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There is no mention in this article of the greatest fear people should have of a single payer nationalized health care system. Countries with such systems put restrictions on costly treatments. They will have to go through the system and come up with conditions for who is eligible for treatments based on cost considerations. The US system is more costly. But there is better availability of medical technology. I for one do not want base treatment options on cost. —Preceding unsigned comment added by 18.87.1.204 ( talk) 17:21, 7 May 2009 (UTC)
(begin from neutrino78x.blogspot.com) Nbauman, he did not advocate the idea that somehow the government should provide individuals with health care, and take away their choice in health care providers. Certainly, there was no communist health care system in England in Smith's day. The US Constitution, heavily influenced by Locke and Smith, does say that the government should "provide for the general welfare" but this is different from "provide for the specific welfare of any given individual". In other words, if there is a smallpox outbreak/terrorist attack, yes of course the government should try to stop it (via Locke's "social contract"), but it is not the role of government, in my opinion, and, I think, John Locke's and Adam Smith's as well, to make sure Joe Smith specifically has a health care plan; that's Joe Smith's responsibility, and Joe Smith has the freedom to make enough money to buy one, and Kaiser Permanente, Blue Shield etc have the freedom to sell one to him. This is called "the rugged individual theory", aka social darwinism, first articulated by a Brit named Herbert Spencer but highly influential in the United States, and is quite the successful policy here, given our GDP compared to every other great nation in the history of mankind (Greece, Rome, Egypt, UK in the 1600s, etc: paupers compared to the USA in 2007). Personally I do not have medical insurance, but if I want to see a doctor, I don't have to wait 10 weeks like in Britain, I simply call (one of) the local doctor and make an appointment, usually he's available the next day or maybe 2 days later, then go in there, I see him, and pay US$75. If I had Blue Cross medical insurance (one of several private health care plans available in the state of California), I would pay US$35/month, and a doctor visit would be US$10. Not free but pretty cheap, I just haven't subscribed to that because I'm lazy. :) If I have an emergency, I can call 911 (like 999 in the UK), and get free health care at the emergency room. Anyway I have been advised by senior Wikipedia people in the past that Wikipedia is not intended to be a debate society, and I figure that's reasonable, so I'll just leave my suggestions as they are...thanks for everybody's consideration... people can contact me via blogspot to tell me how stupid I am if they want (I know how frustrating it can be to see comments online that make you angry but then you can't email rants to the author lmao), feel free to delete these comments...(end from neutrino78x.blogspot.com) 71.116.71.27 04:27, 11 March 2007 (UTC)
The issue of criticism is quite complex because this weird term "single-payer" seems to add confusion to the debate on health care. I made a small change today which highlights a problem with single-payer with private practice which does not arise in single-payer with publicly employed practitioners. I feel inclined to think that if this article is to remain, it needs to be split into pros and cons sections, but I haven't the time to do this. -- Tom 00:42, 15 July 2007 (UTC)
The definition of single payer is inconsistent. In the first paragraph it is defined as a system in which the government assumes the role of paying for health care; further down it says that there are "two types", one in which the government pays for private doctors, and the other in which the government runs the whole health care system. The only use I've ever heard is the first, the government pays private doctors. Is it ever used to refer to a government-run health care system? Nbauman 19:59, 13 February 2007 (UTC)
Try to find some sources (preferably in peer reviewed journals). :) Nbauman 21:55, 13 February 2007 (UTC)
Curiously USA-centric for an article about a system which isn't even used in USA. Move most of that stuff to some other article. The "single-payer vs. to socialized medicine" distinction in the intro is also weird in that context. HFuruseth 16:40, 22 February 2007 (UTC)
Hfuruseth -- it should be referred to as "communist medicine" in my opinion. ;-) "Socialized" should have similar (negative) implications in the mind of the reader but for some reason, it often doesn't. I think in Europe they tend to support communist solutions because they still have the idea of The King Will Take Care of Us, for which the Americans clearly did not stand. ;-) lol, all kidding aside, my point is that "socialized" is not as politically neutral as "single payer". Some people think "socialism! woo hoo!" others (the majority in the glorious Republic of the USA, including myself) think "socialism! gross!" whereas "single payer" is just a neutral summary of the proposal. It's like, you can say "partial birth abortion" or "late term abortion" and they have totally different political implications. 71.116.71.27 08:29, 6 March 2007 (UTC)
This section has no attribution at all. It doesn't quote anyone who holds these views. If anyone actually believes these things, you should be able to find someone to quote. Nbauman 08:25, 10 March 2007 (UTC)
= I believe written by an advocate, it's obvious.
