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Thread: Single Payer Or Not: Matching Problems With Solutions

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    Single Payer Or Not: Matching Problems With Solutions

    A good Health Affairs blog post reminding that there's more than one way to skin a cat: Single Payer Or Not: Matching Problems With Solutions

    They consider three problems with the health care system and while noting how single-payer would address them they also consider others ways to tackle them.

    • High Cost Burden For Lower- And Middle-Income Households (Alt. to single-payer: expansion of ACA subsidies)
    • Opaque And Highly Variable Health Care Prices (Alt. to single-payer: all-payer rate-setting models like Maryland's, other regulatory interventions, or price transparency initiatives)
    • Lack Of Accountability For Total Health Care Spending (Alt. to single-payer: see excerpt below)


    Lack Of Accountability For Total Health Care Spending

    What Else Could be Done?

    Not all regulatory efforts to create sustainable budgets have been successful; notoriously, the sustainable growth rate system for paying physicians under Medicare was ineffective. But some promising initiatives exist at the state level. The Maryland global cap payment system for hospitals has been shown to reduce both hospital and overall spending. Moreover, Maryland’s hospitals managed to operate under restricted revenues without adverse financial consequences. Massachusetts has also been implementing a global budget to keep its overall spending trends more aligned with the growth of the general economy. Both efforts are led by independent government agencies that are responsible for ensuring reasonable levels of cost growth. Although New York’s Medicaid global cap ultimately required modifications, its early years showed it is possible to slow spending growth even as enrollment surged.

    Market-based approaches to moderate spending growth include contracts, such as those used by accountable care organizations, which hold provider organizations accountable for managing costs of a population of patients below benchmark amounts. An early and successful example is the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract program. It has exhibited reduced spending growth by up to 12 percent over the course of eight years, while improving patient care.
    You can read the full post for a brief outline of each of these problems, how single-payer would make progress on them, and what else can be done.

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    Re: Single Payer Or Not: Matching Problems With Solutions

    A single payer system would be one way to balance the wealth in this country. Currently, the rich have way too much money in comparison with working people. Since it would be mostly the rich who would wind up paying for a single payer system, the poor would get something for very little or nothing.

    I think that's fair.

    That's how it is in the socialist European countries like Sweden and the UK.

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    Re: Single Payer Or Not: Matching Problems With Solutions

    i'll take single payer.

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