Wednesday, January 20, 2016

More PK and Single Payer


Paul K has another item on the unfeasibility of Single Payer.  This one utilizes the not uncommon mislabeling of  Vermont's attempts as "Single Payer."

A better account of Vermont's almost , but-not-really, single payer plan is at PNHP--.
Covers most of the same territory as the Kliff article-- but is more informed on single payer , e.g. --" It’s a misnomer to label Vermont’s Green Mountain Care plan 'single payer.' It was hemmed in by federal restrictions that precluded including 100 percent of Vermonters in one plan, and its designers further compromised on features needed to maximize administrative savings and bargaining clout with drug firms, and improve health planning."

I would add that Vermont's small population, and therefore, risk pool would hamper even a true single payer process. But, Single Payer would still be best. This was, indeed, a political/organizational failure, not an economic one.

Further-- it is also inaccurate to include doctors (and other practitioners) in the list of those who will be negatively financially impacted. Institutional costs-- pharma, hospitals and the like will be reduced. But practitioners will actually be more empowered, and less burdened, so as to be able to be appropriately compensated. Canadian institutional costs are far less than ours, Canadian practitioners-- particularly primary care physicians-- are compensated similarly to U.S.'s--- especially once you take the weight of insurance required work off of their backs. 

And BTW, Colorado Care's universal care initiative  to be voted on in November is not Single Payer either.  From funding tab of summary : ColoradoCare will serve as a supplemental plan to Medicare and will apply to become a Medicare Advantage Plan. For any other health insurance plans that are in effect, ColoradoCare will be a secondary payer, up to the payment level of ColoradoCare coverage.

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