This page needs some work. The article as a whole is disorganized.
It should be organized to define the subject, summarize it, define the debate, divide the subject into its component issues, and give the pros and cons of each issue.
Many of the paragraphs and sentences are poorly worded and inaccurate, and there is POV or unsupported assertions left. They often repeat themselves, and sometimes contradict themselves.
I believe that every statement should be supported by reliable sources, and for me the best source is a peer-reviewed medical journal. I have my own opinions on the merits of single payer, but I think the article should reflect the pros and cons of all significant points of view.
There is a rather large number of sources to this article -- some of them reliable, others not so reliable.
This is a good time to improve this article, because Michael Moore's movie Sicko is creating increased interest in single payer, and this article comes up near the top on Google searches for "single payer", "single payer health care", and similar searches.
If anyone has any ideas about how this article should be rewritten, or any reaction to my edits, I'd like them to discuss it here. Nbauman 23:19, 6 July 2007 (UTC)
I will undo the recently added link to the Centre for Policy Analysis. The web site contains articles that contain very dubious claims. Some examples
1 "More than 1 million Britons must wait for some type of care, with 200,000 in line for longer than six months".
2. "In France, the supply of doctors is so limited that during an August 2003 heat wave -- when many doctors were on vacation and hospitals were stretched beyond capacity -- 15,000 elderly citizens died."
"One (British) cancer patient tried to get an appointment with a specialist, only to have it canceled -- 48 times."
For these reasons I find it unacceptable to use the CPA as source of reliable information. -- Tom 19:34, 27 July 2007 (UTC)
That's a cute graphic, but I see a lot of problems with it. The biggest problem is that it's original research.
Usually, when I see a graphic like that in an article, it summarizes the text of the article. But this graphic introduces some concepts that aren't in the article. That's one of the reasons it's wp:or. Nbauman 07:46, 1 August 2007 (UTC)
I would just like to point out that so far, Kborer, you are the only one advocating for your own graphic. As I read this discussion, all other editors' responses have been to remove it. -- Sfmammamia 02:15, 4 August 2007 (UTC)
The criticism section contains a number of thinly-veiled attacks on critics of proposed single-payer systems. For example, the first paragraph wraps opposition by the insurance, pharma, and other parts of the medical industry in critiques of the critics themselves by Oberlander and Moore. The section should contain only the criticisms that opponents of the proposal have, without commentary by other people. Later commentary includes Angell's pro-single-payer critique and the POV paragraph following the second bullet point near the end of the section.
I would fix this problem in short order myself, but I suspect that doing so would simply be met with a reversion by somebody. Therefore, I am offering this discussion first before making any change. -- Dachannien Talk Contrib 20:41, 1 August 2007 (UTC)
I propose that we change the article title to be less ambiguous. Single payer health care could refer to any system where the government provides the funds which includes socialized medicine. What this article is talking about, however, is a specific type of single payer system, in which health care providers remain private employees. Some sources refer to this incorrectly as single payer, while others use a more precise term: single payer insurance. [1] Kborer 15:45, 3 August 2007 (UTC)
There are referenced definitions for the two terms, and those definitions show that the two terms mean different things. A similar example would be dance and folk dance. As discussed above, the article used both terms interchangeably and was very misleading. That is why I forked the article, and there is nothing POV about it.
If you want to talk about why I deleted the polling section, see the discussion above under the "Sicko revision" heading. If you want to discuss my conduct, or anything else that concerns you about me, please feel free to use my talk page. Kborer 02:28, 20 August 2007 (UTC)
Since the discussion was closed and single payer health insurance was deleted, I'll post my response here.
While a few editors chorused these complaints against it:
Examining both of these pages, and their associated talk pages, will show that these claims are baseless.
First, the fork was initiated after a discussion on Talk:Single-payer health care. Only three editors decided to voice their opinion: two (including myself) wanted to fork the article, while the third disagreed. After two weeks and no new opinions, I created single payer health insurance using new text and many new references. A few days later, as I was working to focus the two articles on their separate subjects, the new article was suddenly proposed for deletion with complaints similar to the ones above.
I explained and gave references for why the objections were without merit, but no one cared to debate the proposed deletion with me. Even though four editors think that the creation of this article was unjustified, I believe that it should be reinstated.
From this article: Single payer is "An approach to health care financing with only one source of money for paying health care providers." Does socialized medicine fit this description?
