Re: Graduated National Health Plan Needed

[EMAIL PROTECTED] (Jonathan Smith) wrote in message news:<[EMAIL PROTECTED]>...
> [EMAIL PROTECTED] (Bettina) wrote in message news:<[EMAIL PROTECTED]>...
> > [EMAIL PROTECTED] (Jonathan Smith) wrote in message news:<[EMAIL PROTECTED]>...
> > > Gretchen Evans <[EMAIL PROTECTED]> wrote in message news:<[EMAIL PROTECTED]>...
> > > > On 20 Oct 2003 08:10:37 -0700, [EMAIL PROTECTED] (Jonathan
> > > > Smith) wrote:
> > > > 
> > > > >[EMAIL PROTECTED] (Bettina) wrote in message news:<[EMAIL PROTECTED]>...
> > > > >> > "Karl" said: <> 
> > > > >> > > > >> > > > > > > If it was as cut and dried as you make it out JS this 
> > > > >> > > > >> > > > > > > issue wouldn't have the political life to linger as 
> > > > >> > > > >> > > > > > > long as it has.
> > > > >> > > >
> > > > >> 
> > > > >> And THAT is what this all boils down to. Data and tables and
> > > > >> statistics and links are not the only path to the truth 
> > > > >
> > > > >Not the only - but it takes the emotion and the subjectivity out of
> > > > >it.  Do you really want decisions about your health care made based on
> > > > >good information or someones intuition?
> > > > >
> > > > >> and they
> > > > >> certainly do not inspire major political change. Like it or not, human
> > > > >> beings make choices based on not just their left brains but their
> > > > >> feelings and experiences,  which is why the issue of universal
> > > > >> coverage is not going to go away. (js, since you're obsessed with 
> > > > >> definitions and subsets, single payer is a subset of UC, okay?)
> > > > >
> > > > >Absolutely - SP is a subset of UC - Just like  a Staff Model HMO
> > > > >(Kaiser)is a subset of managed care.  But we all know that a staff
> > > > >model HMO is UNIQUE (right Pixie?) - hence I claim the SP is also
> > > > >UNIQUE.
> > > > >
> > > > >If you want to suggest that all SP are UC - fine, but you need to also
> > > > >understand that not all UC is SP.  In fact, few UC are SP and neither
> > > > >you nor pixie has gotten to the holy grail - an SP that actually
> > > > >works.  Got a few great examples of UC that work - Kaiser,
> > > > >Germany...but not a one in the SP category.
> > > > >
> > > > >You two want SP but are having so much trouble defining it, makes one
> > > > >think you'd never even come close to implementing it.
> > > > >
> > > > >js
> > > > 
> > > > I have absolutely no problems at all in 'defining' "SP", or "UC", for
> > > > that matter.  
> > > 
> > > Yes, you do Pixie.
> > > 
> > > > The problem obviously arises from your inability to
> > > > understand those definitions.. or accept them. 
> > > 
> > > When your definitions move in the wind, it's tough for me to keep up.
> > > 
> > > So, are UC and SP the same or differnt todfay?  What's the difference?
> > > 
> > > js
> > 
> > I suspect you're trying to get Pixie to pin down an ironclad
> > definition of  SP and UC so you can say "gotcha!"  
> 
> Not gotcha...she does that well enough herself.  Her insistance that
> it MUST be SP to work and the inability of any one of you to provide a
> working example that it does suggests that a definition is in order.
> 
> > about some fine
> > point in her definition. There is no ironclad definition of the
> > details, there is just the principle that health care should be
> > publicly financed 
> 
> Now you throw in a new term "public funding"  What is that?  Is this a
> euphemism for progressive income tax based funding?  If you agree that
> employer/employee funding meets the condition of public, that is
> different.
> 
> > (and privately delivered), 
> 
> This is contrary to what was offered up in the JAMA publication.  Do
> you suggest that public hospitals and clinics (county owned,
> university owned, etc) be disbanded or privatized?
> 
> > and implementation will
> > be slowly developed and tweaked and tweaked again.
> 
> Sorry - you don't do SP half-assed.  Either do it or don't, but don't
> do it piecemeal and incrementally.
> 
> Unless of course you want to make it voluntary and allow folks to
> opt-in?
> 
> When the term SINGLE PAYER is used, it is in reference to the
> FINANCING of care - not the delivery.  SINGLE PAYER, by definition, is
> exactly what it says - ONE entity totally responsible for the funding
> of health care services.
> 
> Tax-based government sponsored single payer is what I think Pixie
> describes as her model of perfection.  The assumptions is that the
> resources to pay come from taxes, the central overnment takes on the
> responsibility for program administration, and there are NO competing
> mechanisms for financing or payment.
> 
> I find that to be inherently inefficient and unfair.  No one does it
> this way except maybe the UK and that is a dead horse - no additional
> beating necessary.
> 
> A mandatory participation scheme based on employer contributions with
> freedom of choice in what benefits and what program administrator
> individual can elect would ensure the greatest efficiency and
> accomplish what you want - 100% covered (no uninsured) without
> compromising freedom.  One size does NOT fit all in health care.
> 
> js

You KNOW I didn't mean dismantling public hospitals: pretending to
misinterpret words casually used in this informal forum is one of your
rhetorical devices -- when I explain what I meant you will accuse me
of expecting you to be a mind reader. OK, here's what I meant: saying
privately delivered is simply to dispel the common assumption that SP
would mean government hires all docs, owns all hospitals, etc.
Don't do SP incrementally? That's exactly what's happenin now: if you
count government employees more than half the population is covered by
government-sponsored programs, and that proportion is growing.
And mandatory employer "contributions" will never pass COngress (SP
won't either in this COngress) because the business lobby would never
accept it.
I have an idea you'll love -- how about mandatory discounts by
insurance companies on an income-based sliding scale?
Bettina