Name: Single payer healthcare (new date)
Start: 2024-05-25T11:00:00-04:00
End: 2024-05-25T13:00:00-04:00
Location: Lucky Tree

**Let's discuss single payer healthcare**
Single payer healthcare is another great idea that is getting ruined. Even though I agree that specking about ideals and “perfect situation in vacuum” having government paying for healthcare seems like the most humane solution. However, I am not big proponent of talking about idealistic scenarios in vacuum.
Here are some example articles to read:
Some definitions:
[article 1](https://www.wsj.com/articles/what-is-single-payer-anyway-it-depends-who-you-ask-01549644167)
Pros:
[article 2](https://www.wsj.com/articles/the-case-for-medicare-for-all-11553815403)
cons:
[article 3](https://www.wsj.com/articles/the-false-promise-of-medicare-for-all-1542066511)
Transparency:
[article 4](https://www.wsj.com/health/healthcare/hidden-hospital-fees-cost-patients-hundreds-of-dollars-0024cd95?mod=Searchresults_pos9&page=1)
Current United States Healthcare system is as far as possible from single payer system, and claiming that instating full-blown single payer system a-la UK or Canada would mean completely destroy the system that exists in use and then “build a new system from the scratch”, and if there is one thing history tells us, is that breaking something in order to build something from the scratch is a recipe for a disaster. There is so many factors that you won’t be able to account for in this situation. Besides, people who live in UK and Canada in many cases are very unhappy about their healthcare. The grievances on people in UK and USA are very different, if people in USA are most concerned with astronomic costs, the people in UK are concerned with prohibitive wait times to see a doctor and inability to access the care. Are we supposed to choose between these grievances or are we supposed to make a number of serious, but consecutive changes to the current system to make a significant improvement, and then reassess the possibility of ever achieving single payer system?
And if you think about it, certain facts become obvious:

1. pricing transparency must be improved, even though there were a couple of great steps that were done in that direction recently, hospitals and insurance companies fight back and try to conceal all the pricing information from the people, in some cases their pricing strategies appear borderline criminal. That must be addressed and fight must be relentless
2. Middle men in the system make ridiculous profits. Even though people keep saying how “evil big pharma does this and that” it is worth remembering that Pharma is the only industry that invests about 20% of their revenue in research and development to produce new medicines that will save people’s lives and will improve people’s quality of life. The middle men of distribution and insurance companies, however, are only that - middle men, their work is necessary, but it must be transparent, and there must be no monopolies in these spheres, and they are currently are quite corrupt.
3. As a follow up to 1 and 2, “capping drug prices” as single payer proponents normally suggest immediately results in slower innovation, because innovative companies become more risk averse if they know they can’t recuperate the cost of medical research. The costs of bringing a new drug to market are astronomical, and mostly this is due to the simple fact that you have to conduct clinical trials, which are long and costly, but are absolutely necessary to prove efficacy and safety. US is a driver or innovation and much of this is because they can charge a lot for novel drugs in USA.
4. Now, you can rightfully ask - ok, they may change $1000000 for super novel gene therapy because it costed a ton to bring to life, but why do they charge so much for insulin that was invented forever ago and it’s so expensive to make? And I would agree here, and the answer is two-fold. 1) There shouldn’t be monopoly for producing old drugs that are off patents. 2) Patent law should be written such that the companies wouldn’t use loopholes.
5. Going full-on single payer for all very quickly is dangerous, what seems more feasible is to expand access to certain types of health insurance for poor/people in need, which would be paid by government
6. In long term access to governmental paid health insurance can be gradually increased, until it will get to some resemblance to complete single payer system, though if this is done **very gradually,** the risks are smaller.
Different opinions are welcome, and you are welcome to convince me to see the situation differently.

Natalie

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