The 10 Essential elements of REAL SINGLE payer- Not an option, it prioritizes health and saves money
A "Single Payer" Healthcare plan is a *solution* that is known to create a strong nationally loved health care system that WORKS.
The Single Payer approach does that by not making major changes from what we have now at the doctor or hospital level, and not by eliminating one doctor medicine, buying up practices, capitation, globalization, or forcing wages down or shipping poor patients elsewhere, (NONE OF THAT IS THE PROBLEM) but instead, by being there for people. NOT by denying care in ANY way.
Also, by not competing. (Competition in health care increases, not decreases cost!). There are no "metal levels" tiers, or tears. It just IS.
Its said that "a stitch in time saves nine" and nowhere is that more true than in health care. Saving money is natural and automatic with single payer healthcare and in order to work at all, its not an option, its not a health care plan for the poor, its not a cherry picking high deductible plan for the wealthy healthy, its the only game in town also so ALL doctors are in network and no "supplemental" insurance is necessary.Single payer's core assets are its simplicity, inclusiveness, bargaining power on pricing and rapid availability when needed when somebody gets sick. Also, single payer avoids needless competition, i.e. duplication of and race to add expensive often unnecessary services without planning, which saves a LOT of money because then patients need not be "retained" or "managed" and can be allowed to be cured or get better. In short, its seen as a threat by those who want to use healthcare and sick people, or the American taxpayer, as a profit center to be "milked". A single payer does not demonize differential diagnosis of illness and medical testing, it does not attempt to discourage curative care by charging people money if they are sick but not if they are not. (This is both so they will be honest with the doctor and because sick people already have enough problems as it is.) Single payer is a huge saver of money. That is indisputable. Its not 'more expensive' than a typical healh care system, its less expensive, while delivering better quality. Also, it saves each person a huge sum of money over their lifetimes, (likely a mid or upper six figure sum).
Which is exactly why is hated by many in US politics today which in case anybody hasn't noticed, is run by corporations.
You may want to save this so you can refer to it the next time somebody tells you they want "a single payer option". No.. there is no such animal..
Single payer is something far different than what we have now. It cant be grafted on as many people seem to want to tell us. If we institute it it likely would be a Medicare for all system but without any other systems. That would also require modification of our trade policy. (Very very important, and urgently needs to be done, soon, very soon, or we'll be trapped by our own stupid deals. And once that happens, no election will be able to fix it. If that happens its likely politicians would lie to us about it. Not tell us the truth.)
Most important point, if one removes any of the top key elements, it doesn't work at all. So, it then becomes not an option. Then the entire country becomes doomed to sink farther and farther into the mess we're in today. And secret deals make the mess impossible to reverse, soon. Failing our country and its people.
Elements of a REAL Single Payer plan:
1.) Single payer health plan is the single means of payment for all doctors, hospitals and meical service providers of all kinds, exclusive of all others which are merged into one. So one could say it was Medicare for all, and there would no longer be other kinds of health insurance, or self-pay.
1.a) In case this is not clear from above. ALL doctors are "in network". A simple form will allow doctors who are currently licensed but not active in practice on a daily basis to receive payment with no ordeals when they do render services. This would allow many medical professionals to render care on an ad-hoc basis when it was appropriate.
1.b) There is no "gap". No health insurance can or needs to be sold. Wealthy people can not and would not buy out of the system by paying doctors in cash because the system would be designed so that was not necessary. Having the wealthy people included and equal to everybody else is important because that's what keeps the system good. Allowing them to opt out would ruin it, that's a good example of how all the elements of single payer need to be present for it to work.
2.) Single payer health care has to be FREE. With no bills and no tiers to punish people who 'wont pay' or 'cannot pay'. (That is also important for it to be seen as exempt from certain trade related entitlements which otherwise are being given to foreign health services and staffing firms to enter and exploit the market.) Also, everybody who is in the country would get care when needed. No money is involved or collected. In other words, when you go to the doctor for the first time, you likely will just give them information, such as your social security or some arbitrary code they will use to put you into their computer and subsequently, when you go to any doctor you will be covered 100% and will not receive any additional bills, except perhaps a single small payment which would be waived if somebody didn't have it without question. People would not be deprived of health care under any conditions. Money would not be a factor in deciding how to care for somebody. Money would not be involved at all from the user's perspective.
3.) The single payer system must be run by doctors who actively practice medicine, and those doctors would be sworn to put the quality and political independence of the health care system above everything else. There would be no "gag clauses" (secret contracts that give insurance companies veto power over all treatments) and obviously no de-listings for doctors for being frank with patients or for giving them necessary treatment. That is very important because many Americans now have to go to self pay to get decent care. They tend to be wealthier people and most do it because doctors who do self pay do it because the insurance companies gag them and are forcing doctors to deliver increasingly substandard care. That would have to end, in other words, the payer would cover all medically necessary care, period, and not try to tell doctors how to practice medicine as insurers do now. Nor would the government try to lower the legal standard of care as it is trying to do now. We would however save so much money with single payer it likely would cost less than we pay today which is an astronomical sum that averages tends of thousands of dollars per year per family. (Typical cost for a decent individual plan for a couple is several thousand dollars a month. Obamacare is basically insurance of last resort. A single payer plan would be equivalent to the best health insurance plans - fee for service plans which in many cases are no longer available for any price. (When they are available they can easily cost >$50k a year for an individual or >>$70k a year for a small family. That's a 10 year old figure, its likely more now.)