Kborer
22:42, 29 August 2007 (UTC)
The "varying degrees of interchangeability" is what makes this so problematic and also the great deal of mis-information about various types of health systems (mostly put out by pressure groups with vested interests) just adds to the problem. Sfmammamia may be right that some people use the term to draw a disctinction, but we also know that others label the Canadian system as "socialized medicine" so for other people it cannot mean what the paragraph implies. I think WP articles should aim for clarity. Although one might argue that we need to reflect life as it is, the counter argument is that there is a "correct interpretation" and WP should stick to that. For example, just because some people confuse terms as "islamic" and "islamist" is not a good reason for repeating the confusion in the WP articles on these subjects. Knowlegeable people know better and WP should reflect the best of human knowledge, not the worst of pejudices and ignorance. When we discussed the meaning of "socialized medicine" at that article, it became apparent that the best definition of it was regulation and control, and here at "single payer" we are talking about meeting costs from a single fund. Sfmamammamia's revised paragraph has words of uncertaininty like "some people" and "may remain" so it is not an inclusive truth. Having precisely defined what is "socialized medicine" and what is "single-payer", I think it most unhelpful to start mixing them up again. They are not polar opposites of one another, even íf some people treat them as such. No one is advocating making US health providers employees of the government (as far as I am aware) so the need for this distinction is itself fairly meaningless anyway. Removing it from the article would merely improve clarity.--
Tom
09:21, 31 August 2007 (UTC)
Is single payer the same thing as national health insurance? Kborer 02:11, 31 August 2007 (UTC)
I just re-read the Aug 30 2003 PNHP proposal carefully and actually it is not prescriptive about whether the single payer is the government.
The PNHP says "Funds for the NHI could be raised through a variety of mechanisms" though it does go on to say that "funding based on an income or other progressive tax is the fairest and most efficient solution, since tax-based funding is the least cumbersome and least expensive mechanism for collecting money".
Also the National Library of Medicine definition only refers to "one source of money for paying health care providers", and goes on to say that "the payer may be a governmental unit or other entity
Because of this, isn't the statement in the article's heading that Single payer is when "the government assumes the role of an insurance company" making a much stronger statement than it should about the source of funding and its management? -- Tom 14:20, 8 August 2007 (UTC)
I've reworded the phrase that introduces government involvement, to indicate that it is typically the single payer. -- Sfmammamia 20:38, 8 August 2007 (UTC)
To Sfmammamia. Sorry I accidentally undid your talk page edit..Its reinstated now. Hopefully my meaning behind reinstating the edit on the main page is clear. Although SOME people assume its the government, single payer advocates like PNHP say it COULD be the govt. So the original statement in the main para that it IS the govt was wrong. This possibility that is MAY be the govt and is often assumed to be the govt is made clear in the next to paras. The main para is more factual and in accordance with the definition that follows on from it. I hope that is clear.-- Tom 15:03, 9 August 2007 (UTC) I understand what you mean by typically, but should we not take the lead from the original proponents and the medical profession? -- Tom 15:12, 9 August 2007 (UTC)
You say it would impossible. Can you justify that, or is it your assumption? I gave an eample earlier of the BBC in the UK but perhaps you might better see it with a US example. The Federal Reserve Bank system was set up by government but acts completely independently of political control and its member banks are owned privately. It is part public and part private. Its only acts to protect the currency and the stability and smooth operation of the banking system and it cannot be swayed to serve the vested interests of the serving presidency, the commercial banks or the ruling party in either house of congress. Its mandate is much broader and long term than any one of those groups serve. Perhaps that is what the PNHP group meant when it deliberately left the matter open. A Federal Health Insurance System could be to medicine the what the Fed is to banking. If I were a proposer of this idea who chose my words carefully to define A, which has a subset B, I'd be a bit annoyed if people ignored my careful words and just talked about B, especially if B is loaded with negative connotations (as government control of anything in the US seems to be). It is tantamamount to misrepresentation. I agree that many people may assume B and not A, but surely it's fairer if Wikipedia makes it clear what the proposers said in the definition was A. We are not hiding the presence of subset B or disguising its use by mentioning it immediately after the proper definition. -- Tom 00:25, 10 August 2007 (UTC)
