Talk:Single-payer healthcare/Archive 2

US???

 * United States' Medicare, Medicaid, and TRICARE 

This makes no sense. Since when do seniors ONLY USE medicare? Like seniors don't have private insurance, or that private insurance pays medicare to pay the hospital??? If it's single-payer it has to be a single-payer. The US doesn't have any form of single-payer system except for military and VA hospitals! 76.66.196.229 (talk) 13:03, 7 February 2009 (UTC)


 * As the introduction to the entry says, a single-payer system is one in which providers are paid "from a single fund," not necessarily a system in which providers are paid from only one fund. I realize the NLM definition could be read that way, but I don't think that's the intention. I don't know of any single-payer advocates who want to prevent people from going outside the system (with their own money). I think doctors and patients are allowed to opt out of the system in Canada, but I'm not positive.


 * If you could find a WP:RS to define "single payer" your way, I'd be interested. Nbauman (talk) 15:39, 7 February 2009 (UTC)

competing private health insurance prices and set conditions on policies so that they are less beneficial to the elderly and the sick
I see that User:Sfmammamia deleted my addition which said

"thus avoiding some of the problems inherent with competing private health insurance companies which naturally will price and set conditions on policies so that they are less beneficial to the elderly and the sick"

and did so with the remark that this is heavily POV and not supported by references.

I added the statement in the header because it is an often used justification for using Single-payer over other forms of insurance. I did not do so lightly. The American Medical Student Association in its document Single-Payer 101 gives this very reason as the main philosophical argument for single payer. It says

This situation – private insurance companies making record profits while health insurance premiums and the number of uninsured skyrocket – suggests that insurance companies have an incentive to price people out of health care to maximize profit. The methods by which private health insurance companies achieve this include denial of insurance to people with pre-existing conditions, heavy utilization review, and “cherry-picking” (selectively insuring the healthy and charging higher premiums for the less healthy).

The AMSA gives references for these claims (which I have not given here, but they can be read in the source document). So it seems to me to be saying that the insurance companies are pricing people out by making pricing and policy decisions which selectively insure the healthy and price out or pick out the less healthy.

Michael Moore in Sicko makes the same observations about private Health insurance.

Similarly PNHP gives this as the third of four core principles

Pursuit of corporate profit and personal fortune have no place in caregiving and they create enormous waste. The U.S. already spends enough to provide comprehensive health care to all Americans with no increase in total costs. However, the vast health care resources now squandered on bureaucracy (mostly due to efforts to divert costs to other payers or onto patients themselves), profits, marketing, and useless or even harmful medical interventions must be shifted to needed care.

The operative phrase here being "efforts to divert costs to other payers or onto patients themselves", This is of course contrary to the whole purpose of health insurance (which is that the lucky well should meet the health care costs of the unfortunate sick). The extract came from Proposal of the Physicians' Working Group for Single-Payer National Health Insurance

I was not sure how to say this in the lead and I did modify down the tone, but I believe that the statement that I added addresses one of the core arguments put forward by those proposing Single-payer systems.

I could just add it back in with the references but I'd rather achieve consensus with User:Sfmammamia on this one. --Hauskalainen (talk) 19:50, 7 February 2009 (UTC)


 * Given that the lead is supposed to function as a summary of the article, I think we have to be careful what we add to the lead. It might be appropriate to add to the statement at the bottom of the lead, something like this:  Supporters argue that it would provide universal coverage with at least the same quality and greatly lower costs by overcoming some of the problems inherent in a system of private, for-profit, competing insurance companies." Then the section on proponent arguments in the article should be expanded to include the details of those problems.  The problems you mention and cite so well in the discussion above should be in the article, not alluded to in the lead without support in the article.  How does that approach strike you? --Sfmammamia (talk) 20:52, 7 February 2009 (UTC)


 * I agree that article leads should summarise the content and I am amazed that somehow this is a main argument of proponents but is not already in the body of the article. But you will now accept, I hope, that my edit was not POV on my part and it is supportable by references.


 * Your proposed wording does seem to be very watered down because it hides the main issue. (


 * I recall a part of the Sicko movie which played some recorded discussions from the Oval Office in the Nixon era about insurers supporting the introduction of HMOs. It went something like "the less health care they give 'em, the more money they make" (where "they" are the insurance companies, and "'em" are the insured). To which Nixon replied saying something like "That's good".)


 * Its a cruel irony, but surely it's the profiteering that happens when insurance companies, rationally discriminate in pricing and imposed conditions against the sick and elderly (quite contrary to the spirit of the concept of insurance), that has led to calls for the introduction of single payer and the elimination of for-profit insurance in health care in the U.S.--Hauskalainen (talk) 22:56, 7 February 2009 (UTC)

POV and all that
Someone added a claim of "POV" (label on the entire article) just today or last night. They added it very shortly after my adding a short little section with ref. about Taiwan. Someone else deleted the POV note. I did not carry out this deletion. It's fine to discuss concerns about POV. However, it's not fine to add a POV notice and then state nothing in the edit, and also state nothing in this Talk section, about the specifics of the concern. Doing that makes it impossible to "resolve this before removing the POV notice" since the concern is left unstated. Bottom line: I'm ok with raising such issues, and was not the one to delete it,but the concerns need to be (in a timely manner) stated here, or else, if they are not, then the deletion of the POV label is appropriate. The POV label is not designed as a catch all for "I don't like the facts/references in this article" without any specific concerns detailed carefully. --Harel (talk) 22:08, 24 July 2009 (UTC)

Hey. I didn't add the original POV tag, but I did add one to the head of this article after trying to dig through it. Many of the initial references I found point to websites that promote Single Payer Health Care. References should point to NPOV 3rd party sources such as a newspaper. Also, the article is a big of a wreck. I came here to try & find out what Single Payer Health Care is. The introductory paragraphs are way to long & confusing for someone who isn't working on a Single Payer Health Care campaign. The cited references appear to be out of order, quotes are being taken from non-neutral websites to try & explain it and they are doing a very poor job. I know there are Single Payer Health Care fanboys who are chomping at the teeth to promote their cause, but really, they are making the explanation of Single Payer Health Care way to confusing by trying to both 'sell' their system & debunk myths about it all at once. Slow the heck down. Get a good initial description up front & THEN you can dive into the controversy later on in more detail.--65.27.130.81 (talk) 21:47, 31 July 2009 (UTC)


 * I agree with you about the confusing too-long parts of the intro, making it harder to follow. That's recently been improved. But I agree with Hauskalainen below that PNHP is a reliable group -- particularly when you notice the source of their claims.If it's an un-supported claim, that's one thing. But most of the data from pnhp.org 's page including the surveys, they are citing and even link to journals, peer-reviewed professional journals where the survey or poll data was published. If you have concerns about a particular citation(s), those can and should be raised and discussed here, of course.. --Harel (talk) 23:54, 13 August 2009 (UTC)

Well I agree that some (but not all of those references) are less than ideal but substantially I have seen in the past sufficient evidence not to doubt the general truth of what they say. Therefore I will not scrub the request for a better references. But the POV claim is too strong. As the U.S. does not have a single payer system and as the term is a U.S. term (it is not used outside the US as far as I can see), it is hardly surprising that it is advocates of a change that are using the term and where references will be found. So the "non-neutral sources" argument is not really a valid one. There was some confusion in the introduction and I have tried to address that. I think PNHP has been a fairly reliable source of information, but you can always try to convince the community editing here otherwise of you have evidence to the contrary. There is a proponents and opponents section laying out arguments for and against. I agree that Wikipedia should not be used for promoting causes, but neither can it ignore advocacy campaigns by not producing articles such as this and therefore they must and they do reflect opponent views as this one certainly does. For this reason I am deleting the POV issues tag. If there are things that confuse you still, please let me know and I will clarify it for you and tidy the text at the same time.--Hauskalainen (talk) 21:10, 1 August 2009 (UTC)

Two contradictory statements in the introduction
The introduction states that

"In particular, the term "single payer" is not to be confused with "socialized medicine." The term "socialized medicine" refers to a system, like the U.S. Veterans Administration, or the UK health system,"

so the UK health system is socialized medicine not single payer

then

"The United States is currently the only high-income industrialized country in the world that does not have some version of a single payer, public health insurance"

clearly according to the first statement there are lots of countries that don't have single payer public health insurance most of the EU for example have socialized medicine

it actually seems that basically only a few British common wealth countries have a "single payer" system

The citation the article links to doesn't mention single payer, it mentions "health care for all"

Its also factually inaccurate most of the EU countries listed don't cover citizens from other EU countries or non-EU foreigners even if they pay taxes in the country so thats not "health care for all" but health care for those with the correct passport  —Preceding unsigned comment added by 77.54.106.121 (talk) 20:36, 26 July 2009 (UTC)


 * There is no contradiction here. Imagine someone said, "the term 'mammal' is not to be confused with the term 'horse'" So you can have single payer with socialized medicine or without.


 * So when you say, "clearly according to the first statement there are lots of countries that don't have single payer public health insurance most of the EU for example have socialized medicine" this is not correct; you seem to think that as soon as an EU country has socialized medicine, it "can't be" single payer. But that's false. It can be both; socialized medicine refers to doctors, hospitals being publicly paid/employed/administered. Single payer refers to public run insurance, as opposed to for-profit corporations running the insurance. So it's a false conclusion to say "Aha! this one's 'socialized medicine' so it's NOT single payer" that is a non-sequitor. --Harel (talk) 00:11, 14 August 2009 (UTC)


 * You are right that the statements are contradictory. On a note of clarification, I don't think it's correct that most of the EU have socialized medicine - I'm pretty sure a lot of them have insurance-based systems. The UK certainly does not have a single-payer system, however.Dingdongalistic (talk) 20:15, 31 July 2009 (UTC)Dingdongalistic


 * The statements are not contradictory; see above. You are correct that 77.54.106.121's broad brush-stroke description of EU's health systems is far from accurate, however.--Harel (talk) 00:11, 14 August 2009 (UTC)

(talk) and (talk) have some misconceptions.

Here is my take on this. Single Payer is a concept that gets rid of the inherent problems with multiple insurance funds as is seen in the USA today by meeting costs from a single fund. The inherent problem with muliple funds that need to make a profit will always try to manage the risks in their fund populations by endeavouring to retain profitable clients who pay premiums and make claims lower than their premiums over time whilst trying to ditch the unprofitable ones (e.g. the chronically sick and those needing expensive treatments) who make claims way higher than their contributions through premiums. Logically the Canadian system AND the British system both do this because there is no need for the single fund to show a profit. In Europe, where there are multiple funds, the problem of uneven distribution of costs and incomes between multiple funds is usually taken care of through risk equalization funds or pools - a form of re-insurance. These funds do not try to make profits, just to cover all their costs and get maximum value for money for their members.

