Originally Posted by
Segnosaur
That's an irrelevant distinction. Any costs related to malpractice insurance need to be covered by whatever fees the doctor or medical institution charges.
Yes, but those other countries often have ways to limit malpractice payouts and insurance... limits on payments, rules about how lawyers are paid, etc.
True. The USA does seem extraordinarily prone to trying to solve even the smallest problems with law suits, an expensive business.
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The point is that if you go to a single payer without changing the malpractice laws, your costs may still be higher than they could be.
Possibly. But it will depend on how the system recompenses doctors. Most of them use a "standard fee" approach - a list of common services each with prescribed recompense (in Australia, this list is vast). The doctor may choose to charge the patient more than that amount, but s/he will get back only that amount from the government. The patient effectively pays the difference. So if the doctor wants to add their malpractice insurance costs on top, fine. But that is not an issue for the single-payer system, it is an issue for them.
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Ah yes, the most crappy argument that was ever put forward, but which keeps getting repeated over and over again. "Be happy with waiting lists because at least you will be treated quickly if its an emergency". Its a bogus argument, because it ignores the real pain and suffering that can result from being stuck on a waiting list (not to mention it can also lead to premature death, even if its not an emergency).
I never said it was a perfect argument. In fact, I made it clear it was over-simplified. Nor is it perfect or an excuse. There will be plenty of situations where people will be forced to wait for procedures while they are in pain.
But no system can afford to have a personal doctor and a fully stocked radiology suite and surgery suite and pharmacy standing by everywhere for every single person in the country. I exaggerate to make the point that available resources are scarce and not readily available everywhere, so patient care needs to be prioritised. That's what the waiting lists are, and the process is actually quite complex. Do not for one moment think that people get put on these longer lists because of neglect. Medical staff feel their pain and would love to treat everyone immediately. The reason is simply the lack of resources right now, NOT because some faceless wonk in Ottawa decided a rotator cuff injury is of no consequence.
The clue to better service is to have more resources available immediately, of course. And that means more money from government. And that in turn is an ongoing food-fight that happens in every country that has socialised medicine. And the generosity of neighbours like the USA in providing some specialised medical care for Canadians is another solution.
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Let me give you some real life examples...
I have a cousin. He injured his shoulder (possibly a rotator cuff injury). He finds it very painful for him to raise his arms, but has to suffer though because his job involves physical activity. He was stuck on a waiting list for several months to get an MRI for a proper diagnosis. To you his pain and suffering doesn't matter because "gee wiz if its an emergency he'll get treated". Its not an emergency. He's suffering. If he were in the United States he probably would have had an MRI within a week.
Here's another example that's a bit more personal... I may have sleep appnea... I often stop breathing at night. Its a condition that has been linked to an increased risk of Stroke or heart disease. I mentioned it to the doctor over 6 months ago, but they have yet to find a slot in a clinic to do a proper sleep study. So while it is not an emergency per se, it still may shorten my life. (I do believe there can be waiting lists in the United States, but those waiting lists are much shorter.)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933773/
Two examples. Meanwhile, how many people were NOT treated in the USA for necessary and urgent medical reasons because they had no insurance? How many were turned away? How many in poor rural areas now have to travel long distances to a city to be treated because their doctor has had to close up shop? How many hospitals closed because they were deemed financial nonviable by their insurance company owners?
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Actually yes, yes it does.
In Canada, what treatments are provided/funded are determined by the government, which is sometimes slow to react and often has different priorities.
Indeed. Sometimes this does indeed happen. Sometimes. But oftentimes it doesn't too.
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Let me give you an example: There is a genetic diseases called Fabry's disease which can cause serious health problems (including heart and kidney problems). There was a point where treatment was not being provided in Ontario, despite the fact that such treatment was being done (and covered by many user's insurance) in the United States.
It is fully covered now.
More details.
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I do not doubt that knowing you will be covered by insurance (regardless of your employment situation) is a good thing.
What I am complaining about is people who ignore or hand-wave away all of the possible problems involved with various alternatives.
Nothing is being hand-waved away. Single-payer is not a perfect panacea. It has inherent problems, and depending on how each nation implements it, specific problems. But it is proven in hundreds of other countries to be generally a more efficient way of affording and delivering health care.
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And let me make a prediction... if the Democratic party does decide to push a true single-payer (i.e. no private insurance) option in the next election, you will see a rush of right-wing newscasters to Canada to point out every patient who has ever been on a waiting list, in an attempt to say "See? This is what the Democrats want for your health care!"
No country ever implements a "true" single payer system. There will always be some form of private health insurance required and involved. The Dems know that; they are not entirely dim. So I rather suspect the idea of them eliminating all private health insurance is a GOP fear tactic, not anything to do with reality. Although if Warren does push this particular line, that will be VERY silly.