The polls section looks, quite frankly, like total crap. That's probably why it was deleted earlier. I strongly suggest replacing the verbose and poorly formatted poll data with a short summary of the poll results, with links to the appropriate articles for those who actually need to see the data in that much detail. -- Dachannien Talk Contrib 10:03, 20 August 2007 (UTC)
I think we need a bit of structure to this debate, because we're really getting nowhere in determining what there is consensus on and what is still heavily disputed. Here's the flow of the debate as I see it:
We need to answer these questions in the process of determining what an appropriate final state for that section would be. I think the consensus on the first answer is fairly clear - responses in this discussion have ranged from "the polling data is not appropriate to include verbatim in Wikipedia" to "if the polling data were replaced by a prose section that was written correctly, that would be fine". In other words, I think we all agree that including the polling data verbatim isn't necessary. Wikipedia policy also suggests that replacement with a prose section is appropriate. -- Dachannien Talk Contrib 18:49, 27 August 2007 (UTC)
I just read the poll data and there is indeed a lot of data. Too much to include fully and probably would be breeching copyright if it was). But I do think the findings are relevant to the article. If, as an outsider to the issues in the US, I was asked to summarise it, I would put it as follows
This is the impression I got from reading the whole data and I don't claim to have checked the above back to the poll. -- Tom 21:14, 29 August 2007 (UTC)
It might be a good idea to find polls from those countries that use this system I also recommend checking the data in the opponents section for what operations are touted by the US system, because opponents have used operations usually payed for by Medicare (most notably hip replacements) to try to show that the American system is better. —Preceding unsigned comment added by 75.69.118.1 ( talk) 02:52, 23 October 2007 (UTC)
I made a new graphic, but since the last one was so controversial I will post it here for review before putting it up. Kborer 01:49, 22 August 2007 (UTC)
This quote is given in the article but the link it to a subscription site so I cannot verify it. It seems strange a thing for him to say because it goes on to mention the delivery system as being an important factor. But the important factor about single payer is not the delivery system but the fact that there is a single risk pool. Are we sure that he made that quote in the context of discussion about the term "Single-payer"? If anyone has a WSJ subsription and can verify the full quote for us that would be great. I have no doubt that they are forms of socia insurance ...its just the bit about the coupling to a private delivery system. -- Tom ( talk) 23:37, 1 January 2008 (UTC)
The article in one place says the hospitals are mostly run by the provincial governments and in another that they are mostly private. They cannot both be right. Which is correct?-- Tom ( talk) 23:39, 1 January 2008 (UTC)
I have initiated an article on equalization pools. In health insurance, a risk equalization pool is a way of achieving a competitive insurance market and achieving universal health care. In essence the payment and premium collection bureaucracy rests with the insurers who now compete on a level playing field and must set prices and coverage publicy and which cannot reject applicants or limit health care coverage, on the grounds of health status or age, nor many they set different co-pays and deductibles etc... i.e. many of the things that people seem to object to most in the present US system. It is therefore an alternative to creating a single payer system, so it is somewhat tangential to this article. It is used in many countries where there is (or is intended to be) a competitive insurance market in health insurance. It requires the government to control an agency to equalize risks between insurance pools to encourage clearer competition and can be the instrument of government funding for health.
Even though risk equalization would be a competitive alternative to single payer health care I am surprised that this article does not mention it. The system is used in three countries that I know of (Germany, Ireland and the Netherlands) but it may be used in others too.
I raise the issue here because (a) someone may be interested to investigate the issue further and (b) might be kind enough to help add to the equalization pool article as they do so (as I have not provided any references as yet).-- Tom ( talk) 19:50, 17 January 2008 (UTC)
"Single-payer health care is an "American" term." No, it is just a term. This sentence seems to contradict itself.
Single-payer health care is an American term describing the payment for doctors, hospitals and other providers for health care from a single fund. The Canadian health care system, the British National Health Service, Australia's Medicare, and Medicare in the U.S. for the elderly and disabled are single-payer systems. —Preceding unsigned comment added by 71.146.93.96 ( talk) 06:25, 30 January 2008 (UTC)
Single-payer health care is a term used by Americans to describe the payment for doctors, hospitals and other providers for health care from a single fund. The Canadian health care system, the British National Health Service, Australia's Medicare, and Medicare in the U.S. for the elderly and disabled are all described as single-payer systems.
