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  • “Single-Payer” Healthcare Means “Single-Decider” Healthcare

    Posted by Shannon Love on November 7th, 2012 (All posts by )

    The Democrats rebranded socialized medicine as “single-payer” medicine so as to confuse people without the time to track all leftwing code words. They did the same thing for their own name in the ’80s, changing from “liberals” which was associated with the raft of failed leftwing policies of the 1970s, to “progressives.”

    It’s a good example of their contempt and disdain for the American people. They think, “People are so stupid that if we call something by a different name, one without negative connotations, they will support something they otherwise would have opposed.” (Remember, leftists rationalize that you are their inferior and that they must always manipulate you for your own good.)

    It doesn’t work long term, of course, because words acquire the connotation of the phenomena they label and not the other way around, e.g., idiot, moron and retarded were all originally words invented by doctors and scientist trying to create kinder, gentler and more scientific terms to describe people with subnormal mental processes. But the condition of being subnormal is viewed as negative so any word used to describe that condition becomes negative and eventually a playground pejorative.

    Deceitful words are highly dangerous in politics. No less a luminary than Confucius himself wrote that the first act of good governance is to name things honestly. This is more true in a democracy where people have to know what they are voting for.

    “Single payer” is a deceitful phrase not only because it attempts to rename something in order to confuse the people but also because under socialized medicine, everyone pays. It’s just that what you pay and what you get are unrelated. It’s only “single payer” from the perspective of the health care providers because they are the only ones who ever get paid.

    What is truly “single” in socialized medicine is who decides what medical treatments are available. Obamacare is structured around the idea that federal technocrats will decide which treatments will be available and which won’t. Individuals and doctors will choose from a restricted list. Socialized medicine has to be structured this way because from the perspective of the patient, all medical choices under socialized medicine cost the same and they will rationally choose the highest-quality treatments regardless of the real cost or real need. We will most likely follow the Canadian practice of outlawing all medical treatments the government doesn’t pay for, so we won’t even have that sliver of choice left.

    Hitting back against the Left means fighting their Orwellian control of language. Don’t let them use the warm and fuzzy focus-group-generated marketing phrases that they use in public discussion. Socialized medicine can also honestly be called, “single-decider medicine,” “politicized medicine,” and “politician managed” medicine. All these phrases capture the essence of the central question of your health care: Who decides what happens to your body.

    For Democrats the answer is always, “we decide.”

    Democrats give “free” stuff for the same reason that fishermen give free worms to fishes. To get “free” medical care you have to surrender control over your medical decisions. You have fewer and fewer actual choices. You’ll just be told what your treatment’s going to be. You won’t have complete or even meaningful partial control over any medical decision.

    Well, except for abortion.

     

    31 Responses to ““Single-Payer” Healthcare Means “Single-Decider” Healthcare”

    1. grey eagle Says:

      [Shannon: Deleted as off topic]

    2. Michael Kennedy Says:

      There are ways to reform health care without destroying what we have. France actually has the right idea and it is pretty simple. Their health care is funded by payroll deductions and the funds (there are several) pay a flat amount for each service. The doctor (or hospital) is free to collect an additional charge if the patient agrees. Doctors have to post charges. If patients choose to go only to those whose fees are set at the fund payment amount, doctors will be pressured to adjust down. It has worked well and French health care gets very high marks from those who have used it. By setting the reimbursement and multiplying by the number of procedures, you can predict cost.

      Politicians, like ours and the Canadians, don’t like this system as they want to promise FREE care. It never works. Canada now allows private care. Our present system is almost gone. Now, it will never return.

    3. Simon Primer Says:

      The tactics of the left proved very effective in the long run. They won.

