We, the people, are sick and tired of hearing that "single payer is off the table" in the same breath with "health care reform." Attempting to "repair" a broken-down old vehicle without considering the possibility of a replacement as an alternative simply makes no financial sense. The same is true with trying to repair our broken health system.
We are besieged on all sides by all the profit-generated complaints about the evils of "socialism" creating waiting lines and people dying while waiting for health care as well as the specter of "paying for somebody else's doctor bills." That is pure malarkey and far from the situation as it already exists. Let's take a look at the model that is already before us.
A prime example is our existing Medicare/Medicaid system:
Nobody is required to get permission to see a doctor! You go to the same physician who has been your family doctor for years or, if you choose, you may pick one out of the Yellow Pages. You need no pre-approval. You go to the doctor. That's it.
There is no waiting line! When you call for an appointment, the receptionist will ask questions about your need based on your own complaints. If your need is urgent, most doctors will "work you in." If not, you may have to wait a few days.
There is no pre-approval required! Your personal doctor decides what you need. If you require a specialist with skills and training beyond his own, he may refer you to one. If your problem requires surgery, you will be sent to a surgeon who cares for people with that complaint, and the surgery will be scheduled. At no point is anyone looking over his shoulder from whom he requires permission.
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If necessary, you will enter a hospital at the convenience of the surgeon or physician! This will probably be a facility at which the doctor practices daily and will likely be not a great distance from your home. You will receive the same treatment as do all the other patients. (As you perambulate through the halls, you may see a private room at the end of the hall but pay it no mind. That is for somebody who thinks their station is too exalted to allow them to mingle with the Great Unwashed and are either there "on comp" or paying through their blue noses to satisfy their own egos.)
With those arguments out of the way, when you are restored to health, you will get a statement of explanation of the charges. You are not expected to pay in full, only to check the statement and to notify the insuring agency of any discrepancies that you may find. YOU are the first monitor of the honesty and accuracy of this billing.
A bit later, you will receive a second statement which will show the amounts paid by Medicare/Medicaid and any balance which you are charged with paying. Currently, if you receive both Medicare and Medicaid, you pay nothing at all. If Medicare only, there is now a system of "deductibles and co-payments" but, in most cases, you will find the care providers to be quite patient with the small partial payments which you can afford in your own budget.
There may be charges that are deemed necessary to the care you required and are not covered. There is a schedule of maximum hospital time allowed to your particular surgery or problem. This may be appealed by your doctor due to unusual circumstances but they will seldom hamper your recovery or strain your wallet. In today's system, you will not be allowed to get free breast implants, abortions, face lifts, or even surgery to improve your vision (except for cataracts), but those services such as cardiac surgery, appendectomy, or cancer, will be treated as routine.
This concept is not a foreign one to our free nation. Throughout our history, people have banded together and formed "cooperatives" in order to have a larger organization for purposes of bulk purchasing or marketing more efficiently. Even today, the land is dotted with "farm co-ops" which were founded for that purpose and, in rural areas, electrical power is still successfully functioning after having been begun by Roosevelt's Rural Electrification Agency. Many city people belong to "child care co-ops" where mothers exchange their labor to provide care for their children while they work, and "food co-ops" flourish as people who prefer fresh, locally-grown produce to the canned, sterilized, and polluted stuff that is sold in the supermarket.
The purpose of these cooperatives is simple. That is to "cut out the middle man," the amorphous figures who produce nothing and provide nothing but profit from the work of others by controlling the access of human interaction and sharing. Our lives are full of them! We cannot go to an individual business owner to invest in their business. We must go through a stock broker who, in turn, deals through Wall Street and all the organizations represented there, each of whom takes a share of our money before it ever reaches its intended target. So it is with medical care. We go to an insurance company who takes our money, tells us to which doctors we may go, then tells those doctors what procedures they may and may not do for us, keeping a share of our money at every step. They are not at all concerned with our health, only with the money they can keep for the privilege of brokering the services of our physicians.
Think of single-payer medical care as a giant cooperative where everybody pays in what they can afford, on a sliding scale, and each is allowed to take out what they need. This is the same principle on which we finance our government, pay for our public services, (from the bottom up), pay for our military, and even bail out our over-acquisitive banking system.
It's called "democracy" and it's the American Way! How dare they take it "off the table"?!?