The article currently says
"A single-payer system could put the government, rather than private insurance companies, in the role of deciding which procedures and medications would be covered"
I am not sure why this is a criticism. It seems more like a sound-bite. Most people in the U.S. get covered by their employer's insurance so there is little or no element of consumer choice with the private insurance coverage they receive. If the government in a single-payer system did not cover certain procedures surely the insurance companies would step in and offer additional coverage over and above the basic national package. This is what happens in the Netherlands for example and it can assure the insured person of the coverage they feel they need. Similarly if a employer's policy in the U.S. for example was lacking, surely the insured person could buy the extra coverage they need. The two things seem to me to be fairly similar. A person has a chance of influencing the health care system in single-payer systems because they are to some extent democratically accountable. I am not sure how an employee could influence his/her employer's purchasing decisions or the employer's insurer's coverage policy. -- Tom ( talk) 19:05, 25 September 2008 (UTC)
![]() | This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 | → | Archive 5 |
There is no mention in this article of the greatest fear people should have of a single payer nationalized health care system. Countries with such systems put restrictions on costly treatments. They will have to go through the system and come up with conditions for who is eligible for treatments based on cost considerations. The US system is more costly. But there is better availability of medical technology. I for one do not want base treatment options on cost. —Preceding unsigned comment added by 18.87.1.204 ( talk) 17:21, 7 May 2009 (UTC)
(begin from neutrino78x.blogspot.com) Nbauman, he did not advocate the idea that somehow the government should provide individuals with health care, and take away their choice in health care providers. Certainly, there was no communist health care system in England in Smith's day. The US Constitution, heavily influenced by Locke and Smith, does say that the government should "provide for the general welfare" but this is different from "provide for the specific welfare of any given individual". In other words, if there is a smallpox outbreak/terrorist attack, yes of course the government should try to stop it (via Locke's "social contract"), but it is not the role of government, in my opinion, and, I think, John Locke's and Adam Smith's as well, to make sure Joe Smith specifically has a health care plan; that's Joe Smith's responsibility, and Joe Smith has the freedom to make enough money to buy one, and Kaiser Permanente, Blue Shield etc have the freedom to sell one to him. This is called "the rugged individual theory", aka social darwinism, first articulated by a Brit named Herbert Spencer but highly influential in the United States, and is quite the successful policy here, given our GDP compared to every other great nation in the history of mankind (Greece, Rome, Egypt, UK in the 1600s, etc: paupers compared to the USA in 2007). Personally I do not have medical insurance, but if I want to see a doctor, I don't have to wait 10 weeks like in Britain, I simply call (one of) the local doctor and make an appointment, usually he's available the next day or maybe 2 days later, then go in there, I see him, and pay US$75. If I had Blue Cross medical insurance (one of several private health care plans available in the state of California), I would pay US$35/month, and a doctor visit would be US$10. Not free but pretty cheap, I just haven't subscribed to that because I'm lazy. :) If I have an emergency, I can call 911 (like 999 in the UK), and get free health care at the emergency room. Anyway I have been advised by senior Wikipedia people in the past that Wikipedia is not intended to be a debate society, and I figure that's reasonable, so I'll just leave my suggestions as they are...thanks for everybody's consideration... people can contact me via blogspot to tell me how stupid I am if they want (I know how frustrating it can be to see comments online that make you angry but then you can't email rants to the author lmao), feel free to delete these comments...(end from neutrino78x.blogspot.com) 71.116.71.27 04:27, 11 March 2007 (UTC)
The issue of criticism is quite complex because this weird term "single-payer" seems to add confusion to the debate on health care. I made a small change today which highlights a problem with single-payer with private practice which does not arise in single-payer with publicly employed practitioners. I feel inclined to think that if this article is to remain, it needs to be split into pros and cons sections, but I haven't the time to do this. -- Tom 00:42, 15 July 2007 (UTC)
The definition of single payer is inconsistent. In the first paragraph it is defined as a system in which the government assumes the role of paying for health care; further down it says that there are "two types", one in which the government pays for private doctors, and the other in which the government runs the whole health care system. The only use I've ever heard is the first, the government pays private doctors. Is it ever used to refer to a government-run health care system? Nbauman 19:59, 13 February 2007 (UTC)
Try to find some sources (preferably in peer reviewed journals). :) Nbauman 21:55, 13 February 2007 (UTC)
Curiously USA-centric for an article about a system which isn't even used in USA. Move most of that stuff to some other article. The "single-payer vs. to socialized medicine" distinction in the intro is also weird in that context. HFuruseth 16:40, 22 February 2007 (UTC)
Hfuruseth -- it should be referred to as "communist medicine" in my opinion. ;-) "Socialized" should have similar (negative) implications in the mind of the reader but for some reason, it often doesn't. I think in Europe they tend to support communist solutions because they still have the idea of The King Will Take Care of Us, for which the Americans clearly did not stand. ;-) lol, all kidding aside, my point is that "socialized" is not as politically neutral as "single payer". Some people think "socialism! woo hoo!" others (the majority in the glorious Republic of the USA, including myself) think "socialism! gross!" whereas "single payer" is just a neutral summary of the proposal. It's like, you can say "partial birth abortion" or "late term abortion" and they have totally different political implications. 71.116.71.27 08:29, 6 March 2007 (UTC)
This section has no attribution at all. It doesn't quote anyone who holds these views. If anyone actually believes these things, you should be able to find someone to quote. Nbauman 08:25, 10 March 2007 (UTC)
= I believe written by an advocate, it's obvious.