So conceptually the British system us Single payer, but traditionally single payer advocates in the U.S. do not refer to the British system as single payer because their way of thinking is that health care is still financed by a system of insurance involving the incurrance of costs which a refunded from a fund. In the UK, the provider and the funder are the same entity and so the insurance model is not appropriate. In practice there is not much difference between the UK and the Canadian systems as many Canadian hospitals are publicly owned (though by no means all) and most general physicians in Canada are private businesses but contracting to the state which in fact is exactly the same as happens in the UK. I guess the biggest difference is that in the Canadian system as in the American system, patient spending has to be tracked and reimbursed. In the UK, nobody worries about doing this, and it may be why the UK system has one of the lowest levels of administrative costs. The Canadian system is regionally run with only some funding coming from the Federal government. In the UK the whole system is centrally funded but is regionally run with some co-ordination/co-operation coming from the center. In Finland the system is partly employer funded with an occupational funded care system and there is regional system of care run by the local communities for those not working (children, the unemployed, the retired and so on. There is a variety of funding models in Europe but they are broadly similar with a large percentage of funding come from general taxation and the rest coming from insurer funds that are usually (but not always) run as not-for-profit ventures. In every case in Europe, the practices of these funds are NOT ALLOWED by law to discriminate on age or health status as happens in some states in the United States. The creation of the EU has expanded some cross border co-operation that existed before the creation of the EU. For instance Europeans can travel to any country in the EU and receive health care on an emergency basis on the same basis as a permanent resident of that country and at the same price, merely by showing a European Health Insurance Card issued in his own country. So travel health insurance is not needed in Europe. If a person in the EU finds that he has a particular health care problem that needs treating and cannot get access to that care in their own country (either because the service is new and not yet available, or if the waiting time is too long) they have the right in EU law to travel to another EU country where they can get that care. They do not have to pay. They get their home insurer or health service to pay for the care in the foreign country. It is certainly not true that "only a few British Commonwealth countries have a single payer system. Italy, Spain, Finland, Sewden, Denmark, Norway, Iceland and Ireland to name but a few.--Hauskalainen (talk) 12:17, 1 August 2009 (UTC)

Rename the article Single payer health insurance
Following my earlier comments (above) maybe the article should be renamed as "Single payer health insurance" because the model is really one of insurance (costs being met from a fund) which distinguishes it properly from health care which is about the care itself. What do others think?--Hauskalainen (talk) 12:17, 1 August 2009 (UTC)


 * The problem is that in the context of the US single payer is thought of in the broader context of possible ways of reforming the "healthcare system" The article can and should emphasize that Single Payer is a (proposed) reform which would only address the financing. However it is also one of the primary options (albeit marginalized in Congress as 'off the table') for reforming the US health "system" that is out there. So wikipedia readers will need the entry to be clearly findable and organized in that context, otherwise many Americans, and others, may misunderstand and not see that it's one of the proposals for general broad 'healthcare reform' --Harel (talk) 00:00, 14 August 2009 (UTC) (even though, yes, it's a healthcare reform proposal based on health-insurance reform...but "healthcare reform" is the main, almost the only, term used for broad systemic changes for improvement that are being proposed)

External links (again)
I was a little hasty in deleting the whole section of external links, and was rightly reverted. However, I am still concerned that the external links section is too large for a start, and also too weighted towards those advocating single-payer health care. I am concerned that this gives undue weight towards the proponents. Those links that provide extensive further information (from a quick look, singlepayercentral.com, pnhp.org) are OK, but those that appear to be campaign websites are not. Quantpole (talk) 10:06, 31 July 2009 (UTC)

ISSUES MARKER and RELIABLE SOURCES? MARKERS
I see that some editor has marked the article with a flag indicating that there are multiple issues and that there are now several sources marked with Reliable Source? markers.

As I read the article it seems fairly balanced and most of the sources do seem to be reliable or verifiable in some way. I see no attempt by any editor to bring these issues to the TALK page. I am therefore inclined to remove these markers. Sowing unnecessary doubt about the content of this article and its sources seems to me to be a POV action not supported by any discussion. --Hauskalainen (talk) 13:48, 1 August 2009 (UTC)

Hi. That was me. I did mention it near the top of this discussion page. The ones I flagged as unreliable sources were weblinks that were clearly advocacy webpages & blogs. As far as I understand advocacy websites are neither considered reliable nor NPOV for Wikipedia's purposes. Reference links should go to newspapers, encyclopedias, books or dictionaries etc. If you feel I am wrong on this let me know.--65.27.130.81 (talk) 19:28, 1 August 2009 (UTC)


 * As for links from "advocacy groups"do you mean PNHP for example? I agree with Hauskalainen above that PNHP is a reliable group -- particularly when you notice the source of their claims.If it's an un-supported claim, that's one thing. But most of the data from pnhp.org 's page including the surveys, they are citing and even link to journals, peer-reviewed professional journals where the survey or poll data was published. If you have concerns about a particular citation(s), those can and should be raised and discussed here, of course --Harel (talk) 00:04, 14 August 2009 (UTC)

POV In "most physicians..support" survey?
The Carroll/Ackerman "study" cited to prove that "most physicians in the United States support government legislation to establish national health insurance" is not enough to make such a claim in an encyclopedic work. Its sample only included members of the AMA, and respondents only numbered 2193. The AMA only represents 20% of practicing physicians. The AMA instantly approved of Obama's plan despite the CBO's claims that there would be no reduction in costs for either the government or for employers. The AMA is no longer a bi-partisan organization. Hectard (talk) 14:17, 4 August 2009 (UTC)


 * Actually the fact that the AMA still refuses to support Single Payer (and is going along with the Congress-Obama proposals, which are completely different from single payer, as they try to keep the existing for-profit corporate-based insurance system) shows bias in the opposite direction, if it's "bias" per se. It was published in a peer-reviewed, and very respected journal...these 2193 represent a sizable number of physicians and "the 2193 Respondents did not differ significantly from nonrespondents in sex, age, doctoral degree type, or specialty" so are representative of the 5,000 doctors...again, not that 2,193 is small either. If you don't like the results, maybe you'll like the 2002 study by the same group in which only 49% of physicians supported single payer, but we can't pick by results. Indiana University School of Medicine M.D.'s with additional degrees conducted the survey, and it was published by the well respected Annals of Internal Medicine so unless Annals of Internal Medicine publishes a retraction or error etc, it's a study, not a "study" in quotes.

"Unreliable sources"
I've added this tag for the Rasmussen pole not to suggest that Rasmussen itself is unreliable, but that we do not have reliable confirmation of what the poll question said exactly; as summarized in the comment, the link provided to the Rasmussen poll which is http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/july_2009/the_public_s_view_of_health_care_debate has a link in it, inside the phrase "Just 47% Favor Congressional Health Care Reform, 49% Oppose" but when you click on that link, to see the actual details of the question so make sure Wikipedia is reporting it correctly it takes you to the wrong detail page; it takes you to the same page as the "23% Believe Health Care Costs Will Go Down if Reform Passes Congress" (no they are not all pointing to the same page; the one on Massachusetts for example is pointed correctly, as is the 23% one,but not the "49% oppose" one) This needs to be fixed if we are to keep this reference; perhaps the person who added it can contact Rasmussen and ask them to fix their link so that like the Massachusetts and the "23%" results, we also have an actual page with details about this "49% oppose" result.

See also another section I'm adding to discussion: suggesting we add a section about opinion polls - otherwise the first intro section will get crowded. We can all put reliable opinion polls with various wordings and results in one section, and have the intro section merely summarize it.

There is another "unreliable sources" tag that seems based on anti-Single Payer POV and which I will delete unless a very good explanation is given: there are three sources not one given, and further, the sources merely document that certain commentators (those with a substantial audience; e.g. Democracy Now is on over 100 radio stations) have pointed out certain things. Thus the sources are strong and reliable enough to say "the sky is blue" and even more strongly, are reliable enough to put for a portion of the wikipedia entry which merely says, "some commentators have said the sky is blue" as is the case here.--Harel (talk) 22:39, 8 August 2009 (UTC)

First sentence
An IP editor has made massive changes to this article without discussion and edit warred when reverted. That's a real problem, but for starters let's consider a specific change made by the IP editor, reverted by me, and the re-added by another account. It changes the first phrase from "Single-payer health care" (the article title) to "Single-payer health insurance." There is no consensus for this, it goes against our standard practice of referring to the article title right away, and it is factually inaccurate. The article is not about "Single-payer health insurance" (indeed I don't really know what that means) it it about Single-payer health care. I'm not going to revert further just yet, but I strongly encourage the new editor to revert this change since it is misleading and not something that was discussed. If other editors agree with my argument here I would also encourage them to change back to the original wording. This article has enough problems without misrepresenting the topic in the first sentence. --Bigtimepeace | talk | contribs 20:58, 12 August 2009 (UTC)


 * The term "single-payer health insurance" is used by the National Health Care for the Homeless Council and Physicians for a National Health Program among other groups. It, like "health insurance reform" as opposed to "health care reform" shifts the focus from health care to health insurance in the context of a country's health care system. Emphasizing the insurance part reduces confusion with NHS-type national health care. That article ledes should start with the title is not a hard-and-fast rule: I prefer to see which term wins out in the article before changing the title (if necessary). 河蟹 (talk) 21:08, 12 August 2009 (UTC)
 * The fact that those groups use it, or that the change in wording "shifts the focus from health care to health insurance in the context of a country's health care system" is quite irrelevant for this article. It's a good PR move by a group like PNHP (whom I very much respect), but this is a Wikipedia article, not a PNHP press release. Two google searches  show that "single-payer health care" is used 5 times more often than "single-payer health insurance." It's also the title of this article, which is quite germane. The topic is single payer health care, not "single-payer health insurance." They are distinct (the former topic is more capacious), and what you are really proposing here is a shift in article content. You are admittedly doing so because one sounds better to groups who advocate for this kind of system. That is completely inappropriate for a WP:NPOV encyclopedia article.


 * The fact that "article ledes should start with the title is not a hard-and-fast rule" is not a reason to not begin articles with the article title&mdash;we need a compelling reason to depart from that beyond the fact that you think it's a cool idea. You have given no compelling case for why we should depart from Wikipedia convention or the title of the article, and you do not have consensus for the change in question. Please revert pending further discussion, as it is inappropriate to try to ram a change through in the face of objection. --Bigtimepeace | talk | contribs 21:32, 12 August 2009 (UTC)


 * My reading of the article is that it is about the single-payer health insurance. Only the 3rd paragraph of lead departs from this, and that lead should summarize the article, not act as what some editor aspires the article to be. I am for the reasoned discussion of the article's scope, not the blind and forceful application of a convention that may harm the article's content. One reversion of your lead change is not "ram[ming] a change through in the face of objection".


 * Incidentally, clarity of terms does work politically against those who would conflate national health insurance with socialized medicine, but my intentions are strictly nonpartisan. It seems that this visceral reaction against a word change exposes this article as an amalgamated synthesis of two distinct health care topics. 河蟹 (talk) 22:29, 12 August 2009 (UTC)
 * Let's get this clear&mdash;I did not change the lead, an IP editor did, I changed back to the original version (which goes back at least to this version from late 2006), you (immediately) changed back to what the IP had written. So yes, you are trying to ram through a change in the face of an objection, and your claim about the "blind and forceful application of a convention that may harm the article's content" is unsupported and quite frankly a little ridiculous. You need to justify changing the lead sentence in a way that does not conform with the title&mdash;you still have not done that, and I'm not going to be wowed by your attempts to turn this around into me somehow playing by the rules just for the sake of it and harming the article as a result. You've had an account here for about two days, so it's a bit early to start lecturing others.


