[MRM]

I agree with you, Len. I just can't figure out how to return the mess we have back to a real market driven system. That's how I got to start thinking about a single payer system. You can design a single payer system that guarantees a basic level of payment to the provider but still allows all the providers to remain in the marketplace competing for patients.

Single payer is different from socialized medicine, even the Canadian and UK model. In socialized medicine the government takes over the providers, puts them on a salary, and controls the treatment each person receives in exchange for making it free. Under a single payer system the providers remain private but the government acts as the overall insurer. Insurance companies would be free to administer the program, so they and the providers would stay in the marketplace. The main difference is that the risk pool would be all US citizens and the federal healthcare agency wouldbe the single payer, except for optional programs that individuals sign up for and pay on their own. Instead of paying health insurance premiums we would pay some sort of a healthcare tax. The idea is that by creating the largest risk pool and simplifying reimbursement by having only one payer, the system gets more efficient and cheaper, so your health care tax will be far less than your current health insurance premiums plus the taxes you already pay to cover the uninsured.

There are other market-based ideas for fixing our health care system, but this is the basic concept that seems to me to work best, given what we have to work with. I'm certainly open to other, more efficient ideas.