This page needs some work. The article as a whole is disorganized.
It should be organized to define the subject, summarize it, define the debate, divide the subject into its component issues, and give the pros and cons of each issue.
Many of the paragraphs and sentences are poorly worded and inaccurate, and there is POV or unsupported assertions left. They often repeat themselves, and sometimes contradict themselves.
I believe that every statement should be supported by reliable sources, and for me the best source is a peer-reviewed medical journal. I have my own opinions on the merits of single payer, but I think the article should reflect the pros and cons of all significant points of view.
There is a rather large number of sources to this article -- some of them reliable, others not so reliable.
This is a good time to improve this article, because Michael Moore's movie Sicko is creating increased interest in single payer, and this article comes up near the top on Google searches for "single payer", "single payer health care", and similar searches.
If anyone has any ideas about how this article should be rewritten, or any reaction to my edits, I'd like them to discuss it here. Nbauman 23:19, 6 July 2007 (UTC)
I will undo the recently added link to the Centre for Policy Analysis. The web site contains articles that contain very dubious claims. Some examples
1 "More than 1 million Britons must wait for some type of care, with 200,000 in line for longer than six months".
2. "In France, the supply of doctors is so limited that during an August 2003 heat wave -- when many doctors were on vacation and hospitals were stretched beyond capacity -- 15,000 elderly citizens died."
"One (British) cancer patient tried to get an appointment with a specialist, only to have it canceled -- 48 times."
For these reasons I find it unacceptable to use the CPA as source of reliable information. -- Tom 19:34, 27 July 2007 (UTC)
That's a cute graphic, but I see a lot of problems with it. The biggest problem is that it's original research.
Usually, when I see a graphic like that in an article, it summarizes the text of the article. But this graphic introduces some concepts that aren't in the article. That's one of the reasons it's wp:or. Nbauman 07:46, 1 August 2007 (UTC)
I would just like to point out that so far, Kborer, you are the only one advocating for your own graphic. As I read this discussion, all other editors' responses have been to remove it. -- Sfmammamia 02:15, 4 August 2007 (UTC)
The criticism section contains a number of thinly-veiled attacks on critics of proposed single-payer systems. For example, the first paragraph wraps opposition by the insurance, pharma, and other parts of the medical industry in critiques of the critics themselves by Oberlander and Moore. The section should contain only the criticisms that opponents of the proposal have, without commentary by other people. Later commentary includes Angell's pro-single-payer critique and the POV paragraph following the second bullet point near the end of the section.
I would fix this problem in short order myself, but I suspect that doing so would simply be met with a reversion by somebody. Therefore, I am offering this discussion first before making any change. -- Dachannien Talk Contrib 20:41, 1 August 2007 (UTC)
I propose that we change the article title to be less ambiguous. Single payer health care could refer to any system where the government provides the funds which includes socialized medicine. What this article is talking about, however, is a specific type of single payer system, in which health care providers remain private employees. Some sources refer to this incorrectly as single payer, while others use a more precise term: single payer insurance. [1] Kborer 15:45, 3 August 2007 (UTC)
There are referenced definitions for the two terms, and those definitions show that the two terms mean different things. A similar example would be dance and folk dance. As discussed above, the article used both terms interchangeably and was very misleading. That is why I forked the article, and there is nothing POV about it.
If you want to talk about why I deleted the polling section, see the discussion above under the "Sicko revision" heading. If you want to discuss my conduct, or anything else that concerns you about me, please feel free to use my talk page. Kborer 02:28, 20 August 2007 (UTC)
Since the discussion was closed and single payer health insurance was deleted, I'll post my response here.
While a few editors chorused these complaints against it:
Examining both of these pages, and their associated talk pages, will show that these claims are baseless.
First, the fork was initiated after a discussion on Talk:Single-payer health care. Only three editors decided to voice their opinion: two (including myself) wanted to fork the article, while the third disagreed. After two weeks and no new opinions, I created single payer health insurance using new text and many new references. A few days later, as I was working to focus the two articles on their separate subjects, the new article was suddenly proposed for deletion with complaints similar to the ones above.
I explained and gave references for why the objections were without merit, but no one cared to debate the proposed deletion with me. Even though four editors think that the creation of this article was unjustified, I believe that it should be reinstated.
From this article: Single payer is "An approach to health care financing with only one source of money for paying health care providers." Does socialized medicine fit this description?