 * If you think this article is about single-payer health insurance, suggest a page move (don't just do it, whatever you do, because I think that's a bad idea). I don't agree with you, mainly because I think single-payer health insurance is a non-standard term and you have not suggested otherwise. You have not responded to my point that "single-payer health care" is a far more common term than "single-payer health insurance." Also I'd like to see you explain what you think the latter is and how it is substantively, as opposed to stylistically, different from the former. I'm afraid I still fundamentally don't know what you are talking about (in all seriousness - I don't know).


 * Along those lines, you say, "It seems that this visceral reaction against a word change exposes this article as an amalgamated synthesis of two distinct health care topics." I have no idea what that means or what you think that means, but you have not explained your views here in a remotely convincing fashion, and until you do the lead should stay as it has been for the entire existence of this article. Again if you want to propose a title change, open a new section and see if a consensus develops, or ask for a content WP:RFC to get outside opinion on that question. I'm sure you're familiar with RfCs as you don't seem to be new around here, so you should not have trouble with starting one of those


 * I'm going to go through this article with a fine-tooth comb in the next day or two and examine closely the completely undiscussed changes made by the IP editor, at least some of which are problematic. It will likely result in heavy editing, including the introduction. --Bigtimepeace | talk | contribs 00:14, 13 August 2009 (UTC)

(outdent) How is "single-payer health care" substantively rather than stylistically different from "single-payer health insurance"? As I said, the difference is enumerated in the third paragraph of the lede, a difference which you seemed to attest to. Some single-payer health systems like that in the UK, are based on socialized medicine, while others like Canada's, in which doctors do not all work for the government, are not. The term single-payer thus only describes the funding mechanism —referring to health care being paid for by a single public body— and does not specify the type of delivery, or who doctors work for.

Repeating myself, this article only describes the second (Canada's) type system, and not the first (UK's). This type of social insurance has many different names, depending on what the speaker wants to say about the program: "National", "Single-payer", "Universal" and "not-for-profit" are different, and all usually acceptable descriptors.

In fact, I can't find any references that commonly describe the NHS as a "single-payer" health system at all. This is what I am describing as synthesis. Clarify what you mean by "Single-payer health care". Does it accommodate both aforementioned systems, and will it in the article? If it doesn't, either the lead or title should change. 河蟹 (talk) 00:47, 13 August 2009 (UTC)
 * Well now we are starting to get somewhere, I think. So your contention is that "single-payer health care" refers to a UK type system where as "single-payer health insurance" refers to a Canadian type system. Am I reading you correctly? If so, where do you get that from? It certainly does not come from the passage you quote above as you claim. The distinction made there between Canada and the UK is that the former is not "socialized medicine" whereas the latter is. It's not at all about "insurance" vs. "care." So again, where do you get the idea that Canada is an example of the former and the UK the latter? That simply makes no sense to me, and you seem to basically be making that up. I'm not sure you've thought this through clearly, so you need to try to explain it better.


 * I did not start or write this article, but to me "single-payer health care" refers to any type of health care system where the funding comes from a single public body (which is what the passage you cited actually says). Thus we would cover both Canada and the UK here, differentiating them in terms of whether or not they are "socialized medicine," while acknowledging that in both countries "health care" (not "health insurance") is funded by a single payer (again, the article passage you cite says precisely that). The fact that the UK is not discussed here right now is immaterial&mdash;it could and should be. So, yes, the previous title that has been here for years can "accommodate both aforementioned systems."


 * Before proceeding further, I'd like you to address the questions in my first paragraph in this comment. --Bigtimepeace | talk | contribs 09:23, 13 August 2009 (UTC)


 * My understanding of the terms is exactly that which you have described in the second paragraph of your reply. Here is my argument.
 * Single-payer health insurance is the only type of single-payer health care described in this article.
 * The lead should summarize the main points of the article.
 * Therefore, the lead should be about single-payer health insurance.
 * Whatever the wording—if "single-payer health care" is used as a euphemism for "single-payer health insurance", because it is a more common term, that is fine with me. But this article proscribes a broader meaning for this term, one not reflected in the PNHP reference for the paragraph and one I have not seen before, but one I am willing to concede because it makes sense linguistically. Then the lead can be about "single-payer health insurance". 河蟹 (talk) 17:10, 13 August 2009 (UTC)


 * The problem is that in the context of the US single payer is thought of in the broader context of possible ways of reforming the "healthcare system" The article can and should emphasize that Single Payer is a (proposed) reform which would only address the financing and does not tell us anything about whether the United States of America would also choose to change who doctors work for, or not (more likely, "not") which is a separate question, the article should emphasize.


 * However, just as the term "global warming" is misleading (because other aspects such as ocean acidification are not captured by the word "Warming") and just as "climate change" is misleading (because it refers not to any "change" but to the human-based destabilizing, far more rapid than natural, "change") but are "in common use" -- similarly "single payer" is also the term used for one of the primary options (albeit marginalized in Congress as 'off the table') for reforming the US health "system" that is out there. So wikipedia readers will need the entry to be clearly findable and organized in that context, otherwise many Americans, and others, may misunderstand and not see that it's one of the proposals for general broad 'healthcare reform' -- --Harel (talk) 00:34, 14 August 2009 (UTC) (even though, yes, it's a healthcare reform proposal based on health-insurance reform...but "healthcare reform" is the main, almost the only, term used for broad systemic changes for improvement that are being proposed)

First to the editor whose name does not show up on my screen because it is written in (I think, and my apologies if I'm wrong) Chinese characters (you really ought to put a Latin alphabet word in your signature, see here, so that other editors can refer to you by name in discussions). Simple question: what is "single-payer health insurance?" What does that mean, and how is it different/distinct from "single-payer health care"? I still do not fully understand your point. I have other questions/issues but let's start with that, because our terms are still not well defined and that makes discussion pretty impossible.

Harel I'm afraid I don't understand what your view on the question of the 4th word of the article is from your comment. Do you think it should be "insurance" or "care," why do you take whichever view you take, and if your view is the former then why do you think we should depart from the title of the article in the first sentence of the article? --Bigtimepeace | talk | contribs 22:27, 14 August 2009 (UTC)
 * No reply, and I'm changing back to to "care" in the first sentence. There was no consensus for the change in the first place, it has not been coherently explained either by the IP editor or the brand new editor with a username of Chinese (I think) characters why this change is necessary, and it contradicts the actual title of the article (again without anyone explaining why it needs to do so). This article is basically a walking disaster, but we could at least have the lead sentence reflect the article title. If someone has a problem with this change, please discuss it here instead of edit warring. Again, there was absolutely no consensus for it to begin with. --Bigtimepeace | talk | contribs 02:53, 19 August 2009 (UTC)
 * I've just found Articles for deletion/Single payer health insurance, which shows that this is a two-year old issue. That article was forked out from this one and then deleted (as it should have been). Changing the lead from "care" to "insurance" is even more against consensus given that a fork of this article was deleted two years ago (see also this section above). Consensus can change, but the current consensus is clearly for the current title and for a discussion of SP "health care" not "health insurance." --Bigtimepeace | talk | contribs 05:22, 19 August 2009 (UTC)

Opponents Section
This section is entirely too biased. Who in the world thinks the primary resistance to SPHC is "lack of political will"? This whole section needs to be overhauled, and written by someone who is an actual opponents to SPHC, using legitimate arguments. Not these thin, speciously reasoned arguments that make opposing SPHC look completely unfounded.

I know this entire article is distinctly biased in favor of SPHC, but let's at least have an opposition section that shows the other side of the coin. Cueball (talk) 20:40, 16 August 2009 (UTC)


 * That's right. We need to show them Dems that we Americans are the healthiest people in the world with the best doctors and the best insurance; we don't need no stinkin' so-silly-ism, my Lord, look at how God-awful the Canadians and the Brits have it; they're malnourished, dying of easily curable diseases, and crawling over each other to get into THIS country to get some REAL, state-of-the-art, free-enterprise produced HEALTH CARE, the way God meant for it to be (for a profit, of course!). The ONLY reason we have such high costs of health care here in America is that: (1) it's so damn good; and (2) those 30% or so of stupid, lazy, dishonest Americans who don't pay for insurance so then when they end up dying in the ER, those good Christian docs have to give them minimal treatment (which is still DAMN expensive---especially when it's uninsured); and then DON'T GET PAID FOR IT (yikes! That's THEFT! CATCH THIEF! CATCH THEIF! That's breaking a Commandment, you know, one of God's dictates.) So that's why they have to charge all the rest of us DECENT people MORE and MORE, so as to make up for it (I know those silly socialist liberals say that's just an excuse so they can rip us off, but they just don't understand how HARD we capitalists have it!) So see? It's SOCIALIST already! The solution is NOT to make it MORE SOCIALIST, but instead, to just haul off and slaughter all those parasites who choose not to carry health insurance, or at the very least, STOP ADMITTING them into hospitals, EVEN when they're dying! That should teach them!  —Preceding unsigned comment added by 173.16.124.196 (talk) 07:02, 17 August 2009 (UTC)

Unsectioned comment
(following moved from top of page)

This article seems to me to have a distinct bias in favor of a single-payer system as the best health care solution for the U.S. The reasons given for opposition, in particular, are strawman arguments clearly written by someone who considers opposition to be wrong thinking. I submit, for example, that there is no opponent to a single-payer approach who believes primary obstacle is "a lack of political will." The section on opponents and opposition arguments needs to be written by an actual opponent, not by someone trying to make such people look bad. No matter which polls you favor, none of them show that there is an absence of opposition among either doctors or informed citizens. I suspect that more honest material has been submitted, but that editing has been permitted that should not have been allowed. The current section on opposition must not be left in place. It needs to be deleted. If the editors will not permit an honest opposition article to be incuded, they need to state that fact openly, not describe opposition in a slanted fashion. I do not have the expertise to submit such a section myself, but I know biased and misleading material when I read it. The opening paragraph of the article also portrays oppostion to these plans in a biased negativity. There are many reasons for having reservations about single-payer systems, including a lack of confidence in government, lack of opportunity for choice of plan structure, difficulties that have been encountered in programs where implemented, concern over whether adequate medical personnel exist and will continue to exist to support such a system, concern over the possibility that cost controls with government mandates will unfavorably impact health care, concerns about how and whether such a program would be funded fairly, and so on. Why are none of these objections mentioned? Chuxton (talk) 06:32, 16 August 2009 (UTC)
 * I would largely agree with that assessment of bias, though I think it's likely evolved naturally rather than as a conscious effort to not "permit an honest opposition article." This article has been heavily edited and changed radically from week to week. I think there are a host of issues, lack of WP:NPOV being one of them, but I'm not inclined to make a strong effort to clean up the article body since the text changes so rapidly, often with the edits coming from anonymous editors who don't discuss the changes. Right now the article is simply too unstable to do much with, unless real discussion starts to happen on this page. In the mean time I would be in support of tagging this as having NPOV problems, so at least readers are aware that there are some issues there. Incidentally I say all of this as an extremely strong supporter of single-payer health care for the United States&mdash;I just think parts of the article read more like a piece by PNHP than a neutral encyclopedia article. --Bigtimepeace | talk | contribs 04:58, 19 August 2009 (UTC)


