We need a universal health care system. Here's one idea.

I was expecting someone who vehemently and fundamentally opposes the idea of universal coverage, so I have to admit I was thrown a bit when I read your argument. But I've recouped myself, so here we go. .. 1. The Department of Health and Human Services has operated Medicare since its inception. In 2006, there were 38 million people on Medicare. In addition, some estimates show that 30,000 people a month for the next 10 years will start using Medicare as they become eligible. Medicare recipients also represent a much larger share of health care customers then their share of the total population. It seems to me at least that DHHS has the experience running programs instrumental to health care in this country that would be capable of running a single-payer universal system. If we could just get a president that appoints capable, knowledgeable, worthy people to important positions instead of a president that appoints personal and professional friends who know nothing of the agencies they run, most of government has the ability to function as well as any private corporation. See "Case for Bureaucracy" by Charles Goodsell. 2. I don't know if we are in the biggest recession we've ever been in. To start, you'd have to technically separate "recessions" from "depressions". If not, the Great Depression would be FAR greater. Even if you do separate them, then the recession in the mid to late 1970s when unemployment hit around 10-15% would still have to be worse then this. Even so, your point is taken about the economy. Here's the thing though, benefits from preventative care would be noticed just as quickly as the taxes would be, especially since those taxes would be laid on hospitals, doctors, drug and device manufacturers, as well as taking already taxed resources from Medicaid and Medicare, would all happen before any individuals would be taxed. Economic productivity would grow as workers got healthier and felt more secure about their financial and medical futures. In addition, since everyone would be paying much less for their health care, that's extra money they'd have to get out of debt and/or spend. The economy would benefit greatly from universal coverage. 3. I'm not sure what you're talking about in this point. If you're talking about private hospitals and doctors, you're right. That's why both would remain private. They would compete based on patient outcomes and satisfaction. Medicare is mandating that hospitals report their outcomes starting this year. They plan on extending it to doctors in a couple years as well. They intend to pay hospitals/doctors in the top 10% an extra 10% in their reimbursements, after risk adjusting for regional differences of outcomes for certain diagnoses. This would be continued and relied upon in the plan I mentioned. Competition would still be an integral component of this plan. Besides, private companies screw up just as much, if not more, than government agencies. We just don't know how much because oversight is so much more difficult once a government function has been privatized. The contractors of the Big Dig in Boston will have to pay $456 million in fines due to faulty designs and shotty workmanship. I'll also mention Halliburton and Blackwater. You get my point. 4. It is illegal for hospitals to turn people away for not having coverage, but all they have to do is stabilize people in their ER and then send them on their way or to a public hospital. They still have to eat the costs associated with time, labor and equipment. Meanwhile, public hospitals are so overwhelmed from every private hospital sending them uninsured patients that care starts to suffer. But public hospitals still need reimbursement as well if they hope to make any kind of profit. But because they can't get any from uninsured people, the rest of us pay more in taxes to support these public hospitals. This is one of the many examples of how we all already pay for uninsured peoples' health care, so we might as well do it in a smart and effective way. 5. There would be no need to "mandate" some procedures since just about everything would be covered. Only cosmetic procedures and elective procedures that do not dramatically enhance quality of life would not be covered in the universal plan. Doctors would find much more flexibility in having just about every procedure or service they provide compensated, as well as (and primarily) not having to fight with HMOs to get paid. Doctors spend so much time doing this that it takes away from taking care of patients. With such a simple system, they would be free to spend more time performing procedures and meeting with patients, thus earning more money. 6. As I mentioned above, we already pay for a lot of peoples' health care. Their costs get transferred to us through higher taxes to support public hospitals that aren't getting compensated for their services, decreased tax revenue to the government since hospitals and doctors have to write off so many services as charity, as well as higher premiums and costs with insurers, hospitals and doctors. Our economy also takes a hit because these people take more from the system then they put in because they can't get insurance, yet continue to rack up bills, pushing them towards bankruptcy. Over 51% of all bankruptcies are medically related, which makes the rest of us pay more in credit card interest. I'm watching the news right now and they have a story on talking about how diabetes is already costing the country $174 billion through various means. We're already paying the price for diseases like these, and this is with a private system. A single-payer system would be able to negotiate for lower prices which would bring this number down. 7. Private insurers would have to cut back, but there would be gains in other areas. First, the government would be hiring, and I don't think that is a bad thing if it means that the already trained personnel are making the new system run more efficiently. Also, as it is, over 300,000 beds lay unused because private insurers make their money off of keeping people out of the hospital. Meanwhile, 25% of hospitals are operating in the red. As people who need health care can finally get it, and hospitals can count on getting paid more frequently, they will hire more nurses and doctors. 8. As it is, doctors are in it more for the fame than the money. Like I said before, doctors spend much of their time fighting with private insurers just to get paid. There wouldn't be reduced private practice options. No offices would be socialized. The fact that doctors would be paid much more frequently and the system would be more efficient, I think more people would become doctors. 9. I feel that health care is a right already, and I'm not on any kind of government coverage. If it works as well as I think it will, or as well as similar versions in other countries, why would you want it to go away? 10. People with money do come here to get their health care, because we do have the best system in the world if you can pay for it. Very poor people also come here to get care and don't plan on paying for it. This system keep the quality that we've become accustomed to since hospitals and doctors would still be competing based on the quality of the care they provide. The only thing that would be socialized is the payment of their services, at least for basic care. Private insurers would still be utilized to pay for catastrophic care. I don't think all people want universal care. In fact, I've debated with a few people on this site already that flatly don't. The fact of the matter is that the private system of multiple insurers is broken and cannot be adequately fixed while keeping the same structure. It is the structure itself that has led to the problems we have. Therefore, we need a totally different structure based on a single-payer for basic care.