    4. Will Cruz Says:

      Well, Mike, here is the bad news. The healthcare cliff is around the corner and Obamacare will push it right over. Shortages of Critical care medications are getting more common since last year, we lack new ABTs to combat newer strains of drug resistant bugs. This country is also losing hospital beds at a much faster rate nationwide. Experienced doctors and floor nurses are leaving the health care field in a faster pace and the next 4 years will be a flood. With the Medical Devices tax, expect many medical device manufacturers either leave the industry altogether or make the devices unaffordable except for the rich or politically connected. About the Nurse practitioners that a lot of expert non floor nurses and Obama care supporters are bragging about that will help alleviate the doctor shortages and make healthcare cheaper. Take it from me, an experienced floor nurse, those Nurse practitioners will be next to useless in treating you because they will restricted on what they can do to help you. Their job is to make sure that you are seen by a healthcare professional, other than that, you will just have to wait.
      Expect Long lines in late 2013 to early 2014 when Obama Care goes to effect and expect massive layoffs of nurses and other health care staff as hospitals and nursing homes start closing or down sizing in order to survive. The American people want fairness and free in healthcare, they will get it in spades. Hope they enjoy it.

    5. Will Cruz Says:

      No Simon, the only winners will be the politicians, the rest lost including the Left.

    6. Robert Schwartz Says:

      Michael. No more compromises. I am no loner interested in how to improve socialism. Socialism is death and we are going to die.

    7. Simon Primer Says:

      Will Cruz,

      When I said that the left won, I mean they have achieved what they wanted. Their ideology won. There is no way we can ever turn things around using democracy or having better arguments.

    8. Javahead Says:

      [Shannon: Comment deleted as off topic]

    9. Joe Citizen Says:

      Wow. I am absolutely floored. Just about the last person on this site I ever thought I could find common ground with – Michael Kennedy, says something entirely sensible.

      Maybe it is just his attitude that threw me. But glad to see that you are so supportive of a system of universal governmental health insurance, Michael.

      There is a mandate to purchase health insurance. The system offers universal coverage.

      Of course, this is rather nonsensical..
      “Politicians, like ours and the Canadians, don’t like this system as they want to promise FREE care.”

      Show me one politician of any prominence who has promised FREE health care.

      I’ll tell you what Michael. You start a movement to implement such a system here in America, and I will join you.

    10. Joe Citizen Says:

      “The Democrats rebranded socialized medicine as “single-payer” medicine so as to confuse people without the time to track all leftwing code words”

      As anyone could have guessed from the breathless ranting involved, it is actually you who are trying to hoodwink people, Shannon.

      “Single-payer” systems refer to socialized health INSURANCE. Not socialized MEDICINE.

      Sorry, but I suspect that even your comrades at this site understand this basic point.

      “You’ll just be told what your treatments going to be. You won’t have complete or even meaningful partial control over any medical decision.”

      To the extent that your ranting makes any passing contact with reality, it is a reality that exists for any insurance scheme, public or private. I assume that you have had the good fortune of sufficiently good health not to have had your medical fate decided by insurance company functionaries. The only difference between them and governmental bureaucrats is that the former are under more direct pressure to find ways to deny you coverage.

    11. tyouth Says:

      Re. Orwellian doublespeak; I’m always struck by how “red states” became Republican rather than Democratic state descriptions since, clearly, the Dems are much more (if not actually) “red” in the 1950′s and 60′s sense of the word.

    12. Will Cruz Says:

      Here is the thing, they had gotten what they wanted, the problem is basically simple, can they keep it or sustain it? The answer is no because like everything else in this world, reality tends to rear it’s ugly head and the Gods of the Copybook Headings will always have the final say.

      You want a better argument, watch California, Illinois and New York. These three states are functionally bankrupt , when the United States fall into that fiscal cliff, these three states will soon to follow and believe me, there is nothing more fun to see who among these three States would Obama and his Administration will save first considering that whatever he decides, he and his Administration would catch political hell and consider this, right behind those three would be New Jersey , Michigan, Pennsylvania and Ohio, the last two courtesy of the EPA war on Coal. Another thing, if Obama elects to save these States, he will be forced to save their financially troubled cities as well. Even if Obama raise taxes on the rich to about 100% and tax the corporations at the same percentage, tax the middle class to about 75% and the poor to 50% and reduce the military budget to a bare minimum of 1%. That money is not enough to get us out of the deficit or reduce our debt much less save these Blue States and cities while trying to start Obamacare and increasing Welfare. The Left will soon find out the true cost on running a national economy based on envy and class warfare.

