Originally Posted by Dr Millmoss
I believe it goes significantly deeper than this. The frame of reference is thoroughly ideological. The basic concept at work is that the market and the market alone provides all goods and services that people need. The corollary is, if the market does not provide a good or service, then people don't actually need that good or service. In an effort to resolve the cognitive dissonance created by the obvious differences between theory and reality in this instance, an additional layer of rationale is created whereby it is theorized that if the government simply removed itself completely from any particular market, that supply and demand would come magically back into balance and everybody would get what they need (or what they deserve).
Ideology is certainly a factor in almost every political debate, but it's certainly not the only (or ever the major) factor at play for many people on the conservative side. Experience is a big factor as well.
I currently live in a country with single payer, government-run health care. I understand how it works, and where it falls short.
I was diagnosed with viral influenza several weeks ago after visiting my doctor. Though I've been to the Doc plenty of times before, this time around (possibly because of this thread) I paid attention to the system itself.
I waited for over an hour for my appointment, sitting in a cramped, uncomfortable waiting area. There were no electronic or phone reminders sent out to remind me of my appointment, as is the case with my dentist.
Hand sanitizers and masks abounded, but I had to hand over my health card to the nurse rather than swipe it myself. That nurse has to open the glass window and handle everybody's card herself. May the Lord keep her healthy. Though there are signs asking everywhere, obviously sick people are not bothering to wear masks (which is more a failure of human nature than the medical system.)
I get to the "small waiting room" as Seinfeld calls it, and the Doc checks me and diagnoses the viral influenza. The room itself looks like it was designed by a bureaucrat and decorated by pre-school students. Though viral influenza is usually the first stage of H1N1, I am never told this nor offered Tamiflu (which Canada has huge stockpiles of.)
After my situation deteriorates in a week and I return for another visit (no opportunity for email questions or phone calls - Docs get paid by the visit) I get a few tests and x-rays but no follow up afterward. Though I'm suspected of having H1N1, there's no general testing being done locally for relatively mild cases and I can't pay for a personal test. I now have no idea whether I need to get the vaccine.
The coup de grace comes toward the end of my visit, when I notice the doctor is typing my details into the province's new electronic records system. It's browser-based on a PC, and I cringe upon realizing the URL is http, not https.
Most of the problems with my visit are directly linked to a lack of customer service. You see, in Ontario, there's a shortage of doctors directly caused by government budget cutting in the 90's. (Health bureaucrats cut medical school enrolments to save money.) I can theoretically change doctors under Medicare, but you need good luck to find one taking new patients.
So there's no incentive to have nicer waiting areas, reminders, on-time performance, post-visit follow-up, etc. etc. This is where market competition would help.
Furthermore, the coming American shakeup of health care is, as Gretzky would say, skating to where the puck used to be. It's focused on paying the exorbitant medical bills of the current generation based on a 1960's ideology.
The medical system of the future has to be more about keeping people healthy, not just treating them when they're sick (which is far more expensive.) Single Payer will do nothing to lower American obesity rates or cancer treatments. Both Canada and Europe are now moving to increased private sector involvement for treatment and an increasing role for government in education and prevention.