 * Bigtimepeace,I think you have a point about some sections, "parts of the article read more like a piece by PNHP " but I would disagree with tagging the entire article; the intro paragraphs are very factual (except for one part that has an ANTI-Single Payer POV, namely saying 'some call this socialist' or some such..I don't think this "some people call it.." belongs in the introduction section)...the section on Taiwan and other countries and polls are very factual..other parts that are more POV leaning, can, and should be, tagged as POV. To mark the entire article POV is inaccurate and would give people the idea that for example the intro paragraphs that explain the definition or single payer, or how the term 'socialized medicine' has a different meaning/definition, are somehow POV'd, which is not the case. Let's work to find and fix those sections that need fixing (for clarity, or POV or otherwise). I admit some sections are so long (e.g. 'stated arguments of the pro-single payer") that I haven't read them so far,so haven't been able to try to improve them or see if parts are problematic..--Harel (talk) 05:09, 19 August 2009 (UTC)


 * "I submit, for example, that there is no opponent to a single-payer approach who believes primary obstacle is 'a lack of political will.'" Unfortunately you are not correct: you don't have to look any farther than Sen. Baucus for an example of someone who says he won't push Single payer and who has given as one of the primary reasons that there aren't enough votes, not enough "will" in the Senate..Sad but true. He may not be an opponent "deep in his heart" (he supposedly even said in private he thinks it would work well) but in practice, he won't support it, won't sponsor it, won't advocate for it, blocks it, and has kept it off the table and blocked witnesses for it from testifying talk about opposition to single payer..that makes him, in practice a very strong opponent


 * I submit that what you list is not far from what many of us worried about until we found out that we were not being told the full story and found out we had been bamboozled by "government is always inefficient" and found out that the opposite is true. Lower bureaucracy and lower administrative overhead for any single payer (Canada, Medicare, UK's single payer etc) than for US private insurance. If the article misses some "Anti single payer" fact that is backed up by real hard data, those can be added.
 * If you asked me years ago to read this article before I learned otherwise, someof the facts would have suprised me so much I might, too, have thought there must be a catch, or a bias here...Personally I am dismayed at how ill-educated some of the anti-single payer folks are, here's a very specific example: an earlier edit of this wikipedia page tried to dispute the "49% of doctors support" and made not one but two errors in his "can't be. The MAA does not support the public option" reply, since, first, the cited reference was a survey of doctors, not of the MAA per se and certainly not of the MAA leadership and, much worse error, the implication was clearly that this person thought "public option" and "single payer" were the same thing. So long as such elementary, basic things are not understood,it's hard to work with 'skeptical' editors of this page when they haven't taken the time to read and learn basic definitions to know a difference as basic as that. Of course, some partso of this article are hard to read,and that much be improved, which hopefully will help those who are unfamiliar with single payer at least know what they (think) they are skeptical of, or opposed to, rather than being very opposed to something and not knowing what it actually stands for.


 * too often you hear people say socialized medicine is bad, but they like the care they get at the VA...which is socialized medicine, or, they say they have government programs but don't touch my social security, or, they think that single payer and socialized medicine are the same thing, nope, they are not, Canada and Medicare are single payer systems that are not socialized. Or they think the public option and single payer are the same thing...So I hear you but I hope you can see how difficult it can be trying to work with folks who say they are opposed...worst of all there have been outright VANDALS...who changed the wording to "the vast majority oppose" when the poll was not vast and not even a majority but a plurality, in one earlier version of a paragraph somewhere..etc..
 * Bottom line: if you're not a vandal, and understand the basic definitions, and have references, by all means add them with footnotes(you can even add "government programs are always less efficient" with a reference/footnote...others of us will leave that in but will then link to study after study that show lower overhead for single payers than for the "efficient" and "free" market (or monopolistic) private insurance systems, that has been very well documented in studies by the non-partisan Congressional Budget office and by the Government Accountability Office watchdog, and others)


 * P.S. I agree with you the criticisms section is missing some common criticisms; I've found several useful sources which could serve as references for responses with footnotes to the common concernts/criticisms such as, "waiting lists", or "rationing" etc, but we should add quotes with references on both/all sides there.--Harel (talk) 05:01, 19 August 2009 (UTC)

Suggestion & Qs to minimize unweildiness of Talk page
This page is getting huge, which isn't surprising. I don't want to silence anyone, so one and don't want to be silenced (talk is good) so one suggestion and one quesetion

Suggestion: before we get far above 32 sections/topics here in Talk, try to use the equal-signs to create sub-topics and sub-sub- sections/topics

Question for experts: is there a way of seeing "most recent additions" other than clicking on "history" for the Talk page? That is, a way to display all comments/edits in reverse chronological order? (JUST for my viewing; the default for anyone surfing over to this Talk page would still be the normal section-by-section ordering) I've had to resort to using the browser's "searching within this page" for "august 2009" to try to find recent comments to see if I have any comments/replies to them...I'm sure it's equally becoming challenging for others, too.. --Harel (talk) 05:18, 19 August 2009 (UTC)

(Also is there a *fair* way to call for the deletion of parts that are very old and which we can agree can be deleted like the "# 8 this article is a piece of S*** =" section of this talk page?) —Preceding unsigned comment added by Harel (talk • contribs) 05:19, 19 August 2009 (UTC)
 * I've added some code to the page (see previous edit) which, if it works (this kind of thing is not my expertise) will eventually allow a bot to archive every thread on this page which has not been discussed for over a year. When pages like this get too big, we archive rather than deleting. I probably could have done this manually, but it might be worthwhile to set this up for the bot right now. The dates can be adjust later (for example it could archive everything older than a month) but I think a year is fine for now.


 * I'm not sure I understand your question, but basically the only way to review recent edits is through the history tab. That does work pretty well though, I think.


 * One thing to be aware of is whether or not you are engaging with an active thread. For example Harel, at least once above you opined in a thread that had been dormant for about two years. Not much point in doing that, and if there is still an issue you should start a new section when discussion in the previous one had died down.


 * Anyhow we'll see if MiszaBot comes by to tidy up in awhile (if not I'll figure something else out) and if so that should help matters. --Bigtimepeace | talk | contribs 05:52, 19 August 2009 (UTC)


 * "at least once above you opined in a thread that had been dormant for about two years. Not much point in doing that," Umm, catching myself that I had misread a "2007" as a "2009" was part of the motivation for asking this set of questions! *smile* :-)


 * The auto-archive after dormant for a while sounds great.


 * I agree checking History works well, but only if the volume isn't too big; every now and then there are a very large number of changes in a 38 or even 24 hour period. (another issue is that it's quick slow to click on each "prev" to see each step's changes in history...it may "churn" for quite a while..and that's for each of the soemtimes dozen many changes..Not complaining..just hoping this too improves..I suppose I should write a check to the wikipedia foundation (I think I did once in the past..maybe time to again..))


 * Lastly, another wish-list item besides this archival would be some kind of either auto-threading, or else auto compaction. Compaction would show only the first line or two if each reply and sub-reply (meaning reply-to-a-reply) and sub-sub-reply etc..it would compress the entire Talk section to a clearly-structured tree of sorts...and a click would 'expand' any reply or reply-to-a-reply etc..That would be great.


 * Tip to those who haven't discovered it, use colons (the : symbol) to indent your reply so it's clear what it's a reply to; two colons in a row before each new paragraph would double indent etc. Wish I had discovered this earlier :-) --Harel (talk) 23:35, 20 August 2009 (UTC)

Still Americentric
This article still comes off as 'americentric', despite including verification that Canada and several other non-US nations have implemented single-payer systems:

"Canada has an example of single-payer health care."

This line, for example:

"In the debate about health care reform in the United States, the single payer public insurance option has been proposed as an alternative to privately held health insurance companies, which operate to make a profit for investors."

Not only is this line unnecessary, it focuses on US affairs in an article dealing with a topic which applies to any nation. If you don't mind, I think I might move that out of the intro and into its own section. Thanks. 8bit (talk) 01:39, 22 August 2009 (UTC)


 * I agree some parts are USA-centric. This is partly (a) Because those of us who have contributed to this article who live in the USA haven't been as careful about avoiding USA-centrism as we should have, but also (b) partly because issues such as "political discussion about whether to consider a Single Payer system"  simply do not apply to most if not all other countries - there are no such (or almost no such) discussions because they already have single payer, etc. Maybe further discussion can help us flesh out which is which, or when is when.. In this context however, a second point..


 * There is also a fine line between "what's really 'necessary' " and what's needed to foster understanding among readers. An encyclopedia should forster understanding among its readers. This should include readers (some might even say "especially among those readers..") who are least familiar because the model, in this case single payer, is not familiar to them. So while I can see suggested changes in the language of the sentences above, a strong case can be made, I think that it's necessary to include such features as "no need for profit for investors" which some contributor included, just as much as to spell out the difference between single payer and socialized medicine (which I was among those who contributed), because frankly, without such basic understanding of the "landscape of possible options" understanding is limited at best, if not impossible. Were we living in a world in which most people (which would imply also "most Americans") understood such points as these, it wouldn't be necessary..but that's not the world as it is...that single payer is not the same as socialized med is not clear, and that a system in which the institutions don't need to report to and earn profits for shareholders is even a possibility, is also not clear, to most Americans, ergo not to most readers, unfortunately..hence forstering understanding among a *pedia's readers means some inclusion. Tweaking of language, and context, of such clarifiers is reasonable.--Harel (talk) 03:15, 22 August 2009 (UTC)


 * Added later: by the way some level of *centric is impossible to avoid, e.g. if you're a member of a completely isolated tribe in say Papau New Guinea, isolated from most of modern civilization, I suspect you'd find the majority of wikipedia entries to be something-centric...so perfection in this realm is not practical.. however I do agree we need to work on instances of (1) as above...--Harel (talk) 04:07, 22 August 2009 (UTC)

Problematic citation in 'opponents' section
Where it says "However, supporters of a single-payer system, such as Marcia Angell, M.D., former editor of the New England Journal of Medicine, assert that incremental changes in a free-market system are "doomed to fail."[66]" a quick search through her article shows she neither a_a) characterizes the present system as "free" or "free market" nor b) uses the phrase "doomed to fail" (is there a standard wikipedia tag that instead of saying "citation needed" says "source cited doesn't match what's asserted it says"?) Please clarify or correct citation. By the way once this is fully resolved I'm fine with deleting (or, "archiving" instead as may be more standard) this item in the Talk page. --Harel (talk) 04:05, 22 August 2009 (UTC)

She may not have used those precise words, but she did say "Toss it out and start over? Yes, because it's based on a false premise. Our health care system is based on the premise that health care is a commodity like VCRs or computers and that it should be distributed according to the ability to pay in the same way that consumer goods are. That's not what health care should be. Health care is a need; it's not a commodity, and it should be distributed according to need. If you're very sick, you should have a lot of it. If you're not sick, you shouldn't have a lot of it." I think the editor who added that line to the article summarised the position in that way. Summarising the long piece as "incremental changes in a free-market system are "doomed to fail" does not seem inacurate to me because she is calling for wholesale reform and stating that free market principles should not apply. You may or may not agree with that, but that is what she is arguing. I do not think you should delete it but if needed add a fuller quote.--Hauskalainen (talk) 23:05, 22 August 2009 (UTC)


 * Of course you are right that the issue is whether she believes it, not whether I agree. However one at least one point, I don't see evidence that she believes it. Namely, I don't see her saying she views it as a "Free market" system. I personally don't think it is, it's very monopolistic/oligopalistic, to give just one example,but again I agree it's not key what you or I believe; however again, she does not use that phrase,the phrase "free market". No market is 100% in alignment with "Free market theory" but the healthcare 'market' is very, very far from it...and she does not make any claim about "free" market....so...how about "corporate based insurance market" or "private, for-profit based" insurance market? (but not "free market") system? She does say "..not as a commodity to be distributed like other marketplace commodities"... How about instead of saying "[she] assert[s] that incremental changes in a free-market system are..." that it be worded as, "[she] assert[s] that incremental changes to the current system which treats hearthcare as a market commodity, are...."? Maybe we can agree on that as fairly representing her words?


