Posted in Access to healthcare, big government, Canadian Health System, Crony Capitalism, Dependency, Doctor shortage, Economic Issues, Government Regulations, Government Spending, Healthcare financing, Liberty, Medical Costs, Medical Practice Models, Medicare, Organizational structure, Patient Choice, Patient Safety, Policy Issues, Price Tansparency, Protocols, Quality, Uncategorized, Wait times to see a doctor

Dr. Whatley: Single-payer healthcare – the good, the bad and the nutty – THE DIRECT PRIMARY CARE JOURNAL

Dr. Shawn Whatley


Shawn Whatley is past-president of the Ontario Medical Association. He has worked in emergency medicine, as a coroner, in a vein clinic, and as a surgical assistant. He also held a leadership role at a large suburban hospital. He now practises family medicine in rural Ontario. Visit his blog at rural Ontario. Visit his blog at

The Nutty

  • Hospitals lose money for seeing more patients; doctors earn more for seeing more patients
  • Unlimited sick days for some nurses
  • March madness: hospitals spend like crazy before year-end or lose funding for next year
  • Pharmacists paid more for same service than MDs (e.g. flu shot)
  • Black market in radiology and lab licenses
  • NPs and midwives earn more per patient than MDs
  • Labs have fixed budgets: more tests means less profit per test

Bigger Issues

Single payer healthcare also raises other, more challenging problems:

Those who know cannot speak. The system suppresses dissent. People cannot speak up, because they have nowhere else to work. Professionals working in hospitals or academia must stay quiet. Single-payer systems give tremendous power to administrators who run the monopoly. It enriches and expands government. Price controls appear to limit costs, but profits are found in other ways. For example, price controls force doctors to shorten visits, unbundle care, up-code, or stop providing a service. Centrally planned single-payer systems function on Hayek’s Fatal Conceit, the assumption that planning is possible:

The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.

Local knowledge is impossible to capture or to use in managing the system. Single-payer systems incentivize collusion with government to exclude competition. It creates a psychological change in Canadians. Whereas choice empowers patients, single-payer fosters dependency on the system. It creates increased demand for fixed price services but decreased availability of those services. Single-payer assumes that bigger is always better. But bigger often becomes too big to manage. A CEO of A.T.&T. once said, “A.T.&T. is so big that, if you gave it a kick in the behind today, it would be two years before the head said ‘ouch.’”

Posted in Access to healthcare, Consumer-Driven Health Care, CPT billing, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, Employer-Sponsored Health Plans, Government Regulations, Health Reimbursement Arrangement (HRA), Health Savings Accounts (HSA's), Healthcare financing, Individual Market, Large group insurance market, Medicaid, Medical Costs, Medical Practice Models, Medicare, Patient Choice, Patient-centered Care, Policy Issues, Portable Insurance, primary care, Protocols, Reforming Medicaid, Reforming Medicare, Tax Policy, Technology, third-party payments, Uncategorized

Trump’s New Vision for Health Care

Hats off to John C. Goodman again! His work in leading the effort for market-based healthcare reform over the past 4 decades, and highlighting the government’s role in the dysfunctional mess we labor in, is second to none.

This Forbes article lays out a most concise and accurate rendering of what healthcare has become and why…and what to do about it.

If you’re tired of the hearing healthcare pundits wax feverishly about their favorite villains and how more regulations are the answer; or if you’re just a novice starting to explore the Healthcare conundrum, Dr. Goodman’s work is required reading. I recommend starting here and then circling back to some of his earlier work. The book “PRICELESS” is a recommended next step!

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Independent Physicians, Medicaid, Medical Costs, Medical Practice Models, Medicare, Organizational structure, Patient Choice, Policy Issues, Quality, Reforming Medicaid, Reforming Medicare, Subsidies, Uncategorized, Wait times to see a doctor

Most Americans Want Government-Run Health Care Until They Find Out the Government Will Run Health Care – Hit & Run :

“While 55 percent of Americans say they want a single-payer/Medicaid-for-all plan, those in favor tend to change their minds when they hear that it means giving the government more control over health care, or that Americans would have to pay more in taxes.

That tracks with other polling on the issue. A May poll from the nonpartisan Public Policy Institute of California found support for single-payer state healthcare at 65 percent statewide, but that number dropped to 42 percent when respondents were told at least $50 billion in new taxes would be required to pay for it. That’s a pretty optimistic view of the taxes that would be required to pay for single-payer in California; the actual cost would be well over $100 billion annually.

Are you sure you want government-run health care? Many Americans don’t seem to understand the question. But once they do, the answer is “no.” “