Har, har, har...MediumTex wrote: Ironically, when we talk about expanding Medicare we talk about how bad it would be for doctors, and when we talk about doing away with Medicare we talk about how bad it would be for doctors. And then, of course, everyone knows that Medicare's current configuration is bad for doctors.
I'm not a proponent of deregulating or messing with Medicare. I'm a proponent of setting up a good European system, most likely similar to Germany's. It is completely impossible - why? well...
1 - The FDA charges way more than it's European counterparts to get drugs approved, which decreases competition, raises drug costs and limits choices.
2 - Health professionals educations are covered or at least heavily subsidized, so that they still get good applicants but reimburse less in the form of payments. (To nurses, therapists, physicians, etc.) All of which helps keep costs feasible, but our education system in this country will NEVER be that efficient.
3 - A government run system would have to offer a basic level of care to anyone but ultimately deny some services to individuals who stand to get minimal benefit. In socialized systems, this is addressed far more effectively and objective decisions are made about what treatments can be offered; Americans still hold true to the attitude that "more is better" which makes any government run system we may implement either "immoral" based upon our standards, or financially implausible.
4 - Legal reform on a large basis would be needed to at least minimize physicians incentives to practice expensive "cover-your-arse" medicine.
These are the first major issues that come to mind. There are others, however.