SocraticGadfly: Single payer backing politicos? You can't kowtow to hospitals (or doctors)

June 10, 2019

Single payer backing politicos?
You can't kowtow to hospitals (or doctors)

That includes ESPECIALLY you, Bernard Sanders.

Yes, America's Health Insurance Plans, ie, the health insurance industry and lobby, is the big stumbling block on single payer.

The actors are fake, but concerns behind those they represent are quite real.
But, "bribing" hospitals (and doctors) with promising to leave untouched fee-for-care service, and actual fees, to get single payer passed, is no way to do it.

Jon Walker calls out both Sanders, and also other single-payer or single-payer-lite Dems, AND Physicians for a National Health Program, on just this issue.

Walker is totally right as far as he goes.

But, he doesn't explicitly ask the question of what's your ultimate action if you can't beat hospitals and doctors down enough.

Since he compared American prices to British ones, I'll tell you my answer.

It's incorporating at least some elements of a British-type National Health Service here in America.

I know that Sandernistas or whatever think Bernie's work for single-payer is the bomb.

No, it's not.

It's better than nothing, but per Walker, and per myself, it's not the bomb. It's a small hand grenade.

I've said before that I don't want individuals going broke OR the government going broke over health care costs.

That's still true, and Sanders' small hand grenade (along with other single-payer Dems who don't address the cost issue) doesn't touch that.

I know the Bernie backers don't like to admit that his answers aren't always perfect.

He IS the best Democratic candidate. But, his answers aren't always perfect.

Per the stock photo, how much, in the US, with results varying from state to state, are we paying doctors for stuff that physicians assistants or nurse practitioners could do? How much are we overdoing the medical mantra of "get a second opinion" to having third and fourth opinions offered? How often, per the liked of pieces by John Horgan, are we paying doctors to be overaggressive in their diagnoses — and prescriptions for action — on things like prostate cancer? How much do hospitals go along with this to get "their cut" of doctor's admission fees? How often are we ignoring interlocking doctors' consultancy fees?

(On the "you don't need a doctor" department, I'm not sure how much better Europe is than us, but, on law, they have the equivalent of "super-paralegals" who get a bachelor's degree in law and have for decades done most of the corporate legal legwork.)

Much of this part is specific to doctors in hospital settings, due to the independent contractor type relationship they have with hospitals, and which nurses — and NPs and PAs — generally do not. The issue of racist hospital patients wanting white-only staff illustrates this.

Beyond this, anybody who takes a scientifically critical look at modern medicine knows what a whole book now says — too many doctors overtreat and overprescribe. Single-payer done right has to address this.

And even Greens may not be perfect on this.

Dr. Margaret Flowers busted the chops of Beto O'Rourke on his single-payer head fake. (And Sema Hernandez has yet to cop on accepting a head fake as reality.) BUT .... I've tweeted her this very blog post and have yet to hear back.

American fee-for-service medicine and everything connected to it — overdiagnosing, backscratching consulting arrangements and more, is almost as big a problems as AHIP in first and #BigPharma (plus medical device manufacturing) in second. And, it's not like pediatricians, as she is, engage in this to the degree high-dollar specialists do. But? Physicians can be tribalist themselves. And she is big on Physicians for a National Health Program.

Jill Stein is not as active in the organization as Flowers. But, she too has officially saluted its version of single payer.

Here's another story that talks about how part of America's health care problems is doctors and hospitals overcharging, overtreating and more, all for money.

And, here in Texas, while not writing explicitly about single-payer, Chronicle columnist Chris Tomlinson explains how, in fighting the new law on surprise medical bills, doctors and hospitals will do everything they can for your last dime.

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