I’m genuinely interested in opinions about pre-Obamacare status quo vs expanded Medicare for everyone vs full blown single payer. Reading news articles about it to be informed and my head is spinning

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Healthcare wouldn't be run by the government though, just the process of how private medical institutions get paid.

That's analogous to saying thing elderly people pay for using Medicaid is run by the government.

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And if the govt is the only payer, they effectively control how you operate your business. It may not be a government operated facility but they will control it all the same by controlling the source of revenue.

As a healthcare professional, a lot of the takes here make me sick to my stomach.

I honestly could not care less what is popular, most people have no idea what the realities of care delivery are in this country and the myths about choice are some of the most dramatic and driven by anecdotes of the few.

I dream of a day when a physically and mentally healthy American public is a priority to my fellow citizens.

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Anything run by the government will be grossly inefficient and plagued with fraud. 11 years in the military/ government and I can tell you horror stories

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Bro, I got bad news for you...

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Personally, pre-ACA my insurance and doctor availability was better and easier to work with. Working for a large company my rates didn't go up as drastically as self employed people saw but out of pocket did.

I'd actually prefer the govt to get out of healthcare completely. Allow insurance companies to provide coverage across state lines generating larger coverage pools instead of the current system of state level subsidiaries of the insurance companies serving state based pools of people. My biggest fear from single payer is reduced compensation rates for doctors discouraging people from becoming doctors. What happens to that talent pool if you put them on the GS scale instead of allowing the market to say brain surgery is a 7 figures paycheck.

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How do single payer countries have enough doctors?
If you have single payer, isn’t your doctor availability standardized? Sounds like ACA is a poor standard. Plus it’s the largest pool: everyone.
Procedure cost for hospitals now must be published. Question is whether it will drive comp and cost the way of CEO salary, standardize high, or lower
How is it that we have great teachers, some of whom could even become MBB, when teachers are paid crap?

Expanded medicare and single payer are functionally the same thing.

According to a conservative think-tank "Medicare for all" would actually result in long term savings instead of added cost because a big chunk of today's medical cost is due to marketing, third party financial settlement firms, insurance management overhead, and "discounts" for preferred insurances.

Single payer models tend to mitigate those cost or outright do away with them.

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@AD1 extra costs = jobs for pretty much all companies. Doesn’t stop us from coming in and doing delayerings. I don’t feel great about those projects, but why should those affiliate with HC be exempt?

When some dems describe what expanded Medicare would look like, it sounds like my understanding of single payer...but it seems to be marketed in the news as different?

There's a lot variety when it comes to UHC. You can have full gov. Paid healthcare like Canada or a mix of private and public like Germany.

Sounds similar to Canada PwC1, we are covered by our province for anything related to our health - doctor visits, specialists, hospital, surgery, etc. Prescriptions are offered at a discount through the provincial plan and you can get insurance for further discounts as well as anything not covered by the province i.e. dental, physical therapy, chiro, things like that. I'm originally from the US and yes, there's a lack of doctors here but it's head and shoulders above what I had there. I know everyone isn't in the circumstance I was back home, but if you don't have much money it's a huge relief to know you won't be ruined because you got sick.

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I probably spend more a year than most here do on healthcare due to a disabled daughter.

However, I have serious doubts about the feasibility of a single payer system. The US has a very unhealthy 300 million population. Worlds different from the UK or Canada. Something on this scale has never been attempted.

I do question what it would do to the doctor talent pool. I don’t question the altruistic nature of many doctors but money does play a part, especially in what specialization you choose. Why in the world would you devote yourself to brain surgery over general practice if there was no monetary benefit? You lose years of your life going through fellowships. Huge opportunity cost to doing so.

Most people don't need highly specialized brain surgeons as a regular part of their healthcare plan. Most people need to not be priced out of Healthcare to get diabetes or blood pressure medication.

The status quo is a choice. It's a choice that *already* directly impacts health outcomes. The whole point of public policy in a democrary is figuring out what is best for the most people.

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The main benefits of single payer and a public option are the same. They give government more leverage to control the cost of healthcare by setting reimbursement rates, it’s essentially a way to set prices on a market based product without having to say ‘government price controls’.

The political question is if Americans really want to give up choice in health insurance. When about 50% of the country is still opposed to Obamacare after 10 years, it’s a good bet that the country expects some voice in their own HI. Single payer would eliminate choice, a public option would preserve some.

Capg1 has never heard of a commons, apparently.

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