 * The "doomed to fail" part might be ok..or maybe "would be inadequate" or "will fail to address rising costs and unfair treatment of patients" ? I'll have to re-read what she said, before having a strong opinion on whether there's a better phrase than "doomed to fail"...feel free to share your thoughts on this portion as well..--Harel (talk) 06:04, 23 August 2009 (UTC)

(I see you live in Finland...maybe you could help with information for Wikipedia about the system in Finland, that's relevant to this article on Single Payer as another example?) —Preceding unsigned comment added by Harel (talk • contribs) 06:08, 23 August 2009 (UTC)


 * "Free market" again may have been a loose referral to the commoditization of health care as something to be bought and sold - the reference to VCRs and computers. I agree that its not a proper free market but it is more heavily commoditized than is health care in many European countries for example. The issue is how to summarizer her position accurately.--Hauskalainen (talk) 20:47, 24 August 2009 (UTC)


 * As for the system here in Finland it is a mixed system. Many employed people get their primary care paid for by their employers which buys in primary health care services from private health companies. Others use the public health care primary doctors run by the local townships and cities and paid for by taxes and some user fees. Few hospitals are private and almost all are run by government. National government subidizes the cost of medicines and the purchase of private medical services by employers. So its not a single payer system here at all I would say. Its more a mix of socialized health care and some private providers, just like the UK. On the surface it seems to work OK but it is a bit disjointed. I would say the UK system is more logical and has better integration, better planning features, and is more responsive to community needs. For instance in the UK you can call a doctor or local nurse to your home if you are physically unable to get out but have a basic need for treatment or supervision in the home. The severely disabled and those receiving terminal care might fall into this category. In Finland, as I understand matters, you may have to call out a full paramedic team which is way over the top. People in Finland do not buy health insurance unless they travel outside of the EU. Everyone is covered by the public system but your employer may opt you out of parts of it. The only difference I see between the public and private primary care providers is that the private providers have better fish tanks in the waiting areas.--Hauskalainen (talk) 20:47, 24 August 2009 (UTC)


 * Thanks for this. The part at the end, "People in Finland do not buy health insurance unless they travel outside of the EU. Everyone is covered by the public system but your employer may opt you out of parts" sounds to me like a (modified version of) single payer...but we can worry about this definition some other time when/if we add to wikipedia entry/ies (I did love your line about the fish tanks!) Meanwhile, I'll try to update the other quotation so we do not put the phrase "free market" in her mouth, but, still, preserve her meaning. --Harel (talk) 23:02, 24 August 2009 (UTC)

Canadian brain drain
Regarding recent additions about a brain drain from Canada to the US - this is a somewhat unbalanced argument as it stands. Here's some additional info about this:


 * 13% of Cdn. MDs in US likely to return home: CMA survey from 2007
 * The Canadian contribution to the US physician workforce from the Canadian Medical Association (indicating that 12,040 Canadian-educated physicians were living in the United States in 2006)
 * More doctors returning to Canada than leaving, first time in 30 years - syndicated Canadian Press article hosted by PNHP
 * Myth:Canadian doctors are leaving for the United States in droves from the Canadian Health Services Research Foundation
 * Factors influencing the emigration of physicians from Canada to the United States at PubMed from CMAJ

I'm sure there is far more data than this. Mind matrix  19:54, 24 August 2009 (UTC)

A somewhat related claim to the "brain drain" is the claim that many wealthy Canadians go to the US for necessary (rather than just to speed up their cosmetic and other elective) surgery and procedures. One very wealthy person (former CEO) quoted in Businessweeks begs to differ:

"But Canada's 30 years of experience with single-payer suggests care would not be compromised anywhere near as much as opponents predict. Canadians do face waiting lines for some nonemergency procedures and have far less high-tech equipment. Even so, 'the Canadian system has served society, and the average citizen, better than the U.S. system,' argues Vickery Stoughton, an American who has worked as CEO of both Toronto Hospital and Duke University Medical Center."

This little known but very significant article (a rarity in the business press to give the Canadian system a more fair treatment) is at http://www.businessweek.com/archives/1994/b336351.arc.htm may be a good source to mine for this wikipedia article for other relevant facts and quotations from analysts.--Harel (talk) 23:59, 25 August 2009 (UTC)

First paragraph vs Second paragraph definitions don't fully match
First paragraph: "...from a single source established and managed by government" while second paragraph, which does include a reference, defines it more broadly: "...funding would operate as a public servic...The fund can be managed by the government directly or as a publicly owned and regulated agency.[2]" Seems the first paragraph definition needs to be tweaked. Also, while some semi-public entities have profits (Fanny, Freddie etc) this would be a "publicly owned and regulated not-for-profit agency" should be made clear as well imo. Comments from everyone, and also, help to find the exact line in [2] from the person who first added that, would be appreciated. --Harel (talk) 00:19, 26 August 2009 (UTC)

Netherlands
I just read this section, and I'm not even sure that it is in fact a single-payer healthcare system. As I understand it, funding is provided through private insurers, who must provide a minimum standard cover and are tightly regulated to ensure that they do not discriminate against the sick. There is some funding to equalize risk, but I don't think that makes it a single-payer system. Anyone disagree? DJ Clayworth (talk) 15:44, 15 September 2009 (UTC)


 * OK, I'm going to take this out. We can always put it back later. DJ Clayworth (talk) 13:14, 17 September 2009 (UTC)

United States National Health Care Act
It is unclear to me why the United States National Health Care Act, a bill which has been introduced on a regular basis in the US with no hope of actually becoming law, deserves a mention in the intro. It is already mentioned in the relevant section, and a single initiative (among many in the US) is not that important. DJ Clayworth (talk) 16:19, 15 September 2009 (UTC)

I've also removed some duplication of the various types of healthcare, and reduced the article's focus on the single-payer health care system that the US doesn't have. DJ Clayworth (talk) 19:16, 16 September 2009 (UTC)

Article for deletion proposal - Shona Holmes
Editors to this page may wish to know that the article about Shona Holmes (who has appeared in advertsements and in congress campaiging against health care reform and especially single payer) has been nominated for deletion here. http://en.wikipedia.org/wiki/Wikipedia:Articles_for_deletion/Shona_Holmes_(3rd_nomination)#Shona_Holmes Please feel free to add your comments about this proposed deletion as you see fit. --Hauskalainen (talk) 22:37, 22 September 2009 (UTC)

Types and variations and misc.
1. "Government is increasingly involved in U.S. health care spending, paying about 45% of the $2.2 trillion the nation spent on individuals' medical care in 2004.[3] However, studies have shown that the publicly-administered share of health spending in the U.S. is closer to 60%.[4]"

The sentence beginning with "However,...." contains the near-consensus rejected claim that "the publicly-administered share of health spending in the U.S. is closer to 60%.[4]"''

There are not "studies." There is one (1) study that makes that claim. It comes from leading figures with the US single-payer advocacy organization Physicians for a National Health Program (PNHP). It is a tendentious study, presenting a biased opinioned motivated for the political purpose to make it appear the US government already spends so much money on health care that it wouldn't mean much of a change if the nation adopted single-payer and had government take on a bigger role in financing health care here. I'm a very active, ardent single-payer advocate. I was on the commission created by my state legislature several years ago to study single-payer (as a supporter), and was main author of the group's final report, which I helped present to a parent health committee. I've testified about progressive exhalent reform issues, including single-payer and universal care, 14 times in the past 5 years. I speak to group, give workshops, etc. I greatly appreciate Steffie and David's work in general, but this study of theirs is an embarrassment to the movement. The basis of their claim is that tax deductions employers and workers receive due to premiums paid for employee health plan coverage constitutes spending by the government. Hence, rather than spending 45%, government spends 60%. This is voodoo accounting. In accounting theory, what they're doing is claiming that money that could've been collected in the form of taxes (with different tax laws)--potential revenue--constitutes a real expense. What they claim is that money government never has, does not determine whether it is spent or not, or how much of it is spent or not, or how it is spent is spending by the government. It makes their claim that money spent by employers is money spent by government. This is crazy. Their argument is not taken seriously by people outside of the single-payer movement as far as I know in any wide-scale way. There’s one government economist who agrees with them. I could walk through more of the logic and math about why their argument is flawed, but given that it is given little currency it shouldn't be included on the page unless presented with a serious disclaimer. At that, there are other claims made about what the percentage is, but none hold much sway; 45% is the consensus figure. Get rid of the PNHP figure and its study--singular.

2. "Although many Canadian citizens have supplemental private insurance from their employers, this covers non-medically necessary expenses not covered by Canadian Medicare, and accounts for only 12% of national health care spending.[9]"

The source of that figure is not reliable; the paper does not adequately explain its terms and more. The percentage of private health spending in Canada is 29.9%, with public spending at 70.1%. Those are the relevant figures if one wants to portray the public vs. private spending dynamic, as the reference to US government spending of 45% or 60%. To contrast Canadian spending while comparing public insurance vs. private insurance is an apples-to-oranges comparison with the US. Non-parallel construction.

The authors of the study do not explain what they consider "private insurance." They do not specific what those figures. They portray figures for total private spending, and break it down side-by-side with public spending for different categories of care, e.g. in-patient, but not so with private "insurance." The private insurance figure cannot be analyzed sans details. Canada has private insurance, out-of-pocket, and a very small amount of spending in what is known as a "cash-market" where citizens can go to doctors who work outside the public reimbursement system and get care for anything that they can get in the public system. However, they have to directly pay themselves; they cannot use insurance to pay for those services. Whatever the case, the aggregate private spending information provides the relevant figures to contrast public vs. private. To refer to private insurance, a better source is needed.

I used to participate--years ago--in trying to maintain the entries for universal care and single-payer, but gave up given the game playing that goes on non-stop by ideologues from all sides. The current entries seem freer of that sort of gameplaying. However, a problem exists in the need to cite a source for certain terms like universal care and single-payer. All sorts of definitions exist, they differ, and I don't find any/many that are adequate and accurate. I’m a bona fide expert with my own organization and site and definitions but apparently I can't cite myself. It is a major failing of Wiki that sourced definitions from some pre-existing site are required in some cases where there are no good ones, or so many that it accomplishes little to cite merely one. Can the user community for a topic agree on one?

