The DMV Epitomizes Everything Wrong With the Government: AKA – Are you sure about that Single Payer Healthcare?

imagesFirst of all, at least half the people that work there are sociopaths that actually enjoy making people’s lives miserable.

The other half have the IQ of a sea cucumber, or at the very least act as if they do because it keeps them from having to do actual work.

Here’s a few other problems.

It’s too big to run efficiently.

It has too many rules and regulations, no single person who works there can possibly be expected to remember them all or keep up with them.

There’s no competition. Have a problem with the way they do things? Tough shit, they are the only game in town.

They don’t actually care about people or customer service. Why? Because they have a monopoly. It doesn’t matter how shitty their service is or how poorly they do their job, your complaints go in one ear and out the other because they could not possibly care less about what you think. You are just a number to them, someone to shuffle from counter to counter until you either give up in frustration (yay! now they have less work to do!) or you finally manage to accomplish your task, no thanks to them.

I don’t care if you are liberal or conservative, no one likes the DMV.

Nobody.

How anyone could remain in the belief that the government is efficient or good at accomplishing tasks in any way that is beneficial to mankind after a trip to the DMV?

Yet for some reason this is exactly what liberals really want from our healthcare system.

“Obamacare isn’t working! Let’s have a single payer system instead!”

Yeah sure, that will work beautifully.

Liberals bitch and moan about how “Insurance companies just see you as a number!” but at least they see me as a number that has the opportunity to walk away and take my money with me.

Government departments know they have a monopoly and you aren’t going anywhere, they can treat you as poorly as they want to. It doesn’t have to make sense, because just like your last frustrating visit to the DMV, what can you do? Go somewhere else to renew your license or your emissions test or your tags? Not gonna happen.

Talk to me about being “nothing more than a number” when you are sitting in the questionably sanitary chairs at the Department of Health Services office, waiting 2 hours for A0027 to be called so you can finally talk to a real person, only to be told you need to give them your paperwork and wait for your number to called again, so you can tell someone else what your problem and be told you have to come back tomorrow because no one can help you with that today.

We’ll see what tune you’re singing then.

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14 Comments

  1. Sorry to be Captain Obvious, but Medicare is single-payer, it’s as big as the DMV, and it works better. It’s because there are doctors and clinics all over big cities, but also in every small town, who accept and serve Medicare patients. The way to make the DMV work is likewise to establish smaller local offices, but not every state does that. That’s why in places such as CA folks hate the DMV, but here in WA where there are more locations per capita, it is not hated. In fact it’s rare to ever have more than three people waiting.

    Yes, I’m sure about that single-payer healthcare. It creates better outcomes in other countries at less cost. We are innovative and smart enough to design a system that fits the needs of our patient population.

    • We are incredibly top heavy and we are never going to create a federal program like single payer healthcare that is actually useful.
      You speak about medicare like a person who has never used it or billed it. It’s terrible for doctors generally (especially ‘specialist’ providers) and not that great for patients either.

      It’s also providing for a small portion of the population, unlike a universal healthcare option.

      • My wife is on Medicare, and I work in an Urgent Care. I just preferred to disagree with your argument on merit rather than pulling rank because I have more experience than you do. I help with billing and service issues every day.

        Medicare reimbursement for doctors is adequate and not fabulous. No doctor gets rich serving Medicare patients, so some choose not to do it. Specialists become specialists because it pays more, so they dislike having to accept the same reimbursement as General Practitioners. The paperwork for Medicare is far easier than with private insurers or Workers Comp cases. As far as the service for patients, that is identical to what is given to non-Medicare patients. It’s the same doctors performing the same procedures, just on older people.

        The proportion of Medicare patients depends entirely on where you live. I live and work in a county where the median age is 53. It’s not a small portion of our residents.

          • Doctors have all kinds of reasons for being doctors. Some are in it for the money. I already explained that. Accepting Medicare gets you a 2-3% profit. That’s fine for grocery stores but too small a margin for a small business to survive on. The upside is that Medicare patients have family and friends who are not on Medicare, so if you treat them well they bring in more profitable patients. Plus it’s morally correct to care for your elders. The doctors who include service to humanity in their motives understand that.

            • I do know. I work in a clinic currently and I’m in on the billing for procedures, and I have worked in a variety of hospitals and clinics previously. Facts are facts. I don’t know why you are so angry about it, but I have no interest in impolite debate.

            • Hate to tell you this Mikey, but I also work with insurance in a small medical office and I have intimate knowledge of how very inadequately Medicare reimburses doctors. If the office I worked in took only medicare they would barely make any profit at all.

              That would be a problem for them…and me.

            • Which is why we take both Medicare and non-Medicare patients. In our single-provider clinic it has worked out well.

              One thing not mentioned is that even though Medicare reimbursement rates are standardized, the differences in overhead cost from state to state make it more or less profitable. Adequacy is therefore relative to location.

            • I live in a state with a relatively low cost of living. Try again.

              So your argument is that we take private insurance, so that makes up the difference, though if we were only taking medicare (the current equivalent of single payer based on your argument) we would go under.
              But your argument says that “medicare works so single payer would work” but you just said that medicare alone would not work, because we need private insurance because medicare is not actually adequate.

              Your argument is so convoluted that I can’t even with it anymore.

