Republicans should support socialized medicine

The current system sucks. It’s not free market medicine. No sector of the economy is more heavily regulated than medicine. For the typical working American, it’s almost as if medicine is socialized. Your healthcare plan is chosen by someone else, your employer. No matter how many healthcare services you consume, it doesn’t cost you any extra money (or only nominally more money). The government is already paying for part of your healthcare in the form of a tax break.

The government should take everything over. Doctors should be government employees who get paid a straight salary. This would remove their perverse incentives to give patients unnecessary tests. Doctors would be set free to practice honest medicine instead of being sneaky connivers who load up insurance forms with bogus claims.

A huge amount of man-hours are spent on medical billing. Doctors and their administrative staffs submit bills, then the insurance companies have an army of people denying the bills, and you, the patient gets caught up in this mess also. The system always tries to trick me into paying for stuff that’s supposed to be covered under whatever crappy plan I have. Dumping the whole medical billing system will cut out a huge amount of waste from the system.

Socialized medicine would be a government benefit that helps the middle class. Poor people already get free healthcare in the form of Medicaid and free emergency care whenever they show up at a hospital emergency room. Old people get nearly free healthcare in the form of Medicare. Fully socialized medicine would merely give middle class wage earners some government benefits for the taxes they are already paying.

Would people still want to go to medical school under the new plan? Yes, because the government should provide free medical school education for anyone who qualifies. If doctors get paid the highest salary in the GS system, which is around $150,000 per year, there will be a lot of takers. Also, we can institute reforms here, such as combining medical school with undergraduate school in order to accelerate education and lower costs. Anyway, doctors aren't really the system's biggest cost.

Republicans need to get behind this, because only Republicans can create a sane socialized healthcare plan with proper incentives that would result in better and less expensive healthcare than we currently have. Furthermore, in exchange for the Holy Grail of free healthcare for every American citizen, Republicans can extract two very important concessions from Democrats:

(1) No more medical malpractice lawsuits. With the government being the ultimate healthcare provider, a malpractice lawsuit would just be a lawsuit against the taxpayer. The public will be protected under the new system by the firing of incompetent doctors or other incompetent healthcare employees.

(2) No more immigration of unskilled workers. With the government providing free healthcare, it’s obvious to point out how the nation can’t afford to have people come here and mooch off the system. Only people who will be able to pay enough taxes to cover the government services they consume should be allowed to immigrate.

Comments

[Half Delta]

While we are at it let's force socialization on lawyers and the finance sector. No more extra regulation, no more bubbles, no more frivelous lawsuits, and no more exorbitant salaries.

Let's face it if we don't socialize everything else all the high IQ doctors will take their high IQ ness to the more lucrative fields and you will be stuck with average folk working the scalples.

Honestly Half Sigma this is the most ridiculous post I have seen here. What needs to happen is incentives for doctors to work on preventive medecine practices. 90% of a persons medical expenses are spent in the last 10 years of their life.

[New Anon]

"(2) No more immigration of unskilled workers. With the government providing free healthcare, it’s obvious to point out how the nation can’t afford to have people come here and mooch off the system."

Duuuude,

Britain has a completely socialist healthcare system and not only is their health regime a disaster, they also have been experiencing a tidal wave of turd world immigration thanks the ZanuLabour party.

In fact, a muslim immigrants doctor tried to blow up Glasgow airport a year or so ago.

[Dan Morgan]

For the typical working American, it’s almost as if medicine is socialized.

Not seeing that. My company pays most of my insurance premiums and I pay the rest. If someone in my family needs to go to the doctor or hospital, they pick the doctor or hospital of their choice, and then I split the bill with my insuracne company. The whole process seems rather free market to me.

The government should take everything over. Doctors should be government employees who get paid a straight salary. ...Would people still want to go to medical school under the new plan? Yes, because the government should provide free medical school education for anyone who qualifies.

HS is suddenly Comrade Half Sigma. For someone who says he hates liberals, he has out-liberaled the liberals here.

On the other hand I think that it is only a matter of time before the US has universal health care. So I agree that it is better for Republicans to take the lead on this - but not by creating a single payer (socialized) system. Instead, subsidies can be given out as needed to help people buy their own private health insurance.

The system today works great for most people. So why toss out the whole system? Incremental reforms seem safer.

[loki on the run]

HS,

Haven't you realized yet? The whole illegal immigrant deal is designed to create more consumers for big business rethuglican supporters across the country.

[Lawful Neutral]

No more immigration of unskilled workers.

