On Mon, Jul 21, 2008 at 9:36 AM, Max B. Sawicky <[EMAIL PROTECTED]> wrote:
> This is all well-taken, but as with Dean it goes to level of spending,
> not rate of growth.  With zero inefficiency and waste, income growth
> and technical progress will expand the demand for health care, and
> because it must be tax-financed in great part, that creates a political
> problem.

If you institute single payer and most of savings I've mentioned (plus
some others: for example the medical system has a bigger direct theft
than most - I don't mean stuff that is morally theft - I mean either
stuff that is legally fraud (charging for things not delivered) or
shrinkage (supplies and equipment walking out the door). ) I think it
would be while before you had to worry. Actually during the first few
years of single payer transition cost would eat savings. Cost would
rise for a few years at the same rate, but coverage would skyrocket
and quality would increase.  Within a very short time we start seeing
low hanging fruit picked. You would have a period where costs dropped
drastically. You would have another period where costs dropped slowly.
You would have a third period where costs began to rise again. You
would have forth period where costs rose more slowly than the economy.
It would be fifteen or twenty years to exhaust savings enough for
medical costs to start rising faster than the economy again. And by
then single payer would be entrenched enough that we could fight to
make sure any reactions to the return of medical inflation took place
within the context of strengthening not weaking single payer - i.e.
either increased funding,  or rationing,  or cutting fat - not
privatization.
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