A guide to Single Payer Healthcare

Original post here: https://www.reddit.com/r/coolguides/comments/1bbglvr/a_cool_guide_to_single_payer_healthcare/

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I think this is a bit too simplified. The "Government pays the bill" is not how it works at least in Germany. We have "Private health insurance" and "compulsory health insurance". If you decide to leave the later, you do not pay into the system anymore, but have to get a private insurance (and you might not be able to get back into the compulsory insurance when you get older).
Anyway, the way the system works is that there are many insurance companies that you can choose from with different profiles that take care of the bureaucratic underbelly of managing the whole process. These company has thousands of workers to take care of these processes and guide/deny their customers services. My Insurance company alone has 15.000 employees.
If the "Government pays the bill", then you might need something like 30.000 - 80.000 federal workers to take care of the bills/requests to guide the patients and prevent fraud. Will the government hire them? Is the plan like having a NHS like the UK?
My point is, the Government will not pay your bills. A subsidiary with a over decades grown structure will do that. I can already see how people gonna hate the new structure, as it will struggle for the first 10-20 years to define their processes and layout the services. On the other side will be people with deep pockets still using private insurance. These companies will use their money to attack everything this new government system will do and will rile up people against it to gain back the market.
I am absolutely pro-single payer system. I just hope no one is so naive to think it will be just like the graph shows it. It will be much more complex than that and people need to fight for it and endure some "finding phase" for the first two decade before one of their presidents will trash it again. I can already see fox news headlines about how people died because of the new system or how a grandma in ohio did not got the right care at the right time and therefore the whole thing is apparently a bad idea. It will be rough to say the least. I would not always tell people that the "Government" pays the bill, as many people in the us are sadly on the spectrum of cringe conspiracies and have a retention for everything the "Goberment" does. I think it is a bad idea to say the Government does everything, as it will be used against the system: People will claim their grandma died because of the Government ("death panels!!!") and people will say the government be the one who denied their claim to getting a new hip with 90 years ("outrages!!!!") or some of the funds getting wasted for hard-to-communicate reasons (the swamp!!!!) tainting more and more the public opinion of the governments work. You should better start using the subsidiary in your graph communication that will take the praise/blame for the development. Because the Government will not pay your bills.
Will americans have the voice to change the system? Will americans have the patience to overcome the problems? We can only hope so.
EDIT: Because some people missing the point: I would add a shape between the Government and the Doctors on the right. Could you draw a chart about the UK or German Healthcare-System without once mentioning the NHS or Krankenkassen? They are a n essential part of the system to work and employ thousands of workers. I think the chart oversimplified this aspect.
- U.K. here. “Government pays the bill” is exactly how it works over here. You can just walk into a hospital, be treated and walk out without paying anything or holding any particular insurance. It’s not a GREAT service by any stretch, but it’s free at point of use. We have a booming private insurance sector too - I pay a separate private insurance because although I’m absolutely pro NHS, I wouldn’t bet my life on it.
  
  In Australia, private health insurance is better for non life threatening stuff.
  Emergencies is where the public health system shines. They have a lot more practice with trauma and ED stuff than private.
  I have private too.
  
  This is very similar situarion in Brazil
  
  i always say to americans: medicare keeps you alive and able to be productive, private insurance keeps you comfortable
  … but medicare also drastically reduces private premiums
  
  I very much appreciate your last sentence.
  Medicare is a sad shell of its former self, good luck seeing a GP or a specialist for free these days. Want a specialist to check out your breasts? That'll be $400 for the first visit and $210 out of pocket for all your follow ups, $800 (out of pocket) just for a biopsy if you need it. (Rough numbers from a friend). And consider that most women develop some kind of breast growths in their life time.
  Sure it's not US levels of price gouging, but heck. Medicare is being lost and we're not fighting for it.
  I won't be satisfied until private health is dead. Fuck private health.
  
  i wouldn’t say until private health is dead: there’s always a certain level of comfort or pseudo-science choice that i don’t think should be socialised… for example, my private health covers “alternative therapies” which should certainly not be covered by social healthcare, but people should be given the option to spend their money on that if they want to
  same thing with private rooms, better hospital meals, etc: these things should be optional extras that you can pay more for
  with that said, dental, optical, psychology, physio, and nutrition are all things that my private health covers that medicare should cover or should cover more
  
  Oh yeah, that's true (the alternative therapies), and for extras that aren't at all better medical care
  
  yup:
  public is for keeping as many people as healthy as possible as efficiently as possible: it’s about optimisation
  private is for things that you want but don’t need that would make the care of others less efficient without additional money, and where you can pay for that extra why not allow people to insure for it?
  
  Ah yeah, that is a good way of putting it.
  
  My point was that a chart where your doctor sends the government the bill would be misleading. National Health Service in England, NHS Scotland, NHS Wales and Health and Social Care in Northern Ireland pay the bill (and are basically the government) and are the names people are using to either blame or praise the work of these systems. In a country as divided over the government work as the US is, I think it is a bad idea to say "Government pays the bills" as it neglects all the work and effort (and funding problems) that the subsidiary has to do. Government is just allocating the funds for the NHS to pay out to the doctors.
  
  Ahh good shout. I see your point and it’s well made.
  
  This is why an argument for simplicity doesn't really fly. Agree the US could really use a better government based health system (and yes, there is a sort of option now, but it's a mess) but saying it's simpler on a systems level isn't really true. Most countries indeed have both systems to one degree or another going on at the same time.
  
  from a CONSUMER perspective it’s FAR simpler
  from a system perspective it’s far more complex
  … but you literally never have to worry about that
  living in australia i’ve thought about health care less than i’ve thought about my own health care in the US and i’ve been there a grand total of 6 weeks in my whole life
  need a hospital? just go… need a doctor? just go… need medication? just get it… don’t think; just do it… the doctors are there to triage; you should not have to without any medical training
  and ON TOP OF THAT: just do it whenever you need and don’t worry…
  we
  still
  pay
  less
- Because this doesn't describe what Germany has. There aren't any insurance companies in the graphic. In Germany we don't pay taxes for our healthcare, we pay contributions. So why would this be oversimplified because Germany?
  
  I did not compare it to Germany. I used Germany only as a step into my post. It is over-simplified as it is not how it will be in the US. Can you draw a chart for the UK Health System without once mentioning the NHS or describe the German Health System without mentioning once the Krankenkassen? Between the government and the Doctors will be at least one institution that most possibly will be named "American Health Service" or something like that. Drawing a line from the Doctors to the Government makes it sound like people gonna send their bills to the White house. The reality is that the Government will only allocate the Funds for a certain subsidiary unit that will handle that worksload. The NHS in the UK employed 1.2 Million people. Leaving out that aspect is critical in a chart like that. In my view, the graph is too simplified. If you feel it is telling all you need to know, good for you. Apparently rough outlines like that are all you need. I would at least insert one shape between the Doctors and the Government as there will be hundrets of thousand of workers who will do the actual work. Government will only decide on the funding.
  EDIT: Man you must be mad. Downvoting me one minute after I post this. Using your alt accounts to give yourself 3 upvotes one minute after you posted it? Crazy. But who cares.
  
  I didn't use any alt or downvote anyone. But why would I draw a chart of Germanys system without insurance companies? That wouldn't be the German system.
  And that's my point. This isn't showing the German system. So your initial assessment of this being oversimplified because it's different in Germany doesn't make any sense.

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