I Canada it took about 14 years to get to a one payer system. The Canada Health Act enslaved the doctors!
As a doc, the bigger concern is that it enslaves patients. Physicians in the UK can make boatloads of money, paying their NHS dues seeing patients in the am, and seeing private patients either earlier or later in the day. I think that's a horrible system, but when you hear what physicians are paid over there, it's likely that you are hearing their NHS salaries - not counting their supplemental income from seeing private patients. If you don't have the money to go private, you sit on the waiting lists.
What's happening here in the US is that patient choices are getting smaller and smaller. One contribution to this is that big hospital systems buy out the smaller hospitals and buying out the private physicians - creating a huge ‘mega-store’ type of health care structure. Competition is a great determinant of quality. The type of competition that now exists is the competition to most efficiently and cheaply check off the boxes on the ‘quality assurance’ check list.
Contrary to the assurances and beliefs of the quality assurance ‘outcomes analysis’ advocates, this does not lead to high quality care. it leads to ‘average’ care, with a fair amount of things that slip through the cracks that won't be seen by the kind of statistical analysis that is done. Think of it this way, ‘Dr. House’ would never be tolerated in this kind of system.
This is not to say that all or even most hospital administrators have this mentality, but it's the nature of the system, and it is very sad.
I Canada it took about 14 years to get to a one payer system. The Canada Health Act enslaved the doctors!
For years Canadians came to the U.S. for things such as MRIs and CAT Scans. Otherwise they would have waited two years or more.
A woman giving birth to quints had to go to Montana to give birth because they couldn’t handle it in Vancouver.
Even their own politicians come to the U.S. for lifesaving treatments.
I wonder where they’ll go now?