(In which we mostly correct the Panda Bear .)

Major points to Panda Bear for his passion, but his health policy leaves something to be desired, I must admit. His latest rant is good–and I agree some of it in theory, but he doesn’t seem to be well-versed in the single-payer “woo,” so here we go:

The key thing to keep in mind is that the various plans proposed to insure the entire nation will do nothing to lower the cost of medical care because they are just another scheme to shift the costs from one set of consumers to the other.

Actually, that’s not correct, Panda. Single-payer plans have consistently been evaluated and shown to cover everyone while saving money. They do this by cashing in on the massive savings associated with administrative waste (probably at least $100 BILLION), allowing drug price negotiating, and setting global budgets for health spending. (See the California Health Care Options Project , The Vermont Single-Payer Study , The Maryland Single-Payer Study , Massachusetts Health Care Studies , and Maine’s Single-Payer Microsimulation .) Just to be clear, these analyses were done by The Lewin Group and Mathematica Consulting , not single-payer supporters.

The only difference will be that instead of half, every single health care dollar will take a trip through the federal sausage mill.

60% of health care dollars already take a trip thru the federal sausage mill–yes, 60%–and when they go to the Medicare mill, you actually get more sausage (health care) for your buck. There’s lower overhead costs compared with most private insurers–no advertising, no huge executive salaries, no profit demanded by investors.

The money is going to come out of somebody’s pocket and it’s not going to be the government which has no pockets, just hands to grab from one to give to another

This is how insurance works–not just health insurance, but car insurance, home owner’s insurance–all of it. It’s risk pooling. And the bigger your risk pool, the better to keep the system going. Money for our health care system comes from the citizens, whether it’s from Medicare taxes or loss of income from businesses providing health insurance (the businesses get to write off the health insurance bucks).

This is why the concept of Health Savings Accounts (not to mention privatizing Social Security) invokes such howls of rage from our ruling elites. Not only do they hold the people in contempt thinking them incapable of planning for their own future but the money tied up in these accounts and owned by citizens is just another chunk of money that cannot be stuffed into the voracious maw of the political influence machine.

I’m against HSAs because they won’t do squat for our problems. 80% of health costs are from 20% of patients –those are obviously our sickest patients–and they’re going to spend thru their HSAs within the first 2 days. HSAs are a great tax-free way for the rich to protect their money from taxes, but like I said before, they’re focusing on a leaking faucet when there’s a Niagara Falls right next door. Also, sure, an HSA might make someone think, “Should I really go to the doctor for this cold? Maybe it’s a virus.” Okay, so you’ve saved the system 50 bucks. But what consumer patient, when truly sick, is in any state of mind to decide if he needs the CT scan the doctor is recommending? Or if she should be admitted? Come on. (It’s a myth that more consumer information improves health care decisions , anyway.)

It would be demoralizing to our nation to have the disparities of medical access so wide that the poor and ignorant suffer or die from conditions that those who can think and plan ahead easily eacape. We will, unfortunately, always need to give medical care as charity.

Awkward! 18,000 people die each year from lack of access to proper health care. You’ve never seen an uninsured diabetic come into your ER with a nasty foot ulcer or infection that eventually leads to amputation, Panda? Come on. And survival rates after amputation suck.

I don’t think we will, fortunately, always need to give medical care as charity. There are tons of other nations able to provide for health care for their citizens, because it’s a priority for their countries. We can make it one too, if we want to.

There are many conflicting forces in medical care, each one trying to stiff the other with the bill. The insurance companies want to pay as little in claims as possible which is understandable given the nature of their business. The medical industry, from physicians to the lady mopping the hospital floors, would like to get paid fairly for their services. The government wrings its hands at the cost but at the same time would like as many people dependent on government as possible. The people want all the medical care they can eat but they want somebody else to pay for it.

You’ve really gotta read Money-Driven Medicine, Panda. You’ll love it.

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