Single payer is on the way.

It’s coming, government control of health care. “Population Health”,  here is how I see it.

• ” What does it mean?” It means Hospitals will no longer have to try and attract customers. They will be assigned. By who? I’m guessing our state government under the direction of the federal.  And who are the people going to be assigned, not “everyone” in a community of course…right.  Maybe just the 3.7%  without health insurance?   But isn’t everyone required by law to purchase it? A lot of people work part time, they can’t afford it. Many are not in the work force at all. They are not counted as unemployed, but they are still part of the community.  what of illegal aliens all the “undocumented people” that are streaming across our border…everyday. Those that settle in our community, will they be assigned? Of course they will. Will the elderly also be assigned?    As an added bonus you’re no longer responsible for your own health or the health of your offspring. It’s the hospitals responsibility “From birth to death”.
• “How do we fit in?” The hospital wants a person to stay healthy. Nothing wrong with that. Most normal people want to be healthy. But as in most cases it’s 20% of the population that account for 80% of the cost. You have cigarette smokers, drug abusers,  people who are very overweight,  alcoholics,  depressed people.  People being beaten up regularly by their “significant others”. Finally the elderly who with age related ailments put an increasing strain on hospital services, and are an ever growing percentage.   Looking at the all these “factors”, their “physical and social environments or their individual habits and behaviors” one can certainly encourage a person that a change in lifestyle would greatly benefit their physical and emotional well being. But what if encouragement and an offering of other options and services doesn’t work? Will it take some form of coercion?
• “How do we get paid now?” People who have coverage through an employer pay premiums pre-taxed out of their paychecks, (the employer subsidizes a large portion also, sometimes well over half the cost). The patient has a co-pay of a set amount for medications, doctors visits or trips to the ER. The Hospital or Doctor submits a bill to the insurance company for say $9000.  The insurance reimburses $4900. The patient gets a “statement” in the mail that all he owes is the co-pay.  This seem to work as it also helps cover the cost of people who have no means of paying anything.  The Vermont health exchange sells policies with varying premiums and deductibles, which for some is still out of reach.  But if this new system is working which according to the media it is, then why are we headed to “population health”?
• “How would payment work? The hospital would be “paid a fixed dollar amount” by the government from taxpayers to care for “everyone in a community assigned to our care.”  “The focus is to drive down cost…and prevent hospital admissions.” .

So it appears that in the future there will be “X” amount of dollars to take care “X” number of people. Will there be a set dollar amount for each person regardless of their health status. Lets for example say that the hospital receives “$5,000,000 a year to care for 500 people “assigned from birth till death” That’s $10,000 per person. Not much since dozens of people will shoot past that amount. Many through no fault of their own. Many on account of their lifestyle and bad habits. Will “tough love” be employed.  Clean up your act or no further treatment!  And what of the elderly? They say that the last six months of life can be the most expensive. Physician assisted suicide will be available. Will it be encouraged…to save money. Will parents with fetuses that could have possible birth defects be encouraged to abort…to save money. This is of course rationing. Help those who can be helped and want to help themselves. Reject those who can’t be helped or won’t help themselves.

Government has access to everyone’s medical records. They’re only a mouse click away.  Will decisions of life and death that were the preview of the patient, the patients family and the physician now include a forth, a  government bureaucrat who will decide yea or nay bases on cost? He who pays the piper calls the tune.

This is a brave new world we’re entering.  A nation of former free individuals with free will slowly becoming a herd… “the population”. And it seems the slide is inexorable.

Obamacare was intended to fail from the beginning. So single payer and further government control over the people will be the final result.