    13. Simon Primer Says:

      Will Cruz,

      I don’t think a bad economy would matter. The government will pay it’s debt with newly printed money. There will be many more immigrant voters by then that are used to living in backward socialist societies. The government employees will be the last ones to suffer and left wing majority will be guaranteed. Nothing will change for the better for the same reason Brazil hasn’t turned to small government after decades of corruption and poverty.

      This is a all wishful thinking. The current system is rigged and the only hope is to abandon it and isolate ourselves.

    14. Will Cruz Says:

      Well Joe Citizen, Shannon is correct and you are wrong. Since she worked in health care and I currently am a health care provider, I have seen firsthand how Medicare and Medicaid patients had therapies and procedures rejected because they don’t conform to the treatment standard set forth by Medicare or Medicaid when there is direct evidence that the standard of care was set under ideal conditions and not in real life scenarios. .Work as a nursing home aid

      I’m sorry Joe, but those who shoulder your medical bills get the final say on what your medical treatment would be and there is a big difference between insurance bureaucrats and government bureaucrats, the former can be negotiated with and you have a choice to change insurance companies whereas a government bureaucrat is under direct pressure to save costs with you having no other choice. If you want to appeal your case, an insurance rep will call your MD and determine if your appeal has some merit in a reasonable manner whereas appealing to the government to change their decision, good luck with the red tape and delays to your hearing. By the time your hearing is set, you are either dead or don’t need it anymore.

    15. Will Cruz Says:

      Simon
      The government can print all the money it wants, but sooner or later, they had to deal with hyper inflation and then what? I’m sorry but poor immigrants will not immigrate into a country which have massive economic and financial problems than the country they left behind. Let me put this to you in real terms. I immigrated to the US in 1995 from the Philippines, the exchange rate of the dollar vs the Ph. peso was 1 dollar to 40 pesos. That is real spending money when the avg pay of a nurse back then was 2500 pesos q 2weeks . Now, as a poor immigrant, why would I go the US when the exchange of the US dollar vs the Philippine peso would be 1 dollar to 0.002345 pesos. I would be a fool doing that . That is the reason why I believed that there will be reverse immigration coming real soon.

      You used the wrong comparison. The US is like the UK back in the 70′s in debt, in trouble and very Left. The nearest comparison to Brazil would be the Philippines.

      True, the system is rigged but isolating ourselves would mean they would come after us. Hell, I would rather come after them.

    16. Simon Primer Says:

      Will,

      Inflation will hurt people but government employees will just get paid more and the poor will get welfare. I agree that there is a limit to how bad things can get but being slightly better than Mexico is not a high bar. We will get immigration from somewhere as long as we are richer than Somalia.

      I just don’t see what mechanism will get people to vote right wing. I am pretty sure that we will have more immigrants, more government employees, and more broken families. All vote left wing.

      There is no way to come after them at the moment, but having an Us vs Them mentality is the first step to thinking clearly.

    17. Tim Says:

      Well, the GOP still controls the house by a wide margin. That is the branch closest to the people. Just keep making the arguments. The electorate is not totally stupid.

    18. Mitch Says:

      @ Tyouth: the accepted explanation for the counter-intuitive red/blue designation is that the values were assigned by network TV news editors who were wary of tainting their allies on the Left. My preferred explanation is that people who took the blue pill vote blue, and we took the red pill.