Theschwasound (talk) 07:51, 10 December 2009 (UTC)

New section needed: Arguments in Favor of Single Payer
Initial skeletal outline:   Cost Savings by lowering bureaucracy, administration, and overhead (referneces to GAO and CBO studies having these findings.. Patient Freedom to Choose Doctors (related issues like portability when moving, changing jobs, can be put afterwards as well)  Healthcare decisions made by physicians and other medical experts and their patients.  Prioritizing sicker patients first, rather than more profitable procedures/patients first Democratic (one vote per person) control over the healthcare system  Negotiating global budgets including negotiating best-prices from drug companies through purchasing power.  add your own additional reasons For here, if they really don't fit into any of the above, or add to the above... Suggest references for (and improvements to) above... --Harel (talk) 00:48, 26 August 2009 (UTC) 

No, no, no, no no. A section like this would make this even more Americentric than it is. Let's have stuff about actual Single-payer-healthcare systems, not about US healthcare reforms. DJ Clayworth (talk) 18:19, 14 September 2009 (UTC)


 * Is there anything America-specific about the general concept of who makes the healthcare coverage decisions? No. (I'll resist the urge to put "no, no, no no" there) Global budgets possible, is that specific only to the US? No. How about having lower administration than private? No, that's not U.S. specific either, and one can add other studies besides GAO and CBO.


 * Clearly, it is relevant, and even critical, to a solid and thorough encyclopedia article about a policy option like this, what it's rationale is or what the reasons are, or what it allows, or doesn't allow. That's a far, far cry from having a debate (yes the title had "arguments for" in it to fit in with the flavor of the Entry as it stood at the time which covered various states, groups, etc) and it's a far cry from trying to quote 'all sides'; there are basic, factual, studied and regularly analyzed features and dimensions of such a policy option as single payer, and the list above was merely an outline not a final draft, of what some of those dimensions are. If you find some such future additions to be unfactual or otherwise problematic, by all means raise the concerns at that time. But you cannot give a blanked dismissal of having the article discuss such parameters, any more than you could for an article on a proposed new technology or even technological protocol; its potential advantages, as well as potential problems and limitations, are entirely relevant.--Harel (talk) 02:51, 17 January 2010 (UTC)

Article should be balanced with a criticism section
As it stands the article only seems to provide a positive view of the issue. Since this is a political issue, it does not make sense to have a "Proponents and support" section without a "Detractors and criticism" section as well. On a personal note, as a young adult entering the workforce in the US and seeing the demographic trends (i.e. the baby boomer generation reaching health-care age) it seems as though proposals like this are another way of transferring money that I don't have to the people who spent all their money on making housing unaffordable. The same generation of people who underfunded Medicare and Social Security their entire working lives and now expect my generation to pay for those too. If I am critical of this type of proposal in the US context, I am sure that someone, somewhere has written a criticism. Not that this isn't a good idea, it just is inappropriate in the US context at this moment in time. 72.203.157.85 (talk) 04:45, 23 September 2009 (UTC)
 * No, no, no, no, no. Criticism (and praise) sections make for bad and argumentative articles. Much better to merge positive and negative facts into the article. Non-facts shouldn't be there at all. Since we already have a large article on the US debate, this article can restrict itself to facts. Already did this. DJ Clayworth (talk) 16:09, 24 September 2009 (UTC)

In most of the world, the children work and care for their parents in their old age. This includes medical costs. Usually this is through direct payment to medical providers (assuming that you can both pay and you can find a doctor with the skills needed nearby; neither of these are usually true in the third world.) In the first world, this is instead done through pooling of money by insurance or taxes.Grantor (talk) —Preceding undated comment added 21:45, 22 March 2010 (UTC).

Term in the US
If the title of this article really is specific to the US, then maybe we should change the article title to something more globally understood. The article should cover all the single-payer insurance systems (since we already have extensive articles on the US health care systems and the various proposals). What should the term be? DJ Clayworth (talk) 13:44, 28 September 2009 (UTC)

I came to this page from googling the term "single-payer health care" after reading it in a US newspaper. Many of the the terms from discussion of the US healthcare reforms are not familiar to readers in the UK as there is a general consensus here that our government funded universal healthcare is the best option and therefore discussions about funding options are not often seen. Whilst many of the healthcare reform pages seem US-centic, I think this is inevitable as these issues appear to be much more significant in the US. The terms used may be unfamiliar to UK or global readers, but that it because the concept itself is unfamiliar; hence there are no "more globally understood" terms in British or International English.86.178.51.138 (talk)Caroline, London, 26th May 2010 —Preceding undated comment added 10:51, 26 May 2010 (UTC).

Very 1st world centric
The experience of the 2nd world in single payer healthcare seems to be entirely missing here. Since this negative experience is the source of much of the opposition to single payer systems in a modern context, the absence of USSR, Polish, GDR, Romanian, Mao era PRC single payer systems and the rest of their communist brother systems seems to indicate large POV problems here. TMLutas (talk) 11:11, 8 January 2010 (UTC)


 * The "second world" also ran elections. Yes, they had elections. Horribly flawed and undemocratic, but they did have elections. Does this mean that we need to list the use of such elections as a section in Wikipedia's entry on Elections, as an argument against having elections? That's what the above logic would indicate. If you have arguments against single payer that are based on facts and logical analysis and you can cite, by all means we can incorporate such. That a one-party dictatorship does a less than wonderful job with financing-by-the-state is about as surprising as that this kind of one party dictatorship does a bad job with elections, or for that matter, public broadcasting" or anything else. --Harel (talk) 02:59, 17 January 2010 (UTC)

I really don't understand the thrust of the argument. The essence of single payer is that it is unhelpful to have multiple players because in a multipayer system the payers engage in competitive practices just as you see now in the U.S. where insurers compete to get rid of the sick from their insured pools and retain on their books only the healthiest individuals (like those fit enough to be employed). In a system where there are not for profit insurers, the pools are owned by the contributing members, this tends only to benefit the healthy and dis-benefit the sick (which is the very converse of the object of insurance). In a system where there are for-profit insurers, things get even worse because the pool is not owned by the insured but third party owners, the shareholders, who can cream off any excesses from the pools for themselves. Thus you have the grossly offensive situation of the sick being denied access to insurance and the remaining contributors to the pool being relatively healthy and yet still having premiums sucked out of them and into the hands of people who are in the game only for the profit to be made. Sure, the insurers still do pay out of course, but the gross picture is very clear.

TMLutas seems to be confusing single payer health care and communism. These are about as wide apart conceptually as it seems possible to get. Single payer health care is about providing health care from a single source of funding (typically taxation) but not restricting where you get service from. Communism is a political philosophy in which the state controls the means of production, distribution and exchange and in which property is owned collectively and decisions taken democratically. In single payer systems, doctors take medical decisions and the cost of those decisions are carried by the community. All single payer systems give people the right to choose and if your choice is not covered by the single payer system then you have an absolute right to pay for service privately, either out of pocket or by insurance. There is thus a great deal of plurality embeded in the philosophy of single payer, (and by the way, this extends to systems like those in England or Scandinavia where the single payer also provides the main health care service). The degree to which the state controls the financing of health care is totally in democratic control. If the state provides poor coverage, people will finance the coverage they need themselves (albeitly from their own resources like most other things). That in places like Canada, Sweden, Denmark, they choose not to is a sign that the democratic system is producing the required results.

In a perfect communist system, there would not be any choice other than that which the state allows. The funny thing is that you included the People's Republic of China on your list, and as far as I know, medicine there has never been fully run by the state and it still is not, even to this day. It might be a communist country but it does not have socialist medicine.--Hauskalainen (talk) 13:58, 4 February 2010 (UTC)


 * Hauskalainen has given a good summary of how very far apart single payer is from the official rherotic/official ideology of Communism. Thus TMLutas' examples are off. But since the actual examples TMLutas cites are ones in which the official ideology of "property is owned collectively and decisions taken democratically" was not respected, the examples are one more step even further away removed from single payer. So single payer differs from what TMLutas conceived in all the ways Hauskalainen summarized, plus also different in this additional way. --Harel (talk) 21:58, 11 February 2010 (UTC)

Hauskalainen and the UK
I've removed now several times statements by User:Hauskalainen that the UK's system is not a single payer healthcare. I did this for two reasons 1) it's not clear that the authority he is citing as not considering the UK as single payer is the definitive authority. The statement is a bit short on references, and prima facie the UK healthcare system is paid for by one payer (the government) 2) He changed only the intro, while leaving the discussion of the the UKs system in the rest of the article. If he truly believes this to be the case, he needs to cite references andestablish a consensus on this page for the change. He also (if he gets consensus) needs to change the whole article to reflect this view, not just the intro. DJ Clayworth (talk) 18:16, 18 February 2010 (UTC)


 * I can find several sources that explain that the UK system is not single payer with a really quick search of the internet. The fact is that the UK is not single payer system because in single payer systems you have government paying for the insurance but the practitioners are mostly privately run. In the UK the vast majority of hospitals are government run and the doctors and nurses are employees of the government. Personally, I think that unless you have a reliable source that the UK system is single payer that it should not be listed as such. DanielZimmerman (talk) 15:36, 6 May 2010 (UTC)

"most European countries have single-payer health insurance programs"
There is no citation for users to see a listing of who is a single payer and who is not. In fact, my reading has indicated that most European countries use mandatory private insurance, with subsidies for the poor. That does not fall within the range of definitions for "Single-payer health care". Here is a example article:

Specifically, Switzerland and Germany are entirely private health insurance companies. In Germany's case, there are 200 insurance companies. —Preceding unsigned comment added by Grantor (talk • contribs) 21:38, 22 March 2010 (UTC)

TAKE IT DOWN- it's still shit
yes this article is still shit. single payer is still a term with most of its play in the u.s.

the article sub headings for "in favor of" arguments having redirections to other articles is terrible anti-topical structure.

the "arguments in favor" amount to the necessary parts of this article to describe what was going on.

i say take the article down rather than let it be written and rewritten as it has been to date.

— Preceding unsigned comment added by 24.62.203.245 (talk) 16:11, 14 June 2010‎ (UTC)

Rewrite
Have started rewriting this page. Am open to suggestions. info@healthcareforeveryone-alabama.org Wretan (talk) 12:37, 28 August 2010 (UTC)

NOT "Single Payer" in Continental Europe
Most continental European countries do NOT have "single payer" systems, but systems of multiple private providers operating and competing within tight regulatory parameters. The UK's National Health Service viewed in isolation is a single-payer system, but it is supplemented by private sector provision (including BUPA) for hypocritical left-wing politicians and other wealthy folks.