            • First you’re right. Facts are facts. Fact: Medicare is in debt. Fact: Medicare does not pay nearly enough to doctors. Fact: Medicare provides shitty service. Fact: EVERY SINGLE Government run organization does worse than the private sector. Fact: you’re working in this filed seems to have taught you nothing. Fact: If you have “no interest in impolite debate” get off the internet cupcake.

  2. I work as a consultant to hospitals and although my specialty is in support services I deal with doctors and listen to the conversation occurring during meetings.
    First I will say that it is no ones business but the doctor to determine appropriate fees
    Many quality doctors do not take medicare except for those doctors that have had the patient previously.
    Medicare is being cut even more with Obamacare so it will lose even more doctors willing to participate unless of course that is the only way they can develop patients.
    Doctors who treat medicare patients generally do not get referrals from those medicare patients unless it is more medicare patients – not family members.
    Is your clinic attached to a local hospital or independent? If independent is it non profit or for profit? The answers to these questions might help determine your awareness of the general medical field.
    Medicare is in debt/meaning that it loses money every year – does not pay for itself which is why Obamacare cut medicare and will continue to do so every year it is in existence.
    Most people on medicare that can afford to have supplemental insurance and work with medical groups so they get better services then medicare alone provides. So these doctors/groups have worked out the ways to best utilize medicare to receive the highest financial benefit.
    Single payer is when the government has full control and pays for everything. This has worked so well in other countries where it has been tried that they are near bankruptcy and are cutting services and trying to allow as many private doctors again as possible. Those countries have 70% tax rates and are still unable to cover everything. They do have panels that then determine how to cut services/save money – these are not medical people making these decisions.
    Now if you were old enough you would remember how medical care was prior to government intervention in the 80’s with HMO’s, medicare, DRG’s, etc. Most people in the US did not have medical insurance except for major medical and everyone paid for standard services themselves. Government came in and prices started raising dramatically as they (it took 10 years) standardized costs across the US for services paid to doctors/hospitals. It is government intrusion that has caused these problems.
    There will always be poor people that need additional help – that is why America is known as the most generous country in the world. But even government involvement has not relieved us of this group of people. You need to grow up and stop looking for another mother/father (government) to take care of you and others.
    You should reread some of your responses and realize that your responses are based on urgent care patients not the population as a whole and not doctors as a whole.

  3. Perhaps part of the confusion is because we are using the term “single-payer” to mean different things. Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the United Kingdom). The term “single-payer” thus only describes the funding mechanism—referring to health care financed by a single public body from a single fund—and does not specify the type of delivery, or for whom doctors work. Although the fund holder is usually the state, some forms of single-payer use a mixed public-private system.

    What made a practice viable and profitable under prior law – a mixture of Medicare / non-Medicare patients in my region, may not be as true under the new law. It’s too early to tell. It might work to our advantage, because there are many perks built into the ACA. We don’t accept Medicaid at my clinic, but that seems to be a big new revenue stream for the local hospitals.

    I think the bottom line for everyone is cost vs results. So let’s compare outcomes based on some simple criteria in the U.S. to the 9 largest single-payer health care systems, which are not all run the same way. The data is from the Organisation for Economic Co-operation and Development using figures from 2009, and the CIA World Factbook 2009-2012.

    We in the U.S. spend $7,437 per capita for care, at 16% of GDP, 18% of govt. revenue. For that we get life expectancy of 78.1 yrs, an infant mortality rate of 5.9/thousand and 96 preventable deaths/100k. Japan spends $2,750, 8.2% GDP, 16.8% revenue, and for that they get life expectancy of 82.6, infant mort, rate 2.17, and 61 preventables. Substantial advantages in result for cost are also enjoyed by Australia, UK, France, Italy, Germany, Sweden, Norway, and Canada.

    It’s complicated, but taken as a whole, there’s no denying that single-payer nationalized systems work better than ours, and produce better overall health outcomes for less. There are different problems in each country, like some having long waits for appointments, or a lack of specialists. That’s what makes “better” a hard term to quantify. If you are the one with a rare disease, and you have a cadillac insurance plan, our current system IS better. But it’s at someone else’s expense.

    The overall problem of how to weigh the needs of many against the needs of a few is philosophical as well as financial. It’s complicated, but we have to take on the systemic problems a bit at a time. The previous likelihood of any major injury or serious illness resulting in personal bankruptcy was too immoral and financially unsustainable to continue.

    • No it’s actually not complicated. And yes there is denying all of that because you statistic are are cherry picked, taken out of context and not dealing with reality.

      Single pay health systems cost more, lead to worse care, more death, less innovation, fewer doctors and all around misery.
      If you want to move to any of those countries you listed, you are more than welcome to. Just know that anyone with money in those countries used to come here for medical treatment for a reason. Which you would know if you did even a scintilla of research.

      I’d link some articles, but articles have written words, and I feel those may be beyond your intellect as you seem to only be able to parrot idiots.
      So here are some videos
      ObamaCare Yay Or Nay? The Truth About Canada!

      Re: Why Are American Health Care Costs So High?

      Top Three Health Care Policy Proposals

      that’s a start

      I doubt you’ll watch them as you prejudices and ignorance to defend and I seriously doubt you’ll understand any of it, but I have to try.

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