Kborer
22:42, 29 August 2007 (UTC)
The "varying degrees of interchangeability" is what makes this so problematic and also the great deal of mis-information about various types of health systems (mostly put out by pressure groups with vested interests) just adds to the problem. Sfmammamia may be right that some people use the term to draw a disctinction, but we also know that others label the Canadian system as "socialized medicine" so for other people it cannot mean what the paragraph implies. I think WP articles should aim for clarity. Although one might argue that we need to reflect life as it is, the counter argument is that there is a "correct interpretation" and WP should stick to that. For example, just because some people confuse terms as "islamic" and "islamist" is not a good reason for repeating the confusion in the WP articles on these subjects. Knowlegeable people know better and WP should reflect the best of human knowledge, not the worst of pejudices and ignorance. When we discussed the meaning of "socialized medicine" at that article, it became apparent that the best definition of it was regulation and control, and here at "single payer" we are talking about meeting costs from a single fund. Sfmamammamia's revised paragraph has words of uncertaininty like "some people" and "may remain" so it is not an inclusive truth. Having precisely defined what is "socialized medicine" and what is "single-payer", I think it most unhelpful to start mixing them up again. They are not polar opposites of one another, even íf some people treat them as such. No one is advocating making US health providers employees of the government (as far as I am aware) so the need for this distinction is itself fairly meaningless anyway. Removing it from the article would merely improve clarity.--
Tom
09:21, 31 August 2007 (UTC)
Is single payer the same thing as national health insurance? Kborer 02:11, 31 August 2007 (UTC)
I just re-read the Aug 30 2003 PNHP proposal carefully and actually it is not prescriptive about whether the single payer is the government.
The PNHP says "Funds for the NHI could be raised through a variety of mechanisms" though it does go on to say that "funding based on an income or other progressive tax is the fairest and most efficient solution, since tax-based funding is the least cumbersome and least expensive mechanism for collecting money".
Also the National Library of Medicine definition only refers to "one source of money for paying health care providers", and goes on to say that "the payer may be a governmental unit or other entity
Because of this, isn't the statement in the article's heading that Single payer is when "the government assumes the role of an insurance company" making a much stronger statement than it should about the source of funding and its management? -- Tom 14:20, 8 August 2007 (UTC)
I've reworded the phrase that introduces government involvement, to indicate that it is typically the single payer. -- Sfmammamia 20:38, 8 August 2007 (UTC)
To Sfmammamia. Sorry I accidentally undid your talk page edit..Its reinstated now. Hopefully my meaning behind reinstating the edit on the main page is clear. Although SOME people assume its the government, single payer advocates like PNHP say it COULD be the govt. So the original statement in the main para that it IS the govt was wrong. This possibility that is MAY be the govt and is often assumed to be the govt is made clear in the next to paras. The main para is more factual and in accordance with the definition that follows on from it. I hope that is clear.-- Tom 15:03, 9 August 2007 (UTC) I understand what you mean by typically, but should we not take the lead from the original proponents and the medical profession? -- Tom 15:12, 9 August 2007 (UTC)
You say it would impossible. Can you justify that, or is it your assumption? I gave an eample earlier of the BBC in the UK but perhaps you might better see it with a US example. The Federal Reserve Bank system was set up by government but acts completely independently of political control and its member banks are owned privately. It is part public and part private. Its only acts to protect the currency and the stability and smooth operation of the banking system and it cannot be swayed to serve the vested interests of the serving presidency, the commercial banks or the ruling party in either house of congress. Its mandate is much broader and long term than any one of those groups serve. Perhaps that is what the PNHP group meant when it deliberately left the matter open. A Federal Health Insurance System could be to medicine the what the Fed is to banking. If I were a proposer of this idea who chose my words carefully to define A, which has a subset B, I'd be a bit annoyed if people ignored my careful words and just talked about B, especially if B is loaded with negative connotations (as government control of anything in the US seems to be). It is tantamamount to misrepresentation. I agree that many people may assume B and not A, but surely it's fairer if Wikipedia makes it clear what the proposers said in the definition was A. We are not hiding the presence of subset B or disguising its use by mentioning it immediately after the proper definition. -- Tom 00:25, 10 August 2007 (UTC)
The polls section looks, quite frankly, like total crap. That's probably why it was deleted earlier. I strongly suggest replacing the verbose and poorly formatted poll data with a short summary of the poll results, with links to the appropriate articles for those who actually need to see the data in that much detail. -- Dachannien Talk Contrib 10:03, 20 August 2007 (UTC)
I think we need a bit of structure to this debate, because we're really getting nowhere in determining what there is consensus on and what is still heavily disputed. Here's the flow of the debate as I see it:
