Overtreated: The Case for Single-Payer Healthcare

Steve Olsen, one of the most lucid writers in the Utah blogosphere, has written a nice post on Shannon Brownlee’s book Overtreated.

Brownlee’s (and Olsen’s) points are very relevant. It very much makes sense that in a free-market system where the ultimate goal is maximization of profits, health-care institutions would be less interested in curing illness efficiently. It is only rational (if amoral) that they would be more focused on keeping a catheter to your wallet.

For those who insist that the U.S. healthcare system is not a truly free-market system: you’re right. But it is a whole lot closer than the European systems which routinely provide more efficient care (not to mention the “socialized” VA system).

And yet still free-market apologists complain; most perplexingly about “undiscriminating” overuse (or abuse) of our health-care system, a complaint which I’ve addressed before. I would really like to know who these people are who “abuse” our health care system. How many people are making the regular, routine visits to their physician recommended to maintain optimal health? Just how many people are seeking professional medical advice at the first signs of developing problems? I’m betting the numbers are low. I suspect that to improve overall health in the U.S, we should be encouraging more use of the health care system (albeit use dictated by patient need rather than industry profit as mentioned in Overtreated) not less. The conservative attitude that we should just “walk it off” when our body warns us about health problems and only seek medical attention when things get serious courts disaster.

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9 Responses to “Overtreated: The Case for Single-Payer Healthcare”

  1. rmwarnick Says:

    On TV, people are always saying “see your doctor.” But I don’t have a doctor.

  2. Allie Says:

    There was a comment on another blog about health care issues where someone said that people go to the doctor for little things that they shouldn’t be seeing a doctor for (and thereby wasting money).

    My friend had a sick baby a couple of years ago, they debated going to the doctor, they waited so long before taking him in that the doctor had the baby sent by ambulance to primary children’s where he nearly died.

    Health care should not be about money. And people who think mom’s take their kids to the doctor when they shouldn’t haven’t ever had a sick child.

  3. andrewsmiracledrug Says:

    Great post. I’m always amazed when otherwise educated and intelligent people suggest that health care reform must be market-based or consumer-based. Isn’t that what got us here to the health care crisis we’re in in the first place?
    And as you rightly point out, the incentive for providers is not to cure illness in the most effective way, but to do so in the most profitable way. This means that Americans end up having far more procedures and surgeries than our other industrialized nation counterparts; they, on the other hand, receive far more preventative care.
    I read Steve’s review of Overtreated too, and I hope to pick it up over the break.

  4. J. R. Taylor Says:

    What got us to the health care crisis we’re in is government regulation.

    There are as many as 1,900 separate insurance mandates across the country. You can’t choose–and insurance companies cannot offe–the policy suited to your needs. Then there are government mandates like Medicare, Medicaid, ERISA, HIPAA, SCHIP, EMTALA, etc.

    Doctors and hospitals cannot treat whom they want at a mutually-agreed price.

    Regulation of health care and health insurance has become costly and complicated, and thus it’s extremely difficult to be well informed and know how health care coverage works.

    If the U.S. Congress and individual states take steps to de-regulate and people begin to see and feel health care costs–instead of thinking that someone else pays for their care–then we will become empowered and feel less dissatisfied with our choices.

  5. jennifer Says:

    J.R. – – – I see your point. There are so many different insurance companies, so many different government programs, so many state laws, federal laws, and entire mountain ranges of paperwork that stand between the patient and the appropriate care (be it prevention or treatment).

    It sounds like you are advocating the abolition of all insurance and gov. subsidies? That way people would face their own medical expenses? Did I misunderstand your suggestion?

    I believe that a single payer, universal health care plan would address your concerns and allow people much better access to care. I don’t think that the market approach of patient/customer is really the way to go. Prevention should have more incentives than treatment, and people should not shy away from medical treatment because of their personal ability to pay. We all benefit from a healthy population, but right now our nation’s health is, um, lacking.

  6. Aaron Orgill Says:

    I have to say, I’m getting close to agreement with this, and I’d be interested in trying this out as a 5-year experiment. Probably the only way it can get done is if we leave it very open-ended since we don’t know what the results will be. The medical business should be profitable, but if we are going to make a charity case out of something, it should probably be health care and feeding people. The more I think about it, the more I am of the opinion that there are thousands of other ways to cut government waste, and this kind of thing should be the first use of public money, along with roads and that type of thing. I believe the only reason many conservatives try to cut back on it is that they rightly feel they are being overtaxed, and there are so many clear-cut cases of abuse in this area. As an uninsured small business owner (my family does qualify for a form of Medicaid, so we can rest a little easier), I hope we can make this the first item on the agenda in January 2009.

  7. Derek Staffanson Says:

    You’re right, Richard. I don’t have a doctor. Know very few who do.

    Thanks for sharing that story, Allie. I’ve heard a lot of stories like that in my time, which is why I get so furious when I hear conservatives talk condescendingly about rampant abuse of our medical facilities. I see no evidence that it is nothing more than lies.

  8. S.Taylor Says:

    It was my misfortune to have a physical problem and not have insurance. Some doctors use the Medicaid and Medicare system that pays very little per visit, but money can be made by not treating clients.
    This kind of Doctor will not look at where you tell them the problem is. You have not choice as to where you can receive treatment because no one wants to take welfare insurance. They can keep a person sick and keep making money off of them through return visits.
    I had a bladder infection that turned into cancer because the clinic I was going to would never scope the bladder. For twelve years my health was destroyed and I couldn’t work.
    Thankfully I saw an OB that was an excellent doctor. She did a D&C found I was not bleeding from my uterus and scoped my bladder. She found the cancerous tumor sent me to a good urologist, he removed the tumor and now I’m feeling great again. Twelve years of rotten care at the residency clinics and free clinics for nothing except to be used by students.
    I lost everything, my health, friends and family. My youngest child has never had a life because his only parent was sick for most of his life.
    I guess telling the doctor I had a bladder infection that never cleared up wasn’t giving them enough information. How bad does it have to get before people realize no one wants to be sick. The only people who profit from illness are doctors. Those of us using these horrible clinics have no choice because good doctors will rarely take us unless we are referred to them.
    It is not good business to put the fox in charge of the hen house.
    Thanks for listening

  9. Tammi Diaz Says:

    I a member of the church I fully support HR 676 SINGLE PAYER HEALTH INSURANCE PEOPLE NOT PROFIT! FAMILY VALUES! I have a traumatic brain injury, I have been blessed.

    Healthcare costs and insurance premiums are astronomical. Healthcare expenses cause 45 percent of personal bankruptcies in the country. This cause families to fall apart.

    I have a blog Healthcare & Disabilities http://www.catmeow1962.blogspot.com

    Thank You!
    Tammi Diaz

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