— Preceding unsigned comment added by WikiFlier (talk • contribs) 12:55, 5 October 2010‎ (UTC)

NY Times/CBS Poll UNRELATED to Single Payer Health Care
The poll should be removed from this page. The poll question asks if the respondents are in favor of a public health care insurance OPTION to compete with privatized health insurance. The caption of the poll states the poll is showing how the majority of the US is in favor of a single payer system when the poll itself makes no mention of a single payer system. Again, it refers to a public option in addition to privatized insurance, NOT a single payer system where government run health care is the only option. Please rectify this error. —Preceding unsigned comment added by 96.28.130.3 (talk) 21:26, 20 January 2011 (UTC)

statistical nomenclature
This article uses the term "median" in describing wait time for services in countries that have some form of single payer health system. Median describes the value at which one-half of the observations fall above the value and one-half fall below it. It may be that the correct term to us in the wait-time discussions is to use "mean" as this would be the average wait time and might have some meaningfulness to the readers. —Preceding unsigned comment added by 64.27.230.232 (talk) 00:14, 22 January 2011 (UTC)

Health insurance vs health care
Isn't single payer a health insurance scheme not a health care scheme? Wouldn't that clear up the debate?

Canada taxes and pays (as a single payer) for health insurance but private companies provide the care. Public insurance, private care. Great Britain=public care. —Preceding unsigned comment added by 98.180.219.33 (talk) 15:57, 11 February 2011 (UTC)

California section update request
CA State Senator Mark Leno reintroduced California SB 810, "The California Universal Healthcare Act" on March 11, 2011. Can an editor please update the California section with this information? Thanks!

Senator's page for SB 810: http://dist03.casen.govoffice.com/index.asp?Type=B_BASIC&SEC={5938D509-03E9-4845-9605-F46F87A1758B}

Video to press conference announcing reintroduction: http://dist03.casen.govoffice.com/index.asp?Type=B_PR&SEC={0E44D2C9-74BE-4B0C-81BD-CEA912593120}&DE={DF45DD07-C60E-4D0E-BB14-2DC6EE79F3F2}

98.248.161.70 (talk) 18:20, 31 March 2011 (UTC)

Article is biased.
This reads more like a persuasive essay than an encyclopedia article. —Preceding unsigned comment added by 66.44.247.184 (talk) 02:01, 5 May 2011 (UTC)

Rassmussen Reports Has Been Accused of Conservative Bias Multiple Times
They're inclusion on this subject should be removed and they have been accused of conservative bias multiple times and clearly slanted the results.

— Preceding unsigned comment added by 75.87.146.169 (talk) 08:57, 11 May 2011‎ (UTC)

Is this right?
From the lead: "Single-payer is a market in which one buyer faces many sellers". Is that right? Surely the single health fund is the seller (of insurance)?PiCo (talk) 01:42, 9 June 2011 (UTC)

On the polling section
I cleaned up some accuracy issues on the polling section, which was largely distorting the evidence it was using. Specifically talking about "national health insurance" during the timeframe that the United States was discussing the so-called "public option" is not an implication regarding single payer, for instance. There are a few more issues that come up in light of this:


 * The infographic provided is misstating the NYT poll completely. The poll does not show that much support for single payer, but for a "willing[ness] to pay higher taxes so everyone could have health insurance" that would compete with private plans - decidedly not single payer.
 * The first line shows 78% support for single payer according to FAIR citing a 1987 poll - do we have access to that poll anywhere? If we cannot see the actual poll, given the problems with polling on this issue, I'm not sure we should include that line at all.

Hopefully we can clean this issue up as soon as possible. Thargor Orlando (talk) 21:15, 12 August 2011 (UTC)
 * I've made the changes to remove the infographic and to tie the reporting of the poll to FAIR as opposed to simple stating it at this time, given the lack of any protest over the last week. Thargor Orlando (talk) 16:12, 19 August 2011 (UTC)

Definition(s) of single-payer
The introductory section where single-payer is defined and explained has major, multiple flaws.

1. "Single-payer health care is a public service financing the delivery of universal health care to a given population..."

Single-payer is an economic model for financing patient medical care. Universal care is the concept and practice that all persons within some given population have equal, guaranteed access to receiving some types of medical care. Single-payer is distinct from and unrelated to universal care. One can have a single-payer system without having universal care. One can have universal care without having single-payer. That first sentence presents itself as a definition of single payer, in order to be so, the reference to universal care needs to be removed.

2. "Single-payer health insurance collects all medical fees and then pays for all services through a single government (or government-related) source."

a. There is no such thing as a true single-payer system in the West. All Western nations involve a combination of public and private health care spending. In England, considered a "socialist" single-payer system, public spending is 85% and private spending is 15%. In France it's about 80% public, 20% private (this about average for OECD nations). In Germany it's 75% public, 25% private. In Canada it's 70% public, 30% private. In the US it's 55% private, 45% public (more on this case below). Obviously not all medical fees are collected and then used to pay all services.

b. The literal single-payer does not need to be a government entity, or government-related. One could have a single-payer system if there were a single-payer in the form of an HMO not operating as a government organ with public money. An HMO could gain a monopoly in health insurance coverage, along with the elimination of public health programs, and become a private single-payer.

3. "Medicare in the United States is an example of a single-payer system for a specified, limited group of persons within a country."

Per the explanation in #1 above, Medicare is not a single-payer system because it also includes private spending for the specified population in the form of, as in other nations with "single-payer," supplemental insurance (Medigap plans), complementary (secondary private coverage), out-of-pocket via deductibles and co-pays and non-covered services. In addition, with the enactment of the Medicare Modernization Act (MMA) several years ago, Part C Advantage Plans provide coverage via private HMOs, as does Part D prescription drugs plans. Hence, the amount of spending for "Medicare" (treated similarly to single-payer systems in other nations) is no longer as much of a "single-payer" system as it was a decade ago.

4. "Although the fund holder is usually the government, some forms of single-payer employ a public-private system."

This sentence is an inadequate attempt to explain and note the issues I have drawn attention to and explained in point 1, 2, 3.

The whole introductory part needs to be written in order to give readers an accurate, adequate understanding of what single-payer means. I'll be submitting language after discussion has begun.

I'll provide the specific OECD, WHO, etc. references and figures for the spending, etc. when I submit more comemnts to this Talk.

Theschwasound (talk) 06:40, 10 December 2009 (UTC)
 * Be sure to make your changes one at a time, with an explanatory edit summary. Abductive  (reasoning) 07:30, 10 December 2009 (UTC)

I agree on all points and will make some of the changes. According to the Physicians for a National Health Program Single Payer "refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs." http://www.pnhp.org/facts/what-is-single-payer Jerdwyer (talk) —Preceding undated comment added 19:42, 20 December 2011 (UTC).

Also deleted statement that medicare is a single payer system for a certain segment of the population. It's no more single payer than my company insurance is because it does not meet the criteria of a SINGLE entity handling all health care bills. A system in which some people are covered by medicare and others are covered by private insurance is a partially universal system, not a single payer one. Jerdwyer (talk) —Preceding undated comment added 19:53, 20 December 2011 (UTC).


 * I would like to point out that WP:RS, which is a firm Wikipedia policy, requires us to link to a WP:RS for every disputable claim. If an editor claims that the UK has a single payer system, that editor must supply a link to a WP:RS which says that the UK has a "single payer" system. You can't simply link to a description of the UK system, and conclude that, in your interpretation, that's a single payer system. The link (which I corrected) to the NHS Constitution in the UK section doesn't use the phrase "single payer" anywhere. I searched it. Therefore, the reference to "single payer" has to go out, until someone finds a WP:RS. --Nbauman (talk) 03:51, 7 July 2012 (UTC)


 * I suspect there may be a terminological problem in that the term "single-payer" has no real meaning in the UK, or (I suspect) in the rest of the world outside the USA. If British people were asked to define what type of health care system we have, the general answer would be to define it as what it is called: a national health service which is owned and paid for by the nation collectively and managed by the government on behalf of the nation. Sam Blacketer (talk) 22:48, 8 July 2012 (UTC)

DOMINANT or SINGLE? WRONG CHARACTERIZATION OF EUROPE
I just read the many complaints about this article on this discussion page and I have to agree with many of them. I cannot think of a single country that has a "Single Payer" for health care services. In Europe it may be that your employer picks up the tab, or the employer and the employee contribute jointly into a trade union insurer. There may be a private insurer, or if you are rich you pay for it yourself from your own pocket. If you're poor or unemployed or retired the government surely helps out. Its your choice and its not a monopoly. The UK and Ireland certainly have dominant payers but not single payers but where do you stop counting? In most countries people pay something for their health care, employers pay something and the government pays something. But then government gets its money from taxpayers anyway (people and businesses) so its just a matter of how want to look at it.

This article seems to me to be too dominated by an American perspective and the term, as far as I can see, is mostly used by Americans to characterize Canada's provincial health insurance programs of which there are many in the nation. — Preceding unsigned comment added by 84.250.230.158 (talk) 02:14, 9 January 2012 (UTC)

Overlapping article Health insurance madate
Please note overlapping article with similar problems. Isthisuseful (talk) 17:26, 28 April 2012 (UTC)

Incorrect information on Canada
- The bulk of Canada's health care funding does NOT come from the provinces, but rather from transfer payments from the Federal Government to the Provincial Governments. - Wait times for procedures, diagnostics and surgeries vary widely from province to province and within provinces. The statistics given in this article pertaining to Canada are far too general at best and, most likely, inaccurate at worst. There is no current citation. Ntkahnert (talk) 20:06, 25 June 2012 (UTC)

Problem with "like medicare" in polling section
One of the main problems with the polling section is the claim that some of the polls were compared to Medicare. The section in question is that

"Many polls, such as ones administered through CNN,[57] AP-Yahoo,[58][59] New York Times/CBS News Poll,[60][61] and Washington Post/ABC News Poll,[62] Kaiser Family Foundation[63] showed a majority in favor of a form of national health insurance, often compared to Medicare."

For one, only 4 of the 17 polls (3 that are used in the article) actually compare it to Medicare. The other problem is that Medicare is a form of single-payer and says as much in both this and the Medicare article.

Saying whether or not a single-payer option is "like Medicare" is like saying single-payer is "like single-payer". I don't think we should remove the fact-check citation but we definitely need to remove the "often compared to Medicare" and replace "national health insurance" with single-payer (especially since the AP poll was directly asking about single-payer without mentioning Medicare and there aren't other real "national health insurance" plans other than single-payer). CartoonDiablo (talk) 01:48, 26 June 2012 (UTC)
 * That doesn't reflect the wording in the polls or the wording as understood by respondents. We must go with what the sources say - anything else is original research.  With this said, separating out the polls that say "like Medicare" from those that do not for clarity would be a reasonable compromise, but I'm not convinced it's necessary.   Thargor Orlando (talk) 03:40, 26 June 2012 (UTC)
 * First of all what you did was revert it and in the process reverted the addition of another poll. Secondly you completely avoided the fact that only 3 of the 17 polls actually used the words "Medicare" so saying "often compared to Medicare" is not accurate.
 * But more importantly, The polls were cited in numerous sources as being polls on single-payer. For one, the AP-Yahoo one directly used the words "single-payer" and what other "national health insurance" exists? If Americans weren't supporting "single-payer" on the polls what were they supporting?CartoonDiablo (talk) 05:42, 26 June 2012 (UTC)
 * The public option was considered "national health insurance" because that's what it was - insurance, offered nationally. To give an example, your "question 49" on the ABC poll says "national health insurance...like Medicare."  NOT single payer.  Saying that the poll shows support for single payer is completely 100% false, as it did not ask about single payer.  You've ignored the rest of my point.  Regarding your new poll, the way the LAT positions the poll is not how they asked it - the question never asks about single payer, but "national insurance" "like Medicare."  The current wording cannot stay, as it is factually inaccurate.  Thargor Orlando (talk) 12:26, 26 June 2012 (UTC)


 * I'm not talking about the ABC poll; I'm talking about the 2007 AP-Yahoo poll and the 2009 Time Magazine poll. And that aside, you might want to check the public option article which never uses the phrase "national health insurance" nor has anyone on the subject called it that.


