A wiff of truth about Single Payer and Medicare

[mhparker]

Quote from 151:

The point is I do not want to pay the government to take care of me. I'll die young if it allows me to take care of myself.

The only way to win this is to prove that we are not interested in government run healthcare regardless of the benefits or negative aspects.

Wow! Re-reading Trading In The Zone this morning, I am fascinated by Douglas’s theory about how our brains become conditioned to resist structure, discipline and responsibility. His point in a nutshell is that we’re all born with natural curiosity about everything, and of necessity, our parents have to squelch this curiosity repeatedly. This creates deeply ingrained emotional dissonance – any current necessity to structure or regulate our lives (any perceived loss of freedom) causes an instinctive reaction somewhere on the emotional spectrum between slight resistance and extreme anger or fear. I'm wondering if this also might explain why in every debate about healthcare reform, the people arguing from the right seem much more emotional than the folks on the left. Any thought of “more government” taps in to the same kinds of emotions that get in the way of good trading. Being willing to be governed (whether by trading rules or elected officials) feels similar to being willing to have your curiosity squelched by your parents. Now I understand.

 

[hitech4045]

Wow! Re-reading Trading In The Zone this morning, I am fascinated by Douglas’s theory about how our brains become conditioned to resist structure, discipline and responsibility. His point in a nutshell is that we’re all born with natural curiosity about everything, and of necessity, our parents have to squelch this curiosity repeatedly. This creates deeply ingrained emotional dissonance – any current necessity to structure or regulate our lives (any perceived loss of freedom) causes an instinctive reaction somewhere on the emotional spectrum between slight resistance and extreme anger or fear. I'm wondering if this also might explain why in every debate about healthcare reform, the people arguing from the right seem much more emotional than the folks on the left. Any thought of “more government” taps in to the same kinds of emotions that get in the way of good trading. Being willing to be governed (whether by trading rules or elected officials) feels similar to being willing to have your curiosity squelched by your parents. Now I understand.

Thank you mhparker for your hypothesis on resistance to government, structure, organizing principles, etc.

It is all so clear to me now.

 

[piezoe]

Quote from Mvic:

Keep in mind that most docs who currently take medicare can only afford to do so because private insurance reimburses at a higher rate. If 100% of reimbursement was from medicare most practices would not survive. As it is many practices restrict the % of their patients who are on medicare and are simply not taking on new medicare patients. I don't think that this has been adequately covered in the health care debate so far but the fact is that privately insured patients are subsidizing the care of medicaid patients.

I have long been an advocate for a single payor universal healthcare program but I realize that the government has show that it can not be trusted to reimburse at a fair rate and as any collective bargaining by physicians is outlawed there will be no check on the government nickle and diming the healthcare system in to decrepitude.

Any healthcare reform that does not include increases in reimbursement for primary care (without which you may have more people insured but it will do nothing to solve the problem of access and quality, the best practice medical home model of primary care can not be provided with 100% medicare reimbursement) and tort reform is not credible in my opinion.

If in the first sentence of your post you were to replace the words "can only afford to" with the words "would rather not" the remainder of your post would make more sense, at least to me. With average physician income before benefits after 3 years of practice ranging from $250,000 to $830,000 per year, depending on specialty, it is a little hard to swallow the idea that physicians will go broke if they treat too many medicare patients at today's quite generous reimbursement rates. You can't be serious!

The real reason why medical care in the U.S. costs twice as much as it does in the next most expensive country and far, far more than in most highly developed countries is made clear, I hope, by my parody above of the way American Medicine operates.