What? If this deal was on the table for real, it might be worth taking, but it's not. Plus, isn't illegal immigration already, um, illegal? That doesn't stop it and it doesn't keep enforcing immigration law from being considered cruel, unnecessary, and racist. Even if you could make this deal somehow, there's no way to hold anyone to it.

[rightsaidfred]

Here's a blogger who knows the system, and he's got a pretty good handle on things. This link is a history and comparison of the French system with ours, and it sounds like something we could adapt, with the usual improvements over anything French.

[Independent Accountant]

This idea is absurd. Suppose we adopted it? What would happen? Even more illegal immigrants as doctors would have no incentive not to treat illegal immigrants as the doctors are paid a salary. I can see illegal immigrant "outreach" programs to encourage them to get more medical care, prenatal care, etc. The quality of care will go down since you can't sue the government. Look at our schools. The IQ of doctors will fall as they become civil servants. If you want to socialize something, consider the banking system which currently only socializes its losses through inflation.

[anonymous 1]

The IQ of doctors will fall as they become civil servants.

Most doctors (in my experience) are lying through their teeth when they say they go into medicine purely for humanitarian reasons.

My guess is that you are right that the IQ of doctors will fall if this plan is enacted. However, that may not be the worst thing. There will probably be less 140+ IQ male doctors entering the field if the potential isn't there to make $300K or more a year. However, I suspect that there will still be some quite high IQ women and still a lot of 120-139IQ peoples going to med school. If govt were to raise the starting salary to around $200K a year, I'd suspect a lot more people would still go to medical school.

[mondo]

The problems with socialized medicine is almost the same with problems found in public education: the system will be straining to support an underclass (with poor diets and reckless habits) who consume more value from the services than what they pay into with taxes. Individuals should be able opt for healthcare savings accounts.

[anon]

I'm sorry, what part of the U.S. Constitution delegates the power to create a national health care system, and force citizens to participate in it, to the Federal government? Because I see a 10th Amendment that reserves all powers not explicitly granted to the Federal government for the States and the people, but I don't see a "health care system" clause any where.

I'm tired of being raped of my rights. Whenever a question arises about any Federal program the first place every American should go to is their Constitution. And the first question should be: is this idea even legal?

We've gotten so far away from the model our framers intended it's sick. The Constitution does not consist of only the 1st and 2nd amendments and a description of the electoral college. A national health care system is NOT LEGAL because the power to create such a monster is NOT GRANTED TO THE FEDERAL GOVERNMENT. Neither are most of the other programs if you want to get down to it.

I don't care if a socialized system would prove to be best! (It wouldn't, btw.) My health care is my right. Nothing can change that but a Constitutional amendment. If the government doesn't feel bound by our highest law, then why should any citizen feel bound by any law?

[blah]

One question:

When has forming a monopoly ever reduced prices?

Socialized medicine means forming a monopoly that can never go out of business and has no incentives to improve service, bring in new machines, or try new treatments. Patient choice is critical.

If you want to solve health insurance:

1) pass health insurance portability, like phone number portability. Make it extremely easy to switch providers.

2) deport all illegals

[SFG]

Britain has a completely socialist healthcare system and not only is their health regime a disaster, they also have been experiencing a tidal wave of turd world immigration thanks the ZanuLabour party.
In fact, a muslim immigrants doctor tried to blow up Glasgow airport a year or so ago.
This is what I wonder. The Swedes made it work but they have no major minority underclass. Of all the European countries we resemble England the most. Could it be that the Swedes can do it, but we'll screw it up? One of my concerns about nuclear power is that, while France does it and does well, our tendency to cut corners in the search for greater profit is going to result in a lot of meltdowns.

Most doctors (in my experience) are lying through their teeth when they say they go into medicine purely for humanitarian reasons.
My guess is that you are right that the IQ of doctors will fall if this plan is enacted. However, that may not be the worst thing. There will probably be less 140+ IQ male doctors entering the field if the potential isn't there to make $300K or more a year. However, I suspect that there will still be some quite high IQ women and still a lot of 120-139IQ peoples going to med school. If govt were to raise the starting salary to around $200K a year, I'd suspect a lot more people would still go to medical school.
Right on. I might tweak some of your numbers a bit (over 140 male IQ you fall off the nerd cliff and those guys are unlikely to do anything but academia or programming; I think it's above-average IQ PLUS personality) but you'll get all the girls who want to help people and plenty of nicer guys as well.
What I don't think you'll get are the Wall Street-type 120-139 IQ alpha males who presently become orthopedists and dermatologists, who really don't belong in medicine anyway. I don't really see ruthlessness and sociopathy as desirable traits in physicians. These are the dudes who order unnecessary tests and procedures to pad their pockets. And while MRIs are harmless, you can see how an unnecessary operation is a big no-no.

