http://abcnews.go.com/wire/US/ap20030813_355.html

Well, the temperature in Hell must have dropped a whole lot today! For years people in health care policy have been saying that lowered fees, lower reimbursments and increased red tape would finally drive doctors to demand a single-payer system - perhaps that day has arrived.

I personally don't know what system we should have - we all benefit from a healthy population, so it is a public good and public goods should be in the domain of the government, but I have not seen a single-payer system that really works.

("philling" in for PhillyFan)

Those 8,000 docs must all be commie pinko libs

These Dr.s have been saying what needs to be said, and once again, if we would have tackled this problem back in '93 when the Clintons' wanted to, we would not be in such a mess today!! Bravo Doctors!!! I am sure Howard Dean is echoing everything they said!

While single-payer systems and countries with more "socialist" approaches to health care get lots of bad press, these systems do work in places. In researching my move to Denmark, I have discovered that their health care system is considered very good by most evaluators. They follow a more centralized, government approach, and people there seem to get excellent healthcare.

I think there is an issue of size that comes into play. Denmark has between 5-10 million citizens to manage. We have over 250 million. That creates complexities of scope and magnitude.

However, the principles are not inherently flawed. The delivery is the issue. And that will never get resolved if we are devoting the vast majority of our dollars to paying the fees generated by our current system, rather than investing in a system that works better.

charlie -- interesting point about the size issue. I agree that is a significant factor. Would be interested in hearing some more about what you have discovered about the Denmark system.

An econ professor of mine said, regarding the Swedish semi-socialist system - "it works because there are nine million blonde Lutherans over there."

Certainly both small size and homogenous populations greatly increase the chances of a single-payer system working, if only because 1) the health care needs are easier to predict and 2) there is less "competition" among groups in the country. Humans as a rule are very competitive and want whatever "group" they belong to to have the most stuff. Homogenous populations often do not have that situation, because it is harder to define the "Us" and "Them."

I've often thought the health care system should be run like a utility - a regulated monopoly. As long as there are $$ incentives to promote efficiency in care, coupled with a strict system of quality measurement, it should theoretically work (Now I sound like Jeordi LaForge on Star Trek TNG - "Captain, it's never been done, but theoretically you could reroute the warp drive through the turboshafts")

"Now I sound like Jeordi LaForge" Hey if you look like Jordi I would sit an listen to your ideas all day long,,, esp the part about routing and the turbo shaft

The idea that the single-payer system would be more bureaucratic is a big joke. It's hard to imagine a health care system with more bureaucracy than the American one. With every company having its own forms and different services it will cover, the billing departments in U.S. hospitals are bloated, and the insurance companies have their own administration. The bureaucrats in the insurance companies ALREADY control the health care you are provided with. I saw a recent survey that found that a substantial percentage of doctors admitted to not advising patients of potential treatments because they wouldn't be covered by their insurance provider.

I'm still surprised--though pleased--to see a doctor's group speak out here. It's nice to see somebody has patient's needs at heart, instead of their own pocketbooks. Size concerns are why I suspect that any single-payer system would have to be administered by the states.