4.) The plan would not cover pets. Nor would it cover people who were deceased, funeral expenses would be the responsibility of the deceased person's next of kin or their estate. It would also not cover some highly speculative experimental medical procedures such as rapid cryogenic preservation of a deceased persons body, and cold storage with the intent of reviving them in the future, at least it would not at this time. On the other hand it would cover clinical trials and would cover medically useful cutting edge medical procedures of all kinds with the patient's informed consent, for example, its now possible - and saves money and lives, to put somebody who has suffered a very severe brain injury into a state of chilled suspended animation for a few hours or days or perhaps even weeks until they can be operated on- for example, until a surgical team and operating room is ready or donor organ is available. That being medicine - would be covered without any additional charges. (Also because no system would be in place to bill patients, saving a lot of money) Generally the system would not charge patients money at all. Hospitals could convert some of their accounting departments to serve more patients, although its expected that the prompt provision of medical care early on in the illness process would arrest many illnesses in the early stages and would result in a large decrease in the total expense of health care. This also allows the system to be seen as a 'a service supplied in the exercise of governmental authority' - which only means any "service which is supplied neither on a commercial basis, nor in competition with one or more service suppliers." That is the single most important element of a single payer or other public service system. If even a single commercial provider exists, it will be torn apart by trade policy. Additionally it has to be carved out explicitly in those agreements ahead of their signing, which in some cases was in the distant past. Making single payer FTA-impossible without changes, now.
5.) The plan should cover some additional services such as basic child care for the sick and new parents as well. If a patient was unable to travel, it would cover basic house calls. Vans with additional medical resources would be available in every community to support doctors when needed. Ambulance services would also be fully covered. Poor sick patients and those without transportation of their own would be able to get a ride to and from the doctor in every community for free if they needed one. The idea would be that people would go to the doctor when they needed to and would not defer care for reasons such as lack of money or transportation.
Visiting nurses would be available to check on people with chronic diseases at home. Extensive use would be made of the Internet to allow many kinds of doctor visits to be conducted via the net. Sick patients would have a home terminal which embedded several common medical tools, such as a HD definition camera that could be used to take their vital signs via the net.
6.) Drugs would be covered. Doctors would decide what drugs to prescribe. Generics would be encouraged if their quality was identical to brand names but that decision would be exclusively the doctor and patients. If there was a fee for drugs it would be waived upon request with no questions. Family planning care, birth control, prenatal care, care to allow terminations of unwanted prgnancy all would be 100% covered. Difficult pregnancies and complications of pregnancies would be completely covered regardless of income or legal status.
7.) Every human being who was in the country who got sick and needed care would be covered. No money would be asked of them (where would they put it without any bursars office?) Americans abroad would be covered by arrangements between countries to provide reciprocal care for one another nations nationals, however if such an agreement did not exist, care would not be effected (only diplomacy).
8.) No taxes would be labeled as connected to health care. It would be expected a lot of money would be saved by avoiding massive duplication of services. Doctors would receive a combination of salary and per patient fees but not be paid by capitation, so there would be no incentive to deny needed care.
9.) The system would not be turned into a pawn in the globalization game. The health care system would be run by lifetime civil servants, not a contractor and their subcontractors. There would be no privatizations. The health care system would not be used as a means of globalizing services nor would health care jobs be used to gain bargaining power in trade negotiations. On the other hand, a percentage of jobs in the health care system would be available for an international system of intra-country medical education and mutual assistance allowing foreign medical professionals to participate on a lifetime basis so that doctors in our country could gain experience practicing elsewhere performing medical care for people in other countries, with special emphasis on the home countries of immigrants in their communities. In other words, a doctor whose home was a community with a lot of immigrants from Latin America or Asia, could gain experience say three months at a time in countries of origin so they became more familiar with the physical and cultural backgrounds of their patients so as to better understand their medical situations. Likewise, medical students from both the US and around the world could gain experience in the each others countries and forge lifetime friendships with their colleagues elsewhere which would become invaluable in improving the practice of medicine.
10.) Employers would not be taxed in any way for health care especially not by employees or their age or medical condition. There would be no reason to lay off a competent, high performing employee who had a sick family member because no bills would increase, and also that sick family member could access a wealth of services. Businesses would not be deterred from hiring by health care costs, nor driven across international borders to Canada by them. An employee with sick family member would not find themselves jobless if their family member suddenly had a serious complication. There would be no fear of genetic testing so that genetic information would not become a legal and moral hot potato. There would be no threat of genelining or genetic blacklisting of people with genes for breast cancer, etc.
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