Several things popped out.
I wonder why the fact that "We spend about twice as much on health care â $5,600 per person in 2003 â as the average in other developed nations, yet we still have more than 41 million uninsured." was not among the things that popped out.
First, the idea that hospitals though private would be paid a fixed budget by the government. This would have the same effect as price controls: since the amount of income received is fixed there is no incentive to maintain the facilities, which will deteriorate over time.
This is just one proposal, this is just one idea, it's certainly not in stone, the budget does not have to be fixed or it can be fixed on a per-patient basis which will give them an insentive to do a good job in order to retain their customers. At any rate, police departments receive a fixed budget, so do quite a lot of other organizations, I don't see their facilities and their performance detiriorate over time.
Are doctors fees fixed by the government in a fee for service system? If so, this will have an impact on the quality and quantity of medical service available.
Again there are different ways to handle it but what about doctors' fees now, they are already fixed by the insurance industry aren't they? Every medical or dental procedure has a price associated with it and insurance companies won't pay a penny more. Virtually all doctors now happily accept Medicare, what makes you think that they will not be willing to accept it when it covers everyone?
Second, no co-pays or deductibles tends to lead to a overutilization of medical services, as the marginal cost of getting treatments is zero.
No one enjoys doctor visits, that's probably the best deterrent. Besides early diagnostics and prevention will in the long run save money and lives. And co-payments don't need to be eliminated either, everyone can afford a $10 - $20 co-pay and it will certainly prevent people from abusing the system.
However, there is the hidden cost of the longer waits for getting medical services, which will impact wealthier patients more.
Longer waits are avoidable, besides people will be allowed to go outside the system.
It is not immediately clear to me how having the government process claims rather than private industry leads to cost savings unless the idea is to eliminate the profit.
Eliminating the profit is certainly part of the idea - one global non-profit government run insurance company covering everybody in this country with one set of rules, one set of forms and requirements, one staff, one set of computers and equipment, one building etc as opposed to thousands of insurance companies, each one with their own rules, paperwork and compliance procedures, hunderds of thousands of employees, millions of computers all doing the same things, occupying (and paying rent for) thousands of buildings all accross the country. It all translates into huge administrative cost. Also add to that an obvious conflict of interests - insurance companies are interested in denying services to patients and denying payments to doctors/hospitals.
By that thinking we should eliminate profits in all industries to save costs. I think there was a 70-year experiment with that in the Soviet Union that didn't work so well ultimately . . . .
Our military is non-profit, so is the police, so is a lot of other departments, so is the distribution of healthcare services to Medicare recipients. Using the example of the Soviet Union is a tad disingenuous, try France, Spain, Italy, Israel, Japan and lots of other countries, they implemented single-payer healthcare systems decades ago and they work extremely well.