The problems with socialized medicine is almost the same with problems found in public education: the system will be straining to support an underclass (with poor diets and reckless habits) who consume more value from the services than what they pay into with taxes. Individuals should be able opt for healthcare savings accounts.
That might have worked 20 years ago, but right now the middle class is getting hit too hard with gas prices etc. and has no disposable income.

I'm tired of being raped of my rights. Whenever a question arises about any Federal program the first place every American should go to is their Constitution. And the first question should be: is this idea even legal?

We've gotten so far away from the model our framers intended it's sick. The Constitution does not consist of only the 1st and 2nd amendments and a description of the electoral college. A national health care system is NOT LEGAL because the power to create such a monster is NOT GRANTED TO THE FEDERAL GOVERNMENT. Neither are most of the other programs if you want to get down to it.
Does the Constitution give the government the power to do medical research? To publish the Census records over the Internet? To search airline travelers? They wrote the thing in the 18th century. It doesn't talk about healthcare because there was no healthcare to speak of back then; when Ben Franklin said, "God healeth, and the doctor collecteth the fee", he was telling the truth in his time period. Every other f***ig civilized nation has this. If America's different, you really think that means we're better?

[dearieme]

I wouldn't have the cheek to offer you chaps any advice on this, save for one point - don't copy our NHS. Don't, don't, don't. You'd live to regret it. Or, more likely, not.

[Peter]

As I've said about a thousand times, socialized medicine is an excellent idea IF it is combined with outcome-based rationing. Far, far, far too much money is now being spent prolonging the lives of the dying, when quality of life and hope of anything but very short-term survival are both zero. That has to change.

[New Anon]

"The Swedes made it work but they have no major minority underclass. Of all the European countries we resemble England the most. Could it be that the Swedes can do it, but we'll screw it up? One of my concerns about nuclear power is that, while France does it and does well, our tendency to cut corners in the search for greater profit is going to result in a lot of meltdowns."

I don't know about Sweden, but France's health system is different from Britain's.

In France, they simply put everyone on the French version of Medicare, but, they did not socialize the medical profession itself. France does not tell their doctors who to treat, whereas Britain (and Canada) regulates the entire medical industry from top to bottom which has been ruinous for them.

My preference would be for the Government to give insurance subsididies and allow individuals to buy insurance across state lines, but allow uninsurable Americans with preexisting health problems who cannot get private insurance to go on a Medicare/French national insurance, or the equivalent.

I am not so infatuated with the free market that I am totally oppossed to some government intervention in health so long as it is targeted at sick people who cannot get private insurance.

[Vim]

@Peter

Do you expect me to pay more for healthcare, Goldfinger?
No, little Billy, I expect you to die.

[M]

"HS is suddenly Comrade Half Sigma. For someone who says he hates liberals, he has out-liberaled the liberals here."

Seconded. This is ridiculous, Half-Marx Sigma.

[Rob]

When has forming a monopoly ever reduced prices?

If what you mean is when has a huge customer ever forced its suppliers to cut prices, I refer you to Wal-Mart.

If I got to chose incremental policy changes for healthcare, I would put self-purchased health insurance on equal footing with employer-paid.

Insurance should also only cover what insurance is good for: big, unpredictable expenses. If car insurance covered basic maintenance, it would be far more expensive. The insurance provider would also work as hard as they could to avoid paying out.

There seems to be a general idea that healthcare is expensive because doctors are too greedy. I think they aren't greedy enough. If they were more concerned with money they would cut costs to raise profits. But they don't seem to.

Where does the idea that demand for healthcare is infinite come from? There are large numbers of people who pay very low marginal costs: they do not voluntarily spend much of their time in the hospital. As Fred Reed said, if a man gets a free cast on his broken leg, he will not try to get a cast on his good leg just because he doesn't have to pay for it.

[Rob]

HS,

Have you read Murray's "In Our Hands"?

[SteveBrooklineMA]

$140K? You are out of your mind. Medicine will hemorrhage its best and brightest. That means no innovation. No new procedures. No progress in medical science.

