A good example of where “private” health providers can increase the
efficiency of the single payer health system is the following.

Assume there is a clinic in the private sector doing MRI’s for
workperson’s compensation; automobile collisions, etc. This clinic would
not have a 100% “up time” for the machine. In other words, the capacity
utilization would be something like maybe 60 or 70%.

Bring in the single payer system, which can buy some MRI’s from this
private sector health provider at a good price. The MRI machine is being
used at now 90-100% utilization, and, the private sector as well as the
public is better off.

This is why sometimes, under the single payer system, private providers
would actually help bring us a better system. We cannot reject private
providers just because our politics says “oh we want to own this or
that.” Why does that matter?

In the example given above, that MRI machine would be wasted-ie. a
resource not being used to its full capacity, if the public single payer
system didn’t make use of it.

Unfortunately there is a two tiered system now.

As for the arguement that there will be people taken out of the public
system, like doctors, I agree that is a concern however this is the only
reasonable solution that I see out of our dilemma.

What can happen as well is that Doctor’s who choose to go totally
private will have to pay for the full cost of their medical education.
We can tinker with the system-but I look at the French or Swiss model
and they seem to have a good system. Why can’t we have one like theirs?

There is no doubt that our system is very efficient, but I want to make
it better, not worse. I don’t want a situation where anyone pays for
healthcare-no-that makes my skin crawl. One thing that I will fight to
the death for and that is free healthcare for everybody. This isn’t my
usual blather, but I really believe in free healthcare. Its the sign of
a compassionate society, a civilized society. Dogs and cats get better
healthcare than some people in the US, and that sickens my stomach.

I never, EVER want an American style system up here. It is wrong, wrong,
and WRONG! I hate the idea of their system!

But there are nuances in the debate…

What I’m saying is that I believe in the mostly public system but the
public system is not providing the goods at this time. Is that because
of a lack of money, a lack of efficiency, or both?

Lets look at France-they have a mixed system and their system is better
from the perspective that their health outcomes are a little higher.

So if the private system can provide something for a lower price and it
has the same outcome, what’s wrong with using the private system-maybe
they can find a better way of performing an operation. There is always a
better way to do things-and we can learn from each other.

We should try to emulate France or Sweden. Their systems have better
health outcomes than we do for less $.

I totally agree. Its just that I want the system to remain universal,
ie. without regard to how much money people have. If the state pays for
everything, there will be no problem.

My fear is that if the left (like me) doesn’t compromise, we will wind
up with a non-single payer system, and I don’t want that.

I don’t believe that you will be proven right, however, about the
private providers-I don’t think they will wind up providing much more
care, because they also have to make a profit, whereas the public sector
does not. But I could be proven wrong.

But involving private providers would ensure that the public system is
kept on its toes, and would help reduce waiting lists, I think.

What I don’t want is an american system where you are asked for a credit
card before you obtain healthcare. To me at least that is very very
wrong and I will fight to my last breath to ensure that doesn’t happen.
I just think that is so inhumane.

However, I’m sorta resigned now to having some private/public mix…