 * The point with the "like Medicare" comparison is it's like asking whether it's "like single-payer" Medicare is single-payer. It's why outside the context of the fact check citation it shouldn't even be mentioned. Also a comparison to Canada and England is used about as much as the comparison to Medicare. That and most of the plans you seem to think are just "national health insurance" and not single-payer directly compare themselves to Canada including phrasing about "guaranteed coverage."


 * The bigger point of course is that you are not a healthcare expert or an RS. Multiple sources have called all them "single-payer" polls including the one now and PNHP. No one has called them "national health insurance" or "government in various levels of healthcare" polls. The obvious POV wording is the one that exists now. CartoonDiablo (talk) 17:10, 26 June 2012 (UTC)
 * We need to go off the actual poll wording, not the spin by the writers on the poll. The LA Times one you added, for example - the overview wrote "single payer," but they never asked that.  Why?  Because people do not perceive "Medicare" as "single payer."   Because when single payer is asked, it tanks.  Another option, as opposed to using misguided, inaccurate spin from media players - offer the polls as the question was asked?  Thargor Orlando (talk) 17:21, 26 June 2012 (UTC)


 * So the 2007 AP-Yahoo poll tanked? How about the polls that compared it to Canada and England? The bigger question is, are Medicare (US) and Canada/England single-payer systems? And if so, why don't simply call them single-payer polls when two sources are doing that. CartoonDiablo (talk) 17:38, 26 June 2012 (UTC)
 * You're right on the AP poll, so I'll make that change. The comparison ones don't tell us that, and the "bigger question" is not "are they single payer systems" but rather "do voters recognize them as single payer systems."  It's why we get diverging results when the questions are asked a certain way. Thargor Orlando (talk) 18:28, 26 June 2012 (UTC)


 * I think asserting that voters do not recognize the polls as single-payer would count as WP:OR since (a) all the sources list them as "single-payer" polls and (b) no source has said that Medicare (US) or Canada/UK are not single-payer systems or that supporting Medicare etc. wouldn't be supporting single-payer etc. The other problem is just language, if we assumed voters didn't know we would have to specify on every poll that was "like Canada's system" or "like Medicare" which itself would be burdensome.


 * I took a third way and created a chart. CartoonDiablo (talk) 00:05, 27 June 2012 (UTC)
 * This works. I would, however, consider removing the three-state Quinnipiac as it's not national.  Otherwise, good job on this. Thargor Orlando (talk) 02:59, 27 June 2012 (UTC)

Need unbiased author
This article is written more as a promotion than an explanation, citing benefits without corresponding detriments. It also features images that advocate a single-payer healthcare system, as well as poll results showing its favorability, both of which further erode its credibility. Given that this article should be informative rather than persuasive, I recommend deleting the entire article unless it can be rewritten by someone who doesn't have a vested or political interest in the subject. KiloVoltaire (talk) 18:18, 30 June 2012 (UTC)KiloVoltaire
 * I don't disagree - any suggestions? Thargor Orlando (talk) 21:01, 30 June 2012 (UTC)

"Right wing polls"
My restoration of the old prose section was reverted, claiming that it used "right wing polls" to "mislead." What data was missing? What "right wing polls" are being used that make my prose section (with essentially identical data) problematic as compared to the table? Thargor Orlando (talk) 16:51, 11 October 2012 (UTC)
 * The content you put in used push polls to skew responses. They gave a misleading impression of how much Americans would rather have a single-payer system. -- Scjessey (talk) 17:10, 11 October 2012 (UTC)
 * Can you please be more specific? The table section is merely the polls in the prose organized into an unsightly mess.  If there are polls to add to the prose, by all means, but this idea that there's a skew isn't evident. Thargor Orlando (talk) 17:25, 11 October 2012 (UTC)
 * The Rasmussen poll is a push poll. It's designed to make it seem as if American's don't want single-payer, when they clearly do. -- Scjessey (talk) 13:22, 12 October 2012 (UTC)
 * Rasmussen is not a push poll, it's a respected, widely-cited organization. That you dislike their results is one thing - that the version you reverted back to includes it anyway tells me that we shouldn't have an issue. Thargor Orlando (talk) 02:33, 13 October 2012 (UTC)
 * Scott Rasmussen is respected by the right-wing, but every organization familiar with polls knows that Rusmussen polls always skew a point or two to the right. But that's not the issue. The problem here is that the specific poll used here is a push poll, with questions designed to get a result favorable to interests against single-payer health care. As you can see from the list of polls helpfully provided by the 31.170.166.18 below, the Rasmussen result is an outlier. Your version of the wording assumes this outlier is the norm, whereas the other version of the wording correctly does not ascribe too much weight to the Rasmussen result. Anyway, there's no consensus for your change to the existing wording. -- Scjessey (talk) 13:56, 13 October 2012 (UTC)
 * Where's the consensus against it? And you have no proof of it being a push poll, just your long-standing political biases.  Thargor Orlando (talk) 19:40, 13 October 2012 (UTC)
 * It was rewritten, and then you reverted it because you didn't like the way it was worded. America wants single-payer and that outlier poll doesn't reflect reality. Please stop using Wikipedia to further your agenda. -- Scjessey (talk) 19:53, 13 October 2012 (UTC)
 * Where is the evidence that America wants single payer? Even Politifact rates that false. Thargor Orlando (talk) 22:05, 13 October 2012 (UTC)
 * Click on the link left below by 31.x. -- Scjessey (talk) 14:21, 14 October 2012 (UTC)
 * Yeah, most of those polls aren't about single payer. Thargor Orlando (talk) 15:17, 14 October 2012 (UTC)
 * LOL. One of the polls (the last one) is not about single-payer. All the rest are. You're killing me, Thargor. -- Scjessey (talk) 15:23, 14 October 2012 (UTC)
 * Really? Is single payer "universal health insurance?"  Is it something as simple as "guarantee health insurance for all" or does that imply something more for the questionee?  By your logic, anyone who was in favor of the "public option" was actually in favor of single payer.  There's a reason Politifact considers your belief generally false.  So are you still going to fight this, or are you going to accept the facts? Thargor Orlando (talk) 19:20, 14 October 2012 (UTC)
 * You are wrong or unable to read or both. The polls in that link all talk about full health coverage paid for by the government in one form or another. That is single-payer. Maybe you don't understand the meaning of single-payer? -- Scjessey (talk) 22:18, 14 October 2012 (UTC)
 * That's actually not the wording of many of them at all, and Politfact shows fully well how that wording changes people's perception. Thargor Orlando (talk) 23:56, 14 October 2012 (UTC)

has a comprehensive list of polls from 2007-2010. 31.170.166.18 (talk) 16:53, 12 October 2012 (UTC)
 * For the sake of reference, about six different sources consider all those to be single payer polls (including the Rassmussen one). CartoonDiablo (talk) 19:24, 14 October 2012 (UTC)
 * Yet none of them actually are. Thargor Orlando (talk) 19:34, 14 October 2012 (UTC)
 * You're wrong. As usual. -- Scjessey (talk) 22:18, 14 October 2012 (UTC)
 * This is where the person who wants to include the information needs to prove it. Thargor Orlando (talk) 23:56, 14 October 2012 (UTC)
 * No, this is where the person who wants to revert the page to an earlier version that was changed because the earlier version was wrong and gave too much credence to a deceptively-conducted push poll needs to explain himself. America wants single-payer. Get over it. -- Scjessey (talk) 00:00, 15 October 2012 (UTC)
 * Rasmussen's not a push poll. Your entire protest regarding the source is inaccurate, as is your concept of the facts.  Unless you can back up your claims with evidence, you're going to be reverted.  Remember: "the burden of evidence lies with the editor who adds or restores material."  You want to restore material that gives an improper viewpoint of the actual facts, you're responsible for justifying it with evidence.  Thargor Orlando (talk) 00:05, 15 October 2012 (UTC)
 * Of course it is a push poll! It was conducted at the height of the Occupy Wall Street protests (which the poll focused on) with the question about single-payer snuck in at the end. Plus it was only 1,000 adults in a telephone-only poll. It in no way compares to the vast body of polls before or since that have concluded that Americans want single-payer. Honestly, you must be extraordinarily gullible to not see this. In any case, your nonsense about burden is ass backwards, since it is you who are trying to change an established section. Your "reversion threat" is meaningless and your tactics are transparent. -- Scjessey (talk) 01:34, 15 October 2012 (UTC)
 * Actually, there were 9 questions from the poll - two about Occupy, 7 about issues Occupy purportedly cared about. The single payer question was not a "push poll," nor is anything else Rasmussen does.  More to the point, it largely matches other polls Rasmussen has taken over the years:   .  You're opposing facts here, and it can't stand. Thargor Orlando (talk) 01:47, 15 October 2012 (UTC)
 * Well it isn't a surprise to me that you should believe that. Nor is it a surprise that you should latch on to the single poll in the field that yields your chosen result. -- Scjessey (talk) 13:59, 15 October 2012 (UTC)
 * A vast majority of the polls yield "my chosen result." That's why it's "my chosen result."  Meanwhile, even the left wing types who dislike Rasmussen don't call it a push poll, for pete's sake.  That's POV pushing of the worst kind, and a claim, like everything else you've tossed out there in the last few days, that lacks supporting evidence.  Will that be forthcoming? Thargor Orlando (talk) 14:06, 15 October 2012 (UTC)
 * You're interpretation of reality is fantastic and quite wrong. I will no longer be responding to your fantasy land comments since they don't make any sense. I'll patrol this article to make sure you don't use it for your agenda though. -- Scjessey (talk) 14:10, 15 October 2012 (UTC)
 * So that's a no, you won't be providing evidence for your claims? You will be ignoring basic verifiability policy? Thargor Orlando (talk) 14:19, 15 October 2012 (UTC)

Lack of any response at the NPOV noticeboard
Given the severe lack of response at the NPOV noticeboard after over a month of opportunity, I assume the protests are no longer in play here? Thargor Orlando (talk) 15:29, 19 December 2012 (UTC)
 * With no further complaint... Thargor Orlando (talk) 15:15, 27 December 2012 (UTC)
 * After two months of no commentary here, and two months of no commentary at the NPOV noticeboard, CartoonDiablo decides to simply revert a change that has no further protest, yet again. Explain yourself, please, or leave those of us who want to improve these articles to do so. Thargor Orlando (talk) 14:30, 28 December 2012 (UTC)