That is the real, never-mentioned problem with all of these government take-over plans. Socialized medicine in the USA would be a death blow to medicine, because the USA the only major market left on earth where investing in medical research has the potential to pay off. No profit motive means no new devices, no new drugs, no new procedures, no new technology. Spare me your vision of the noble NIH-funded scientist sweating away in his lab to save humanity. His goal is to produce journal papers. Spare me your point about European drug companies doing well. Where do you think they make their money?

If we had adopted socialized medicine decades ago, where would medicine be today? Decades behind.

[hugh go naught]

The new politics of common sense - now with 50% more Marxism.

[Ned]

Wow! What a great idea! Then health care can be like Amtrak, FEMA, the Defense Department, the post office and all the other efficient, user-friendly, low cost government bureaucracies. When do we start?

[Natural remedy]

Every other f***ig civilized nation has this.

Nothing like "the everyone else is doing it" argument! Socialized medicine has worked so great in Canada that they come here. Placing the feds in charge of such a massive program is a fine idea, what could go wrong?

[SFG]

n France, they simply put everyone on the French version of Medicare, but, they did not socialize the medical profession itself. France does not tell their doctors who to treat, whereas Britain (and Canada) regulates the entire medical industry from top to bottom which has been ruinous for them.

Might be sensible. The government could use its market power to drive down pharm prices, so we can at least pay the low rates every country gets. IMHO American pharm companies should be charged with treason for overcharging their own people.

Steve: you're in Brookline, not far from the Harvard monolith (if I remember my Beantown geography right). Don't most of the MDs churning out the discoveries over there make very little cash?

[miles]

Sigma is a man of his convictions, I'll always conceed that.

I do wonder how many good candidates for doctors would bite at 150K a year though. That would probably have to be 250K to get a lot of really talented individuals to bite. Even if med-school were free, one has to major in chemistry and minor in biology to get to med school, do med school, and then residency. That is a long time to wait to only make 150K when you can do so many other things to make good money seven or eight years earlier, thus getting on with your life.

[Jim Beam]

We've gotten so far away from the model our framers intended it's sick.

You're right.

The framers were typical agrarian aristocrats of their time. Thomas Jefferson actually despised the earliest corporations in American history.

Not to mention the fact that he had no constitutional right to make the "Louisiana Purchase"...there was nothing in the constitution then (or now) that authorizes the executive branch to purchase territory from other countries.

So..shouldn't we give the Louisiana territory back to the French?

[anonymous 1]

Socialized medicine in the USA would be a death blow to medicine, because the USA the only major market left on earth where investing in medical research has the potential to pay off. No profit motive means no new devices, no new drugs, no new procedures, no new technology. Spare me your vision of the noble NIH-funded scientist sweating away in his lab to save humanity.

one of the reasons a lot of doctors might not be as opposed to this is that salaries in medicine have already taken a hit for a lot of fields. so, a high govt salary might not be as unpalatable as first thought. also, let's separate pharmaceutical costs from physician costs. they are 2 separate but related entities, and too many MDs also don't realize that by massivley increasing drug costs, there is ultimately going to be less money for them. having said that, i'd agree that a lot of research into new drugs would go way down without the present say american market making new drug research so attractive to big pharma.

[Tired of Smoke Rings]

"I wouldn't have the cheek to offer you chaps any advice on this, save for one point - don't copy our NHS. Don't, don't, don't. You'd live to regret it. Or, more likely, not."

Listen to the voice of experience. This is a bad idea.

Slightly off topic:

Resist the call of the wild Sigma. First it's no mean spirited comments, now this? Are you trolling for respectability? Why not cozy up to Tim Wise while your at it and denounce your readership to the SPLC for good measure? Or just give Vim admin rights and get it over with.

[Waiting]

Tired of Smoke Rings,
Maybe this post by Half Sigma isn't what he really thinks but wants to see what liberal commentors have to say. Kind of like drawing them out of the woodwork so to speak. Maybe he just wants people getting all heated up. He has done a good job of it.
And besides, Vim doesn't have time to run this website. He is far too busy with his scientific studies and experiments. I eagerly await his new discoveries in whatever field(s) he works in!

[Lex]

To the reader who writes, "One question: When has forming a monopoly ever reduced prices?" - when a natural monopoly exists?!? (As it does in health care, Duh.)

To HS - firing incompotent doctors? Yes, firing persons who work for the Federal government is a simple and efficent means of ensuring high quality government services...like at the (fill in any agency here).

There is a point here that the all of the medical coding and payment processing needs to be standardized. There is a lot of inefficiency in the way this still works.

