There are no facts to support your assertion that private insurance companies deny services based on arbitrary monetary purposes. They in fact deny coverage based on CONTRACTUAL obligations between the parties to the contract.
I covered this. Average people do not understand the contract they sign. You may say this makes them idiots, and I agree that most people are, but having poor coverage is better than nothing and not everybody can hire a lawyer to make sure they get their policy.
Once again, your assertions suggest that Government has a more moral purpose than the Insurance companies, but I assure that the FACTS suggest that if Government takes over your healthcare MONEY and FINANCIAL concerns will overwhelm the system and thus result in LESS services available, LESS choice and LESS technological research and development; in other words result in MEDIOCRITY.
Choice is pretty meaningless is healthcare, as people do not know what they need or when they'll need it. When somebody gets acutely ill, they go to the nearest hospital. They are in no position to negotiate for price with whoever treats them. The ethical provider will give them options when possible.
But even if choice were relevant, you haven't really presented proof of your "facts" but rather restatements of your ideology. There really is no choice right now for people who get insurance through their employers, and HMOs quite literally restrict choices to their providers for non-emergency care. PPOs give financial incentives to go to their providers, but given the non-monogamous relationship between them and providers it's hard to know who is on what list. There's little to no choice in the private system, only confusion and waste. One confusing and wasteful payment source is going to be less confusing and wasteful than our disorganized and varied system.
The insurance companies have nothing to do with technological research. In reality, governments fund healthcare research here and everywhere, and our supremacy is a function of our excellent medical schools and universities, both public and private. Profit does drive innovation on the provider level, and a government system that asks for cost benefit analysis and evidence-based medicine will give incentives for them to develop products that are actually new instead of me-too drugs and superficially better machines that do not aid in outcomes.
Says you, but the REALITY is that there will be limitations and yes, while they may have ACCESS, they wont get the care in a timely fashion if at all.
While there are exceptions, most of the waiting in the countries often cited is for elective procedures. And neither I nor Congress are advocating for us to copy Canada or the UK, who do not have the best systems either. France and Japan do much better.
Take a look at the wait times to get heart bypass surgery in nations with these programs compared to our own.
And do they have worse mortality rates for it?
I would like to see some FACTS to support these farcical assertions.
lol, the fact that more use of primary care would help with costs is not seriously in dispute. The conservatives who are informed on this merely say that NHI will not increase use of primary care. While I'd agree that NHI is not sufficient in itself to increase use of primary care, it is necessary.
Primary care is necessary for continuity of care, as you have a physician who follows you over a longer period of time and sees your baseline conditions prior to developing acute/chronic complications. This aids in coordination of care, minimizing overtreatment and undertreatment at the secondary and tertiary levels. And offers comprehensive care that is not limited to one system or disease state.
Many studies corroborate this. The increased continuity of care that comes with primary care is associated with greater use of preventive measures, higher medication compliance, better outcomes for diabetics, better outcomes for pregnant women, reductions in hospitalizations, and declines in overall costs.
Coordination is also more likely to be present with primary care utilization. Elderly patients receiving primary care from generalists (as opposed to specialists) are more likely to receive their immunizations and preventive services. International comparisons indicate that nations with a greater primary care orientation (America has 1/3 primary care physicians, other countries have 1/2 - 2/3) have more satisfied patients, lower infant mortality, higher life expectancy, and lower total health expenditures.
Even within America, states with more primary care physicians per capita have lower total mortality rates, higher life expectancy, even adjusting for factors like age and income. States with higher specialists per capita have higher costs but not higher quality.
A study of adults in America who report a primary care physician (PCP) as their personal physician had 33% lower health costs, and 19% lower mortality than those seeing primarily specialists, this is even adjusting for age, sex, ethnicity, health insurance status, diagnosis, and smoking status.
While the above information is taken from many sources, I found them in Understanding Health Policy: A Clinical Approach, 5th edition by Dr. Thomas S. Bodenheimer and Dr. Kevin Grumbach, pages 50-53.
The upward spiral of costs can be directly attributed to Government regulations on the industry, the fact that people with insurance have little to do with the payment of their care, high litigation costs and the fact that many states like California LIMIT insurance companies from being able to provide services in their states if they do not reside within the state itself.
Initially it was doctors themselves. Blue Shield and Blue Cross were founded by doctors and hospitals for doctors and hospitals as their capabilities expanded they did not have a reliable source of income from out of pocket. Hospitals used to be primarily a place to die, not to get expensive treatment. Blue Cross for hospitals grew directly out of the Great Depression.
The doctors and hospitals also consolidated their political power, and the governments actions reflected that. Unfortunately hospital-based care is expensive. When Richard Nixon passed his own healthcare reform in 1973, requiring that employers utilize HMOs when available, he very foolishly included second generation HMOs, which grew into the confusing and wasteful system known as PPOs that continue to plague us.
There are no FACTS to support this assertion. People, normally, do not WANT to see a doctor until they HAVE to. The notion that by having unlimited “access” to limited resources of Government sponsored health providers leads to better health is a lie.
Actually yes there are. Same book I mentioned before has a chapter that talks about Community Health Centers, which were focused upon providing charity primary care to underserved areas:
The neighborhood health centers made important contributions. By improving the care of low-income ambulatory patients, the centers were able to reduce hospitalizations and emergency department visits by patients. Neighborhood health centers also had some success in improving community health status, particularly by reudcing infant and neonatal mortality rates among African Americans.
Where I did my undergraduate work, I volunteered for such a place called Community Outreach. The clinic is actually funded by the local hospital, as it helps them stay out of the red by reducing the use of the ER by the poor.
Education of the public to the causes of poor health will do far more than access; smoking is bad, eating foods high in fat and cholesterol is a bad thing and not having a daily exercise routine is a bad thing.
I agree that is a good idea, but it doesn't really take away from my positions.
People’s HABITS are what causes poor health in many instances NOT the fact that they do not have “access” or the idiotic notion that if Government provides for everyone’s healthcare we will suddenly be healthier.
And one thing the stats I mentioned above highlight is that primary care can have an effect on habits.
The claim that insurance is prohibitive in cost can only be made if one presumes that the consumer should not CHOOSE to spend their money on OTHER things that they CHOOSE to instead of buying insurance for health care.
But pooled risk on a larger level makes costs more manageable, especially by reducing overhead. Hence government insurance. As I said before, individual plans cost even more overhead than employer-based plans, and most people cannot afford coverage that covers all contingencies.
The most asinine argument in this debate is the notion that once Government gets involved in providing healthcare, the costs will miraculously go down; there is not one shred of historic evidence that suggests that whenever Government becomes involved in ANYTHING the costs will go down.
The costs go down automatically because of reduced overhead and the lack of need to make a profit. Whether it will be a lot better or a little better depends on how well it is managed. If they emphasize primary care, evidence-based medicine, and electronic medical records, we will be a lot better off. If not, we will only be a little better off.
The shred of historic evidence that it CAN be done, as I have linked many times, is the VHA:
Veterans' health system blazing trails