    19. Michael Kennedy Says:

      Will, I know very well what is coming, and in many cases is here now. I teach medical students. Five years ago, they were pretty left wing and because of my interest in the economics of medicine was asked at one time to be the adviser for a single payer group. They didn’t realize that I am opposed to single payer. By the way, I don’t respond to trolls. The French system is a hybrid that came after the war. It is actually all privately funded although the government has had to put tax money into it because the pension system is entangled with Securite Social. They also have the problem with British immigrants who haven’t paid into the system and who file applications for the fund for the poor. I did a series of blog posts on my own blog several years ago on the details. The big difference is the market mechanism that we could easily adopt. It is illegal for doctors to charge anything in addition to Medicare allowance, which is going down all the time. Thus, Medicare is “free.” Canada did the same thing but has now allowed private care again.

      One reaction of older docs is to drop Medicare and go to cash practice. Obamacare has a provision that, once it is enforced, will make this impossible. In general, Obamacare has all the wrong incentives and is designed to be a stalking horse for single payer, as in “Medicare for all.” Barney Frank said as much the day before the election.

      I will meet with my group of students today and it will be interesting to see if they have any comments on the election. I am getting the impression that they are less enthusiastic about government medicine than their colleagues five years ago.

    20. Jonathan Says:

      Obamacare reinforced the worst features of the old system and destroyed the best ones.

      The Obamacare incentives are killers. The pro-socialized medicine argument is usually some variant of, “Nothing in the new law prevents your insurance company from operating as before, so there’s nothing to worry about.” The problem is that the law changes the business incentives for insurers by forcing them to insure sick people and limiting their profits according to arbitrary accounting formulas. This guarantees that insurance companies will leave the individual health-insurance market over time, as landlords gradually leave the housing market in rent-controlled cities. Most people will eventually be forced to buy substandard insurance through govt-administered “exchanges” and, after the private insurers leave the market, from the govt itself. Meanwhile payouts to doctors and other service providers will be limited to keep costs down, causing de facto rationing as skilled medical personnel leave the system and waits to see the fewer doctors remaining increase.

      I am hoping, indeed praying, that the medical tourism industry grows to provide some relief from the mess that lies ahead. If I were a doctor or a real estate developer or a hedge fund manager, I would be looking into developing full-service cash-only medical facilities combined with hotels/resorts in the Bahamas, Cancun and other near-offshore locations. Instead of flying to Nassau from Miami for $100 to drink and gamble, you might pay $500 for round-trip airfare and a physical exam or $2k for a colonoscopy including travel and hotel costs.

    21. Percy Dovetonsils Says:

      Jonathan, I know a doctor in Michigan who is seeking capital to build a hospital in India specifically to cater to medical tourists. India’s a long way to fly, however, especially if you have a serious ailment.

      So a Caribbean medical tourism industry would be a most welcome development.

      Besides, now that America is adopting socialized medicine, Canadians need someplace new to go for prompt health care.

    22. Will Says:

      Mike, they can be as left wing as they want to be while in med school. Once they get through internship and residency or sometimes fellowship, these former left wing doctors often develop strong libertarian/conservative leanings when they become attendings/consultants after dealing with Medicare/Medicaid system after so many times. The real world often cures a lot of leftist idealism. Of course, there are other practicing physicians who totally embraced the leftist ideology that no amount of real world experience will ever cure.

      I agree with your observation though, many of the current medical students are now getting either second thoughs about their support for Obama Care or are outsight hostile to a government takeover of health care. As a nurse, I notice my fellow nurses from my old hospital are not enthused about the new reality either. Expect veteran nurses to leave the health care profession altogether as hospitals all over the US start laying off staff.

    23. Jeff the Bobcat Says:

      Getting back to Shannon’s original hypothesis about “re-branding”, I have often thought the ability to “Name” something is a tremendous power. Thus, the course requirements at business schools always include marketing. Calling Obamacare “The Affordable Care Act” makes it more acceptable to the general population; I mean who isn’t in favor of affordable care?

