I don't want to make this a huge political debate but i want to address the point that 'X deciding who lives and dies', where X=government. Currently we're just solving for a different value of X.

Certainly people are deciding who lives and dies; life-saving care is denied specifically by insurers, and implicitly by the fact that many don't have any means to pay for care.

That's not an argument for or against single payer or full govt-run healthcare (though i am for that - i just don't have time to get that into the discussion)...

Actually, I'm curious - do you have much evidence that insurers are deciding who lives or dies? I haven't even seen compelling evidence that having insurance at all (let alone variations within insurance) will determine whether you live or die.

> the government deciding who lives and dies creeps me out

How is that any different than Acme Insurance deciding who lives and dies? And as far as the government is concerned, it's your fellow Americans deciding.

It's different because you can alternatively decide to patronize Beta Insurance.

Don't take that as an argument that insurance is perfect, just as a response to your question about how it's different -- the reason people are more concerned when it's the government making decisions is that there's no recourse.

Patronizing Beta Insurance once your dead is difficult. =) Acme insurance denies my claim, getting Beta suddenly becomes difficult if not impossible. With no public option, I have no other recourse.

Living in Canada, I've never had to deal with the government making decisions, it's always been the doctors. Their is a base line, and you can still get private insurance and go to privately run facilities. You make the distinction too black and white in your original post. You can have a public and private insurance.

It's funny. My wife, a Canadian, talks with my sister-in-law, and has some family down in the US. Sometimes they bring up health insurance issues, and my wife is flabbergasted at the lack of... well... anything. The sheer number of services provided here is overwhelming, and this includes preventative services.

Anyways, I'm starting to ramble. =)

Presumably, you base your decision on which to patronize on whether they are screwing over other customers -- it's also difficult to stop eating at Poisoned Hamburger once you're dead.

I think you're confused a little -- I'm not the OP, so I'm not the one proposing a false dilemma between single-payer and free-market. In fact, in the US we have both, and we just got a nice new law that enshrines the worst features of each.

Sorry about the confusion. =) Didn't mean to.

As for your first point, screwing over the customers: I've never known an insurance company to not screw over customers to some degree.

Anyways, this is all besides the point, because regardless of the insurance company you patronize, their is someone making a decision on your insurance claim. Whether it's the government, or some private agency, their is still someone who has to sign off.

So yeah, someone can just Beta instead of Acme, and it won't change a thing.

Edit: And the final straw, you assume insurance companies will insure you. It's not just about choosing your insurance plan. You have to be allowed to take the plan as well.

> Living in Canada, I've never had to deal with the government making decisions, it's always been the doctors.

Oh really? The doctors decide whether the pharmacy has a given drug? The doctors decide how many doctors are available in a given area? The doctors decide what equipment is in a given hospital, where the hospital is, etc?

I can play this game, too.

> Oh really?

No, not always. My wife and I also have a say, though we usually take the advice of the doctor. So, between us and my doctor, yes, 100%.

> My wife and I also have a say, though we usually take the advice of the doctor. So, between us and my doctor, yes, 100%.

You and your doctor decide whether the pharmacy has a given drug? You and your doctor decide how many doctors there are in your area? You and your doctor decide what equipment your hospital has?

I said what I said and meant it, and it's accurate. You might think I'm making it up, but I'm not. I really don't know how I can be more accurate.

Maybe you could explain why I'm wrong?

> I said what I said and meant it, and it's accurate. You might think I'm making it up, but I'm not. I really don't know how I can be more accurate.

I'd like to see some details.

How do you and your doctor implement your decision that there should be more doctors in your area? How do you get the money to buy specific equipment or build a new facility?

Note that "we vote" doesn't count. "We write a letter" counts only if the recipient always does as you request.

I'm somewhat skeptical given my understanding of a recent case in Canada where, as I understand it, some court found that the right to get on a waiting list for care didn't constitute care so the govt couldn't block Canadians from paying private providers. If you and your doctor could simply requisition facilities, there'd be no waiting lists.

Realistically, most people do not have choice in insurance providers. You get what your employer offers. If you're lucky you might get to choose either an HMO or PPO type plan from either of two different companies. If you're unlucky, you just get whatever your employer chose for you.

A public option is not a total government solution.

>those that want a complete free enterprise solution

Those that want a "complete free enterprise solution" don't understand how the market works and should be ignored (Hint: Market elasticity). What should be done is looking at what is done in all other developed countries and try to create the best system from that (not all of them have "free" healthcare, but none of them are ignorant enough to try a "complete free enterprise solution").