Off Topic Board

That was the proposal to the post I was responding to. Single payer is also the stated preference of the President (don't know if it still is, you can tell with this guy all the time). And we're talking about Canada here, which is the deal right? Health care is a right and it's paid for by the gov't

Unless the co-pay is the full cost of the service, it will still lead to over-use, as well as government-oriented waste. As I have said before, why not just have HSAs and people keep and allocate their money as they wish, with true competition serving to maximize quality of service and minimize cost?

As for safety net clinics for the truly poor, I would support that, and certainly use PAs, med-school interns, and recent grads.

Which costs would those be? Cost of the drugs? Most scripts are pretty cheap.

Absolutely, and they would be particularly good in an HSA system where you are paying directly.

The problem is that the number of people that do not pay is still, relatively speaking very low. I believe it is absurd to create a system intended to serve the entire populace as an answer to a problem that really only involves a small percentage of the populace. You are going to create a mega-bureaucratic mess that is bloated with waste.

The better solution, is to make people, for the love of God, actually be responsible for themselves, or else have to then deal with stripped-down safety net clinics. The overwhelming majority of people would actually participate in a free market system, paying for themselves in a competitive system, with incentive to not piss money away, and with no government bureaucratic waste.

But you were proposing clinics to provide basic care for everyone. I would say it would be MUCH better to have people keep more of their own money (using HSAs, aided by moving the deduction over to the individual) to pay for such basic care directly. The idea of basic clinics in places like Wal-Mart, using PAs, would work great in such a system, for one example of really cutting costs. The effort should be made to make government have the smallest role possible, restricted to those in the absolute least ability to pay for their own care (the truly poor). Further, for those with extreme long-term needs we could help through vouchers or some other solution. But we need to get out of the idea that government is the solution for anything other than the absolute necessary situations.

How is this true? If I have cancer and treatment costs $10,000 but my budget would only allow me to have the treatment if government kicked in $9,000, would this be an 'over-use'?

You should be responsible and not get cancer. By sheer will alone you have to learn to control the rate of cellular mitosis.

And treating an ear infection is incredibly cheap without all the BS that goes along with the current system. I would strongly support tort reform and other changes in regulations that would allow a doctor to simply diagnose something like that over the phone or through e-mail, and allow the prescription of the medication without even having to go in to see the doctor.

I get your point, make going to the doctor for smallish stuff not a big deal so that small problems don't get big. But you are assuming that the current cost of smallish doctor visits would remain as high as they currently are, and I would contend the near total elimination of bureaucratic overhead related to billing, etc., in a fee-for-service system would result in much less hesitation to go to the doctor. There is also strong evidence to show that people still avoid going to the doctor even when the cost is small or nearly non-existent. But another thing is in a system like mine, the concern over higher costs that could be incurred if you don't go when something is small, could be a big incentive to treat things early. The world did still turn before our current health-care plan type system, and medicine was not even in the dark ages at that time.