Commentary on medical news by a practicing physician.

  • Epocrates MedSearch Drug Lookup


    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

    "Opinions are like sphincters, everyone has one." - Chris Rangel

    email: medpundit-at-ameritech.net

    or if that doesn't work try:


    Medpundit RSS

    Quirky Museums and Fun Stuff

    Who is medpundit?

    Tech Central Station Columns

    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews


    Medical Blogs


    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc




    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It


    SOAP Notes


    Cut-to -Cure

    Black Triangle



    Kevin, M.D

    The Lingual Nerve

    Galen's Log



    Doctor Mental



    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House



    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day


    The Business Word Inc.

    Point of Law

    In the Pipeline


    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station





    The Skeptic's Dictionary

    Recommended Reading

    The Doctor Stories by William Carlos Williams

    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn

    Intoxicated by My Illness by Anatole Broyard

    Raising the Dead by Richard Selzer

    Autobiography of a Face by Lucy Grealy

    The Man Who Mistook His Wife for a Hat by Oliver Sacks

    The Sea and Poison by Shusaku Endo

    A Midwife's Tale by Laurel Thatcher Ulrich



    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info



    Wednesday, August 22, 2007

    More Healthcare Discussions: This time from the comments at The Spine (comment #30):

    In the US single payer will not be rationally managed or centrally administered. It will have a myriad of interest groups chasing a finite pot of money; and Congress, the Executive Branch, and any "Boards" or other entities designated as the real decisionmakers (there to keep the costs down, through market power and rational planning) will form a tripartite hydra-headed policymaking mess. And public demands for care will fuel the rest (and fuel the politicos). Health care will continue to be politicized and pressures will always grow to add more and more benefits while running up costs. And always to extend all those benefits to more and more people: do you think the illegal immigrant eligibility issue will not arise? Benefits paid for by citizens for citizens will ultimately - maybe not at first, in order to get it passed - disappear, because political choices will be made to increase costs by expanding eligibility to more people. And of course, there will always be a need to have more, and more, and more, managers of the system - not care providers, but those who look over the shoulders of those who provide care; they'll be needed to carefully and extensively consider the cost benefit of each victim of the system - and there will be untold numbers of appeals, because we are Americans and used to getting our way with health care. The single payer crowd would like a docile population blanketed by rules and regulations, but how often do you think the single payer system is going to say no, when a dispute over care becomes politicized or media-sponsored? It'll be forced to change by laws, or it will agree to change in order to get something else out of the policy makers.

    The upshot is those with little or no political power in this system will suffer the worst in terms of care and access to procedures. We have to keep costs down, the bureaucrats will explain soberly. You may say this happens now, but how will single payer be fdifferent, except to shift the shaft?

    Where else will savings be made to pay for the steadily growing costs? Capital programs to renovate or modernize equipment and facilities; drug costs (so that research and development, AS WELL AS profligate marketing, will suffer), and providers themselves will be paid on the cheap (much as they are now whenever medicaid or medicare have problems - or benefit expansions are proposed).

    There has got to be a better way of providing medical care than single payer. Those who want it are demanding we move to something that does not compare well in care or cost, really, with societies similar to ours.

    That's what I keep asking myself. Why do people think that a single-payer system would be any better than Medicare or Medicaid? The way things work now, Medicare gets the gold (more political clout in the over-65 population) and Medicaid gets the shaft (absolutely no political clout in that population).

    posted by Sydney on 8/22/2007 09:33:00 PM 0 comments


    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page


    Home   |   Archives

    Copyright 2006