No provider is required to take Medicare

No. All it proves is that your liberal schemes were as yet incomplete .

The public option demanded by liberals will be mandatory on all providers. Unlike Medicare, which had that loophole allowing providers to opt out, no doctor or hospital will be able to refuse a patient’s public option card. And as originally put forward by liberals, the public option’s reimbursement rates were to be pegged at only 5% above Medicare rates.

So the Mayo Clinic wouldn’t be able to opt out of that one.

The fact that the Mayo Clinic, one of the top 10 hospitals in America, refuses to take Medicare should tell you right there that top-quality health care is more expensive than you liberals care to admit.

The obvious conclusion is that you’re quite prepared to trade off quality in health care for numbers: Give millions more Americans some health care, even if those of us with complex life-threatening illnesses that demand the best possible care will be stymied.

That’s the same tradeoff the British NHS made.

Like I said, you liberals consider the private sector to exist only as long as you can’t think of a good reason to take it over. Each part of the private sector exists in limbo, waiting to find out whether you can think of a good reason to take it over.

That’s your model of the U.S. economy, isn’t it?

Doesn’t the fact that some providers refuse to take Medicare because reimbursement rates are low only prove that the presence of a large govt program such as Medicare is not ruining the private market?

No provider is required to take Medicare; they are free to contract only with private insurers. If enough of them find they cannot operate profitably on Medicare rates Medicare will either have to raise its rates or it won’t have any providers to offer services.

Once again: you cannot give “free” (or, essentially free) medical service to everyone and keep the same level of care. The providers simply will simply go on strike against it.

http://www.azcentral.com/business/articles/2009/10/09/20091009biz-mayoclinic1009.html

The Dutch system only recently switched to a system wherein private insurers provide basic coverage. For decades before that the Dutch offered a PO alongside private insurers. Therefore, my original contention that there are examples in the U.S. and throughout the world where a PO did not drive private insurers out of business remains true. If anything, the Dutch conversion to this new model only undermines your argument that a PO would drive private insurers out of business.

Equally important, you consistently ignore the example of the CA workers comp PO, which is probably the model that would resemble a healthcare PO the most. The CA WC PO is not subsidized by taxpayer money, it has not driven private insurers out of business and it has kept premiums down by serving as a true competitor. Consequently, it directly refutes every single argument you’ve made against a PO.

After I wrote this, I wished for an edit function. Because I would have used the term “essential public goods”.

There are most certainly parts of the economy where the public interest would not be served by nationalization, just as there are parts where our public interest virtually demands that the service is provided by the public sector (though that does not always mean nationalization – such as fire departments).

If you truly believe that liberals want to have a nationalized auto industry, it is hard to have a sensible discussion on this. Personally, I believe that were the economy not already tottering on the edge of collapse, and the multiplicative effects of a GM collapse not possibly being the last thing needed to send us into depression, the decision would likely have been different. But I guess you’ll continue to argue that it was payoff to the unions, and we have no further common ground for discussion on that point – neither of us will cede to the other’s basic premise.

See – that’s not what I hear. I actually hear that there are many doctors who prefer doing business with Medicare – because they know that as long as they fill the form correctly, they’re going to get paid. No iterative fights with the insurer over payment that both tie up your cash flow AND require additional administration costs – it appears that there is a substantial additional overhead to private insurance, in the costs that physicians must bear dealing with a system where a main method of increasing profit is to deny coverage … often after treatment is already complete.

You might as well discourage tens of thousands of medical students from pursuing a career in medicine–and discourage hospitals from expansion.

Hospitals – perhaps. As someone else noted, it is odd that in America we’ve evolved to a system where virtually all patients demand private rooms, but that’s what the free market demands and thus provides, no matter how cost inefficient.

Students? I truly don’t believe this – I think that there is no shortage of extraordinarily talented young men and women who will continue to enter the medical profession. It is quite possible that we have created a situation via the promise of super high salaries that some of those students were crowded out of the limited number of Med School slots by others who really did choose the profession simply because of the promise of $350K/year for certain specialties.

Personally, I believe that a student with 5% lower MCAT scores and a 3.4 college GPA instead of a 3.7 – but who really wants to be a doctor because they really want to practice medicine … and not because they truly want to own an extra home in the Hamptons – has the possibility of being a much much better doctor.

As shown by the sky high bonuses and salaries for the players in our financial system … and the culpability of those players in nearly bringing the US economy to the ground last year due to a particular form of incompetence properly labelled “blind greed” … the lure of super-high salaries doesn’t always bring the best performers to a profession.

Airlines? Oh, wait, European governments owned their own airlines.
Automobiles? Oh, wait, the U.S. Government owns General Motors now.
Basic materials? Oh, wait, Truman took over the steel mills once.

I would LOVE you liberals to tell us once and for all which parts of the private sector you absolutely guarantee you will never, ever nationalize.

I doubt you will though.

My guess is that you reserve the right to nationalize anything and everything if you feel the circumstances are right. No holds barred.

To you, the private sector exists only on your sufferance. Not as an economic right.

Take Medicare for example. Medicare’s reimbursement rates are so low that doctors are faced with either refusing to take Medicare patients (which a quarter of U.S. doctors now do), or cost-shifting by charging higher rates for patients with private insurance.

If the public option’s reimbursement rate is only 5% above Medicare’s rates (as liberals are demanding), the public option’s premiums will be so low that private insurers will go out of business. No matter how efficient a private insurer is, they can’t compete with a rate set artificially way below market rates. That’s why private old age medical insurance went out of business decades ago–it couldn’t compete with Medicare.

With the public option having morphed into an effective single-payer system paying only 5% above Medicare rates, we will have effectively capped doctors’ salaries and hospitals’ incomes. They won’t be able to cost-shift because private insurers won’t exist anymore. You might as well discourage tens of thousands of medical students from pursuing a career in medicine–and discourage hospitals from expansion.

Of course I want to hold down health care costs. But the only realistic way to do that is to deal with the problem of how medicine is delivered in this country. And I’ve discussed that issue many times. Not to tell doctors that they’re going to have to take pay cuts from now on, or to tell Americans that “Surprise! We’ve set the reimbursement rate for the public option so low that Blue Cross is going out of business!”

Your proposal makes no sense to anyone who understands Economics 101. It is the concoction of liberals who think they can make economics produce arbitrary results by passing laws. They should have learned a lesson from the collapse of command eonomies in the 20th century: Don’t try that again.

Certainly not in all parts of the economy. Only in places where the service being provided can legitimately be labelled a public good. And what constitutes a public good will always be subject to debate in a healthy society.