appropriate single payer system would be a better economic system than we have now

just because a hospital closes its ER doesn't mean it's because they can't afford it, or even more signifincantly not the reason us to be 17% GDP on health and them 10%... it's because they don't want to pay that much money. it's still a lot to surmise that ER money abused is the reason we spend so much more than everyone else. i'm not sure why you think "an ounce of prevention... " etc. when i said that the fact that ERs are paying too much for pople with the cold etc.. i'm saying if we had a single payer system, they would go to get cold medicine instead of ER services. i quoted the adminsitrative cost link earlier.. "Private for profit corporation are the lease efficient deliverer of health care. They spend between 20 and 30% of premiums on administration and profits. The public sector is the most efficient. Medicare spends 3% on administration." "Single payer universal health care costs would be lower than the current US system due to lower administrative costs. The United States spends 50 to 100% more on administration than single payer systems. By lowering these administrative costs the United States would have the ability to provide universal health care, without managed care, increase benefits and still save money" http://cthealth.server101.com... if fraud is 9% of administration, and we see that 32% of every dollar is spent on administration... maybe we can conclude that ten percent of that should be reduced... 28%? it doesn't change much. "I don't see a response to my pointing out that CMS doesn't operate as a technical insurer since it farms out much of the actual administration of its functions. I.e. regulatory, implementation, etc." i'm not the one making the assertion that what they farm out would be significant. it doesn't seem like it would, to me. "I call bs on this argument. You can't go from complaining CMS has lower administration costs to saying it isn't a 'middle man'. CMS is as much a middle man, and it's one that doesn't compete equally. Any attempt to paint the status quo numbers as representative of the best private insurers can do is inherently misleading for the prior reasons listed." as i said... you're the one making the assertion that what they farm out would be significant. you show how it's significant. "First, http://www.kff.org......, Exhibit 9: The US already spends more *government* money than many peer nations. For example Canada spends 7.3% GDP publicly on healthcare. The US spends 7.4%." canada has a national health plan. so, if they are spending 7.4 percent and are mroe like the government single payer systems, with total GDP at 10%... that means they are covering a whole lot more people with that 7.3 percent. i haven't disputed with you that the US's government money expenditures isn't bad, given they miht cover less people for the same amount as others. what would make sense from the other end for the USA? well, we spend 17% GDP, that means the other ten percent from what you quoted is from the private sector. whatever it is that canada is doing to get covering more people for less.... that's what we should be doing. as i said.. it doesn't ahve to be medicare for us to do the plan. as to the cost of growth argument. i don't see your point. you might not go to the doctor as much, but you're still paying premiums for it. "Or, approximately a third of the annual increase in healthcare spending can be attributed to obesity--i.e. personal behavior. Re. McKinsey healthcare study." im sure obesity is a problem in other countries too. it's too much to imagine we're that much fatter or unhealthier that we spend so much more than everyone else. as to the innovation free riding.... you might have a point, depending on how this is calcuated into total costs of healthcare here. i might need to examine studies more. i'd guess they don't count that,as it'd be dumb for a researcher to do. i think it's obvious neither of us are experts on the methodology of the studies we cite etc, as would be necessary to eally understand this issue. as to the 'tehre just a lot of things that could be causing us to cost more' argument, i don't see any magic bullet. "single payers ration care" is significant, though. "arthroscopic surgeries--dramatically reduced the cost of care for select procedures." insurance companies are not the ones doing the innovation. that procedure saves people money. this is between the hospitals technology sppliers and patients. etc with the energy sector... oil companies are like the technology supplier and hospital they aren't a middle man. if we're spending so much money on a middle man, this is not analogous at all to an energy company, or whatever. "insurance supplement: interesting you bring this up--Both Canada and Sweden have banned various forms of balance billing making supplemental insurance effectively illegal. Cheers, now where on the road to servitude" maybe some countries did this. they all didn't. the heart of any ban on supplemental insurance should be on bannig skimming off healthy people to make an easy buck, while allowing other pools to not have money to pool unhealthy people. we could allow people to have more insurance that sin't like that, but what do we have left? insurance that has high premiums that no one wants cause it covers evrything in the book instead of getting them to price shop etc. once we did that... we'll see what insurance really is, a racketerring scheme. the main problems are things like employer plans that allow employees to just bask in going to the doctor etc. they dont' shop around or care much about using it cause that's what it's there for. it causes premiums to go up. it's a vicious cycle. not all plans are like that, but a sigificant amount of them are. "The reasons the US has more expensive care are complex and myriad but this isn't the subject of this debate. This debate is on whether single-payers would better manage the cost of that care. " actually, it is a large part of the ddebate. if we pay so much more, tehre has to be a reason. if we pay so much more, we must be doing something wrong, at least as an ainitial supposition. if we spend 17 and they spend 10... which system is better economically the title of the debate? tehre might be a lot to talk about, but it's all what we're suppose to be talking abou. incentives do matter per your RAND insurance experiement... but if the other countries ration care, that' how they take care of over spending. the US has a racketeerniog system that only sometimes cuts out over use, if you're a smart shopper of insurance, or hat's your thing, paying less in premiums to just get teh essentials in healthcare.