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Re: A single health care payer for the US ? ( Long) From: John Robertson MD (john.robertson@obgyn.net) Sat Jan 22 18:41:33 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: FRANCIS L. HUTCHINS, JR.,MD: "UTERINE ARTERY EMBOLIZATION" Previous message: John Robertson MD: "Re: Uterine artery embolization" In reply to: Garry Siegel: "Re: Possible Partial Mole?" Next in thread: Kathi Wilson, BHSc, RM: "Re: A single health care payer for the US ? ( Long)" Reply: Kathi Wilson, BHSc, RM: "Re: A single health care payer for the US ? ( Long)" At Sat, 22 Jan 2000, RModugno@aol.com wrote: > >Just to stir the yogurt a bit - for those of you who are tired of the >patchwork quilt that makes up American health care - for the cybergyns who >are in Canada and the UK - here are some thoughts on the implimentation of a >single payer healthcare system for the US: > >Why the U.S. Needs a Single Payer Health System >David U. Himmelstein, M.D. & Steffie Woolhandler, M.D. >------------------------------------------------------------------------------ Well Robert - someone is wearing rose coloured glasses. Here are some >------------------------------------------------------------------------------ of my comments (also see my previous post about dollar figures) >------------------------------------------------------------------------------ >2. A single payer system would save on bureaucracy and investor profits, >making more funds available for care. >Private insurers take, on average, 13% of premium dollars for overhead and >profit. Overhead/profits are even higher, about 30%, in big managed care >plans like U.S. Healthcare. In contrast, overhead consumes less than 2% of >funds in the fee-for-service Medicare program, and less than 1% in Canada's >program. except for the truism I have learned that anything run by a government will be less successful than if it is run by the private sector. >. Canadian physicians employ 0.7 >clerical/administrative staff, spend 34% of their gross income for overhead, >and trivial amounts of time on billing2 (there's a single half page form for >all patients, or a simple electronic system). This is somewhat true although there is significant oversimplification here. It is true I don not envy you your billing difficulties (a la "happy new year" thread) >The number of uninsured has risen rapidly, to 39.7 million nationally >[update: This figure is now over 42 million!]. This does bother me, and is one of the reasons I still practice in Canada Meanwhile, Leonard Abramson, U.S. >Healthcare's CEO, took home $20 million in a single year, and holds company >stock valued at $782 million. Gotta love that! > >While there are waits for a handful of expensive procedures, there is little >or no wait for most kinds of care in Canada. This is pure fabrication. Ortho wait lists for hips and knees are 3 to 6 months. cataracts are longer than that. Gyn wait list is 3 - 6 months. There are >virtually no waits for emergent coronary artery surgery in Canada, though >elective cases face delays, particularly with the surgeons held in highest >regard. again total fabrication. Patients with severe angina end up with MIs before they get their bypass/angioplasty. Interestingly, though Canadian MI patients receive substantially >fewer invasive diagnostic and therapeutic procedures, death and reinfarction >rates are comparable in the two nations. We have all been trained in the age of restraint and tend not to order tests unless absolutely necessary. I do recall stories of MDs moving to the states and being told by the RN which tests to order because that's what the patient's plan covered (not because they were indicated). Almost every test I order I ask my self do I need this test, can I get the answer on clinical judgement alone, is it going to alter my managenment or change the patients outcome? > Next message: FRANCIS L. HUTCHINS, JR.,MD: "UTERINE ARTERY EMBOLIZATION" Previous message: John Robertson MD: "Re: Uterine artery embolization" In reply to: Garry Siegel: "Re: Possible Partial Mole?" Next in thread: Kathi Wilson, BHSc, RM: "Re: A single health care payer for the US ? ( Long)" Reply: Kathi Wilson, BHSc, RM: "Re: A single health care payer for the US ? ( Long)"

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