This is indeed an important perspective, especially when support for a single-payer health system seems to be gaining momentum.  It needs to be said that of course the rate of improvement in health care will slow in a single-payer system.  

Of course medical research will continue, and treatments will improve, as the medical profession itself may be affected less by single payer.  But medical devices, medical technology, bioengineering and, yes, pharmaceuticals, might see a decline in investment.

You're mixing up two things.  The spending levels in our health care are a function of many things, including waste and inefficiency (although that is not the only reason).  The spending growth is mostly a function of new treatments, as well as an aging population, growing obesity etc.

I have a question. Is  the U.S. in point of fact responsible for more medical innovations than other nations? In absolute numbers? In ratio to population? In ratio to GDP? Does anyone have hard number either  way.

Because the reimbursement rates for procedures would almost certainly go down in a single payer system, reducing the income levels of physicians and hospitals.  They would make some of that up through reduced paperwork and inefficency, but my guess is that investment in new equipment would probably also slow.

Look, it's a highly complex question, but I do believe that would be one of the tradeoffs.  On the other hand, a good portion of medical devices do not really add a huge amount of value in terms of clinical utility.

Interesting thoughts but I think you all are leaving out a factor that maybe, or at least to my way of thinking, the most important one which is that a huge chunk of society has no health insurance because they simply cannot afford it.

The way it is now these people go to the emergency treatment centers in hospitals to get medical help and the cost as I understand it is then passed on to patients who are able to pay for medical service. This is hardly cost effective nor is it particularly humane.

Personally I think the insurance companies are completely out of control and wield far too much influence among our law makers, I think it is long overdue that we bring these behemoths to heel. Could not a case be made also that part of the high cost of medicine is due to the ridiculously high cost of medical insurance and the way they cherry pick?

I am afraid I cannot agree with you at all, I keep hearing the doom and gloom of going to a single payer system and though some of it may be true we simply must be able to provide everyone with health insurance which will never, ever happen as long as the insurance companies are dictating what doctors can and cannot do as well as setting the costs of medical care.

I disagree. It's maybe a possibility, but I think not a likely one. The addition of 46M people to the pool of buyers shouldn't be sniffed at. Additionally, rationalizing our investments towards those things that will save lives, rather than those things that will sell (e.g. Viagra) might not be such a bad idea.

Also, it's important to look at the straight-up government expenditure on this. While I might not agree with every detail of the CA stem cell initiative, I think gov't-industry partnerships, with money returning to the gov't, are not a bad idea; universities have been doing that for decades, quite profitably. OTOH, I still think that the most basic science should be well-funded and widely-distributed, for free; I'm appalled that Bush is cutting NIH funding, again. My dad, who is one of the foremost researchers on aging, says that of the proposals submitted to NIH each year, about 25-30% would be worth funding, but less than half of those can actually be funded.

RM 'Auros' Harman
auros.livejournal.com