surprisingly, when Saskatchewan, the first province to enact national health insurance act in Canada, started its program in 1963, physician incomes increased by 35% the next year.)
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Research
Wouldn't the US fall behind on research?
Public research money would still be given out like it is now--through the National Institutes of Health. (And just because most of the research you hear about is in the US, doesn't mean discoveries only occur here.) Medical research does not disappear under a universal health care system. Many famous discoveries have been made in countries that have national health care systems. Laparoscopic gallbladder removal was pioneered in Canada. The CT scan was invented in England. The new treatment to cure juvenile diabetics by transplanting pancreatic cells was developed in Canada.
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