      Unfortunately, the only way I know to make any service provided to a customer more “affordable” is to reduce the cost in providing the service. Reduce the cost and then the price can come down or not grow as much. Forcing lower pricing on the provider will inevitably lead to lower quality or availability. Would anyone be happy to have government technocrats come to them and say “You now have to work more for less pay”? I wouldn’t be.

      The Affordable Care Act was never about medical care, it’s about insurance and who provides it and pays for it. Call it the “Government Mandated Medical Insurance Act” and how much support would it have?

      A single payor model consolidates purchasing power. Power is the goal here.

    24. grey eagle Says:

      [Shannon: Comment deleted as off topic.]

    25. grey eagle Says:

      Once Obamacare is up and running US medicine, where will the Canadians go when they need an operation or some other medical procedure? And where will U.S. residents go?

    26. Locomotive Breath Says:

      [Shannon: Comment deleted as of topic.]

    27. Mike K Says:

      “The Affordable Care Act was never about medical care, it’s about insurance and who provides it and pays for it. Call it the “Government Mandated Medical Insurance Act” and how much support would it have?”

      The health insurance business has a failing business model. The insurers were some of the biggest promoters of Obamacare. They don’t want to be in the insurance business. I don’t blame them. What many, if not all, industrial health plans are are self funding plans administered by former insurance companies. They have become “administrative service organizations.” That is a better business plan. They process claims and collect fees.

      I suggest an e-book called Open Wide and Say Moo” by a cardiologist who has actually read the entire 2700 page law. I have read the book on his web site and it is excellent, especially in explaining some of the “Easter eggs” hidden in the law.

      When I began in practice 40 years ago, there were still “indemnity policies” that paid a flat fee for procedures. We need to go back to that, which is the French system. Allowing “balance billing” that is charging extra above what the policy pays would solve the access problem. Medical IRAs would allow some of the alternate systems, like “retainer practices.” That is already being banned by new rules that limit payments.

      For those who still doubt that coming crisis, I would point out that Mayo Clinic in Arizona stopped accepting Medicare two years ago.

    28. Dan from Madison Says:

      The one I thought of was “pro-choice” vs. “baby killing” or “infanticide” in the case of partial birth abortion.

    29. Shannon Love Says:

      Joe Citizen,

      As anyone could have guessed from the breathless ranting involved, it is actually you who are trying to hoodwink people, Shannon.
      “Single-payer” systems refer to socialized health INSURANCE. Not socialized MEDICINE.

      Oh wow, Joe, I have to confess that your are correct. The phrase “single-payer” has nothing to do with socialism at all.

      From wikipedia:

      Single-payer health care is medical care funded from a single insurance pool, run by the state.[4] Single-payer is not the same as universal health care (it is possible to have either without the other). A single-payer-universal-health-care plan for an entire population can be financed from a pool to which many parties—employees, employers, and the state—have contributed.
      Single-payer health insurance collects all medical fees, and then pays for all services, through a “single” government (or government-related) source.[5] In wealthy nations, this kind of publicly managed insurance is typically extended to all citizens and legal residents.
      Examples include the United Kingdom’s National Health Service[6], Australia’s Medicare, Canada’s Medicare, and Taiwan’s National Health Insurance.

      Clearly, few Americans consider the healthcare systems of the U.K. and Canada to be ” socialized” so using the term “single-payer” is not deceptive at all.

      Obamacare is clearly not socialism. You can’t call a program “socialism” just because the government:

      (1) Completely controls which medicines it is legal to manufacture, distribute and sale, not mention actively and pre-emptively censors what medicine creators can tell the American public about those products.
      (2) In addition, gives the Doctors a list of treatment options they can’t deviate from
      (3) Forces people to join the “single-payer” system upon pain of fine and imprisonment based on it’s constitutional authority to levy income taxes.
      (4) “Manages” the insurance pool by microscopic regulation of insurance companies making sure that all insurance companies off the same treatments at roughly the same price.

