[Winona Online Democracy]
We need to be able to envision a nation, or a state, without HMOs or health insurance. The system was created 75 years ago by hospitals to help make sure the bills were paid with physicians following close behind. We created an employer based insurance program. The number of uninsured however has been increasing since the early '70s - (when looking up what uninsured keep in mind the data may include government subsidized programs in their definition of insured.). Universal coverage should mean for all people for all care. Single payer means one place pays the providers with a much simpler system. Our level of quality is poor and needs improvement. Our current system does not provide an environment for that for the whole system for all people. Blaming the patient for overuse is an excuse based on a myth. Systems and charges based on a belief you can change consumer behavior without reducing quality outcomes do not
work. There is administrative waste due to how the reimbursement system is required to be operated. There is excess capacity in some areas (e,g, MRI) with inadequate capacity in others (e.g. ERs) - all driven by $ and not best practice. A system of managing and second guessing doctors cost too much and does not work. High deductibles, tax credits and health savings accounts may help those with money but they do not help all and they will just drive the overall health of the nation down. We have the most costly health care system with the worst results of most modern countries. We fear change and we fear losing what we have. A better system can and must be designed.
Craig Brooks
[Winona Online Democracy]
Well, the re would still be a need for insurance companies that would be responsible for processing claims and providing "supplemental" plans as they do for medicare, I suppose.My recollection, though, is that even though the government doesn't process medicare, the system has lot of flaws. It might be very frustrating for both providers and consumers if there aren't good information processing systems in place. Maybe Dick or Bill can comment on their experiences with medicare (part D and otherwise) and the relative ease of their claims processing to, say, MMIS II which is used for MA claims?I, personally, believe that a single payor system is in the best interest of all, but I'm not sure how we will be able to transition.Kathy Seifert
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