The fact that health care is effecting your employment sucks. To support your case, let me also offer the following:

1. With cost, our system is the most expensive and has mediocre results for the population as a whole. Essentially our system is designed to encourage innovation by allowing people to make a lot of money in the health care field. Costs can be addressed by not making health care an economic engine but scaling it back so other industries can thrive without health care costs.

2. With regards to scaling back, we're going have to look at rationing health care differently. Everyone rations health care and most countries do it by limiting access to specialty care and high end services. In the US, we ration health care by not providing it to those who can't pay.

3. For those who say, government-sponsored health care is un-American, we already have government sponsored health care if you're old (Medicare) or poor (Medicaid). When Medicare was created, there was fully the expectation that it would expand to cover other populations. The first expansion was covering End Stage Renal disease. Dialysis had just been invented and the Kidney lobby was very strong. However, that was the last expansion.

Tim, I would caution you about your term of socialized medicine. To me that implies that the government employs every single health care worker. I think that you are looking for a system that provides health insurance for everyone and is regulated accordingly.

As far as costs, the key ways to address those is not by selectively covering people but to stop paying providers based on how many services they provide (fee for service) and start paying on outcomes, promote primary care or at least stop reward specialists so much (only 30% of US physicians are in primary care. In most countries, 70% are in primary care), coordinate the system, and make cost-effectiveness a part of evaluating new medical innovations. Tim, this is where we disagree as I think that that the current health care players are in the best position to implement this change. Government would provide the regulatory framework, mandates, and fund accordingly. For example, insurance companies are in the best position to coordinate care because they have the data and history of working with multiple providers and paying based on an agreed upon methodology.

Ah yes, castigating opponents of single payer health care as being "from another planet" is a stunning way to start an argument. I love how there are some seriously thoughtful posts on BC that aren't featured because the editor would rather have a post that throws the first stone without fact or lucid explanation.

Bravo.

@Dead- I am advocating exactly that. Universal health care is a great step in the right direction, but some of us won't be helped out because the costs will still be astronomical. I think health care needs to be treated like oxygen- it should be free and everyone should have access.

@Scott- can we pay for it? Yes. But it would require some serious lifestyle and policy changes. First of all, we will have to tax the rich at a far higher rate than we do now. In the 50's and 60's the tax rate on that income was 80 or 90 percent. Let's get back to that and tack on taxes on greenhouse gases, legalize drugs and tax them, and spend less on the military. If you combine all of those and take into account the lowered cost of a socialized system, we can definitely afford it.

@Lance- yes. The only BC posts that are thoughtful are about personal branding, which don't include any hyperbole at all.

From a business perspective this system is unsustainable. From a humanitarian perspective it's abominable. I'm merely pointing out that I really don't see where opponents of single payer are coming from. Unless you're working R&D in the pharmaceutical industry, you really don't have any way to profit from this system.

@Jimmy- INSIGHTFUL!

@Scott. Demand for health care will always be higher than supply. If any country let everyone get all the health care that they wanted, it would bankrupt them. In order to afford it, you set a budget for health care and than set up a system to ensure that people get their health care in a logical fashion and when the money runs out, so does the health care. If it costs too much, you can continue to pay for it but eventually you change the rationing. For example in Germany, primary care providers get paid so much per quarter to manage all the care for their patients. When it runs out, that's it. Thus, primary care providers learn how to make decisions to manage care.

The US doesn't make really hard decisions about rationing it if people have insurance and if they don't, than you get none. That's what our quasi-regulated, quasi free market system has brought us. Oregon made rationing decisions around its Medicaid plan a while ago.

Quite simply, to afford it, you make up a budget and ration accordingly. If you go over budget, you handle it accordingly.

@ Keith- if the government goes over their budget in any country, you risk not having health care. All health care systems have to cut back services when they go over budget or they run a debt, raise taxes, or whatever. That's what makes health care so hard. Rationing is not easy at all and my tone was intended for Scott's question about how a country can afford to pay for health care. It doesn't address the fact that this rationing directly impacts someone's life.

As far as for profits vs non-profits making decisions, I wouldn't get too caught up in the tax status of an organization. I work at a non-profit health plan who contracts with for profit physician groups and buy drugs from for profit pharmacy companies. Our non-profit hospitals in our area also benefit from the lack of information around how much something actually costs when they figure our how much they want for profit insurance companies to pay them.

Everyone makes a lot of money in health care in the US and that's how our current system is designed. We need to accept that we can't get the latest and greatest AND cover everyone.

I deserve a lot of things from the government that I'm not getting.

I want a new bike. Maybe a pony too.