      The word socialization really means socialized cost with political management. That’s clearly not happening with Obamacare because the government doesn’t force socialize the cost nor make all the decisions. Insurance companies can still decide how to invest their premium pool and make a profit and that’s the main thing Americans who oppose “socialized” medicine hysteria where worried about. Can the insurance companies still invest? Yes, then bring it on!

      No wait, wait. I think that “single-payer” still qualifies as “socialized” medicine because its one of the many different ways that governments can both socialize the cost of health care and override individual choices about health care. It’s the whole Socrates is a man, all men are mortal, therefore Socrates is mortal, bit. I can draw a venn diagram if you’re still confused.

      It is a central cognitive defect of Leftists that they actually believe that words, labels and rhetoric mean diddly-squat in the end. Single-payer is still socialized medicine and its likewise disingenuous to assert that the debate was not over socialization and politicization itself but just the exact modality of that socialization. If they were being honest, the Democrats would have said, “we support the single-payer model for socializing medicine.” Instead, you clearly see, “single-payer” dropped in political nomenclature of the left everywhere that socialized medicine used to appear even if they are talking about radically different system.

      I notice that you completely ignored the major thrust of my post which was that Obamacare makes the government virtually the sole decision-maker for individual health care. If your choices about your personal medical care are different from the governments, tough.

      I realize that you don’t actually care much about individual choices, except in the case of abortion, but a lot of Americans do. (And by, “care about individual choices” I mean by where the policies you support place the legal authority to make a decision and note just because you mouth it rhetorically.)

    30. Michael Kennedy Says:

      Shannon, I’m afraid it’s pearls before swine. I expect the trolls to go away after election excitement cools off.

    31. Joe Citizen Says:

      “1) Completely controls which medicines it is legal to manufacture, distribute and sale, not mention actively and pre-emptively censors what medicine creators can tell the American public about those products.”

      What does this have to do with Obamacare? It is the situation today, and has been for a long time. You would like to do away with governmental regulation of pharmaceuticals? Or do away with any penalties for deceptive advertising? Really?

      (2) “In addition, gives the Doctors a list of treatment options they can’t deviate from”

      If they want to get paid. Just like any insurance company does.

      3) “Forces people to join the “single-payer” system upon pain of fine and imprisonment based on it’s constitutional authority to levy income taxes.”

      So? If people need care, then they receive it. Whether they can afford it or not. Under law. Predating Obamacare. It’s a moral principle that one could trace back to our underlying Judeo-Chritian value system. The Romney/Obama mandates simply solve the free rider issue. Wouldn’t you business-friendly people applaud that? (I imagine that is why Romney supported it before he sold his soul to the Tea Party).

      (4)” “Manages” the insurance pool by microscopic regulation of insurance companies making sure that all insurance companies off the same treatments at roughly the same price.”

      That is an exaggeration. Make sure basic minima are in place.

      “It is a central cognitive defect of Leftists that they actually believe that words, labels and rhetoric mean diddly-squat in the end.”

      Funny you should say that in the process of completely distorting the meaning of the world socialism.

      I realize that you understand your own deceptive rhetoric, but for the record….single payer is a socialization of insurance, not of medicine. The VA is a largely socialized health care system – in that the government is the provider of health care, not just of health insurance. No one is proposing to set up such a system like that for everyone.

      Obamacare is not a single payer system, so it is not even socialized insurance. It does not even have a public option.

      Government regulation of various aspects of the health care system are a separate matter entirely – in that they will (and should) exist whether there is Obamacare or not.

      Socialism classically refers to state ownership of the means of production. Neither Obamacare nor any single-payer system would have the state own the healthcare delivery system.

      It is you who seem unconstrained in your abuse of the clear meaning of words. Perhaps as a rightist you have become completely addicted to hyperbole, ranting and scare tactics, since that seems to be the honored tradition of rightwing discourse. But screaming it, repeatedly, don’t make it so.