We need to answer these questions in the process of determining what an appropriate final state for that section would be. I think the consensus on the first answer is fairly clear - responses in this discussion have ranged from "the polling data is not appropriate to include verbatim in Wikipedia" to "if the polling data were replaced by a prose section that was written correctly, that would be fine". In other words, I think we all agree that including the polling data verbatim isn't necessary. Wikipedia policy also suggests that replacement with a prose section is appropriate. -- Dachannien Talk Contrib 18:49, 27 August 2007 (UTC)
I just read the poll data and there is indeed a lot of data. Too much to include fully and probably would be breeching copyright if it was). But I do think the findings are relevant to the article. If, as an outsider to the issues in the US, I was asked to summarise it, I would put it as follows
This is the impression I got from reading the whole data and I don't claim to have checked the above back to the poll. -- Tom 21:14, 29 August 2007 (UTC)
It might be a good idea to find polls from those countries that use this system I also recommend checking the data in the opponents section for what operations are touted by the US system, because opponents have used operations usually payed for by Medicare (most notably hip replacements) to try to show that the American system is better. —Preceding unsigned comment added by 75.69.118.1 ( talk) 02:52, 23 October 2007 (UTC)
I made a new graphic, but since the last one was so controversial I will post it here for review before putting it up. Kborer 01:49, 22 August 2007 (UTC)
This quote is given in the article but the link it to a subscription site so I cannot verify it. It seems strange a thing for him to say because it goes on to mention the delivery system as being an important factor. But the important factor about single payer is not the delivery system but the fact that there is a single risk pool. Are we sure that he made that quote in the context of discussion about the term "Single-payer"? If anyone has a WSJ subsription and can verify the full quote for us that would be great. I have no doubt that they are forms of socia insurance ...its just the bit about the coupling to a private delivery system. -- Tom ( talk) 23:37, 1 January 2008 (UTC)
The article in one place says the hospitals are mostly run by the provincial governments and in another that they are mostly private. They cannot both be right. Which is correct?-- Tom ( talk) 23:39, 1 January 2008 (UTC)
I have initiated an article on equalization pools. In health insurance, a risk equalization pool is a way of achieving a competitive insurance market and achieving universal health care. In essence the payment and premium collection bureaucracy rests with the insurers who now compete on a level playing field and must set prices and coverage publicy and which cannot reject applicants or limit health care coverage, on the grounds of health status or age, nor many they set different co-pays and deductibles etc... i.e. many of the things that people seem to object to most in the present US system. It is therefore an alternative to creating a single payer system, so it is somewhat tangential to this article. It is used in many countries where there is (or is intended to be) a competitive insurance market in health insurance. It requires the government to control an agency to equalize risks between insurance pools to encourage clearer competition and can be the instrument of government funding for health.
Even though risk equalization would be a competitive alternative to single payer health care I am surprised that this article does not mention it. The system is used in three countries that I know of (Germany, Ireland and the Netherlands) but it may be used in others too.
I raise the issue here because (a) someone may be interested to investigate the issue further and (b) might be kind enough to help add to the equalization pool article as they do so (as I have not provided any references as yet).-- Tom ( talk) 19:50, 17 January 2008 (UTC)
"Single-payer health care is an "American" term." No, it is just a term. This sentence seems to contradict itself.
Single-payer health care is an American term describing the payment for doctors, hospitals and other providers for health care from a single fund. The Canadian health care system, the British National Health Service, Australia's Medicare, and Medicare in the U.S. for the elderly and disabled are single-payer systems. —Preceding unsigned comment added by 71.146.93.96 ( talk) 06:25, 30 January 2008 (UTC)
Single-payer health care is a term used by Americans to describe the payment for doctors, hospitals and other providers for health care from a single fund. The Canadian health care system, the British National Health Service, Australia's Medicare, and Medicare in the U.S. for the elderly and disabled are all described as single-payer systems.
The article currently says
"A single-payer system could put the government, rather than private insurance companies, in the role of deciding which procedures and medications would be covered"
I am not sure why this is a criticism. It seems more like a sound-bite. Most people in the U.S. get covered by their employer's insurance so there is little or no element of consumer choice with the private insurance coverage they receive. If the government in a single-payer system did not cover certain procedures surely the insurance companies would step in and offer additional coverage over and above the basic national package. This is what happens in the Netherlands for example and it can assure the insured person of the coverage they feel they need. Similarly if a employer's policy in the U.S. for example was lacking, surely the insured person could buy the extra coverage they need. The two things seem to me to be fairly similar. A person has a chance of influencing the health care system in single-payer systems because they are to some extent democratically accountable. I am not sure how an employee could influence his/her employer's purchasing decisions or the employer's insurer's coverage policy. -- Tom ( talk) 19:05, 25 September 2008 (UTC)