There is also the perverse incentive problem. You may a lot of insurance so you feel you have to use it in order to break even. Like "my shoulder is probably going to be ok but I paid $2500 this year I might as well get an MRI".

The liberal's favorite analysis device is the zero-sum game. In this case it would seem to be accurate. You either deliver less service to more people for the same price, more service to less people for the same price, or more service more people for more money. Who is interested in putting even more money (your, not your neighbors) into this system?

Likewise this "buying power" thing only goes so far in cost reduction. If all the prescriptions are aggregated under 7 insurance companies is that much different to the manufacture than dealing with one insurance company? There are still only a set number of orders so the cost to the company is the same to fulfill the orders. How much does it matter if there are 7 orders for 10 million units or 1 order for 70 million units? The cost cant go to zero in any case.

Nor do I think that people are clamoring for a system where the government says "we are only approving one stain drug to keep costs down".

What would be useful would be promoting a system where some of the recoupment of the cost developing drugs got pushed out to the world market instead of being primarily done in the US.

[blue]

(2) No more immigration of unskilled workers. With the government providing free healthcare, it’s obvious to point out how the nation can’t afford to have people come here and mooch off the system.

This isn't "obvious" at all.

I watched the Democratic debate on Martin Luther King Day. One question was, will your health care plan cover illegal aliens? When Barack Obama answered "no," the moderator asked him "why not?" At which point, John Edwards answered that actually none of the three candidates health care plans provisioned for illegal aliens, because of limited resources. But, he added, he would put them on the path to citizenship so that they would then be covered by the plan.

Given that this is the prevailing attitude among the Democrats, why would they halt the immigration of unskilled workers? I'm sure if they come in under some kind of temporary guest worker program, they would be covered.

[Al Fin]

Tort reform would work wonders. Increasing the co-pay for most routine services would likewise cut down on the "all my kids are coming down with colds--please check all of them and give them antibiotics so I won't have to keep them home from daycare and school!"

[someguy]

Just a question: Many other government organizations, jobs, etc., seem to be over represented with minorities, whom, of course, aren't weeded out due to a ban on IQ-like tests, and propagated due to affirmative action. Would the "socialization" of medicine, in however way you wish to define it, open the door for greater affirmative action and less g-loaded testing (in the form of anything difficult in med school), and therefore, lead to even less bright people pursuing medicine?

[Bleeding]

someguy,
A depressing vision of the future. The socialization of medicine will make it like the DMV. Here is a little peek at what is coming, MLK Hospital in LA:

http://cbs2.com/local/MLK.Harbor.Hospital.2.532730.html

It is a disaster area. I can't imagine why...

[Al Fin]

HS, can you acknowledge the horrendous effect your own profession is having on health care costs, availability, and quality?

If you like the tort system, then how could you possibly promote single-payer government medicine?

Dickie Scruggs is where he and a lot more trial lawyers belong.

[beowulf]

Well, let's see, if an arsonist burns down your house... we don't expect the firefighters to askfor proof of fire insurance before they break down your door to rescue you, or the cops to ask for proof of property or life insurance before they'll investigate a crime against you, and yet we expect the doctor's office to ask for proof of insurance before they'll treat us.

This isn't whether you're eating steak or hamburger, buying a car or riding a bus-- doctors sign our birth certificates and they sign our death certicates, medical treatment is a life and death issue for everyone.

There's a government monopoly fire protection and police work, a government monopoly on health care, frankly, is an improvement where the lack of financial resources (or an insurance card) can kill you.

Yes yes, an ER has to treat you (that's because Congress passed a law requiring it, the hospitals aren't do it because they love Jesus)--- but only until you're stabilized. So that tumor in your head, the painkillers they give you as they kick you out may stabilize you, but sure as hell won't cure you.

[beowulf]

Going to HS's plan (essentially building out the very efficient VA system) would also reduce workers compensation, liability and auto insurance premiums.

A big chunk of the claims for all three types of insurance are for medical bills. The lawyers (and the jury, if it gets that far) has to thrash issues like: Was the injury due to a work activity? Did the slip in fall occur in the Wal-Mart parking lot or on the public sidewalk? Was the whiplash due to the other driver's negligence?, etc.

Billions of dollars are wasted litigating who's on the hook for medical expenses, to say nothing for collection and bankruptcy proceedings resulting from unpaid medical bills.

All this cost shifting became moot with a monopoly government insurer paying all the medical bills. It will save a fortune in litigation and insurance costs.