Single Payer IQ Test – Question 2: What if the single payer does not authorize a service?

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Answer: If the condition is “covered,” it could be illegal for anyone other than the single payer to pay for treatment—so it will be unavailable.

Charlie Gard, not Billy Kimmel, is the face of single payer.

Britain’s National Health Service (NHS) not only denied baby Charlie treatment for his rare genetic condition, but refused to allow his parents to take him to the U.S. to receive a new treatment that had helped some babies with a similar diagnosis—even though the parents had raised the funds to pay privately. The chance of benefit steadily diminished over the months while hospital lawyers fought against the parents’ appeals to courts. Charlie never got a chance at treatment, and he died in hospice.

Some Americans support the stance of the NHS. Dr. Robert Truog of Harvard Medical School told the New York Times that the Charlie Gard case “was being seized upon by some to affirm a money-driven system in which patients who have the means can pursue experimental treatments, even if the chances of success are slim.” In his view, “experimental treatments must be weighed against the benefits for society as a whole.” [1]

Under the U.S. single payer—Medicare, one may purchase non-covered luxury treatments such as cosmetic surgery from enrolled, non-opted-out “providers,” and pay privately. But it is criminal fraud for enrolled physicians to provide “unnecessary” or unapproved covered services, or to accept payment above the allowed amount, even if $0.00 is allowed.

Managed-care contracts have an “enrollee hold harmless” clause, which means that if the Plan denies payment for a “covered” service, no contracted provider may accept payment—and the patient will do without and possibly die, [2,3] unless an independent physician or facility can be found. U.S. single payer will almost certainly be administered by managed-care giants.

Single-payer proponents like to speak of “everybody in, nobody out.” Letting people out, it is feared, would lead to a dreaded “two-tiered system” with “boutique care for the wealthy and mediocrity in a neglected system for the non-wealthy,” as described by Physicians for National Health Program (PNHP).

Single-payer Canada has a two-tiered system, with the better tier located in the U.S., where politicians come to get their heart surgery. Canadians cannot spend their own money in Canada. [4]

The “Jimmy Kimmel test”—coverage for a child like Billy Kimmel with a “pre-existing” congenital heart disease—for the goodness of a health bill is quite ironic. The child of a politically correct celebrity comedian will not be in Charlie Gard’s position. The single payer’s tiers will be determined by political favoritism.

Take-home Lessons:

  • The faceless single-payer calculates the value of your life based on benefits to “society.”
  • The single-payer determines what treatments are “necessary” and “appropriate” for you.
  • Unauthorized life-saving treatments under single payer are available only offshore or on the black market.
  • Single payer wants to keep you from getting something better than others get.

References:

  1. Truog RD. The United Kingdom sets limits on experimental treatments: the case of Charlie Gard. JAMA 2017;318:1001-1002.
  2. Lobb F. The Great Health Care Fraud. Nottingham, Pa.: KimKris Publishing; 2012.
  3. Lobb F. Too Big to Be Legal: Your Mandated Health Insurance. Nottingham, Pa.: Lobb’s Analytical Works; 2014.
  4. Kurisko L, Racer D. What America needs to learn from Canadian medicare. J Am Phys Surg 2009;14:46-48. Available at: http://www.jpands.org/vol14no2/kurisko.pdf.

Printable PDF of Question #2: https://goo.gl/9WDynq

Single Payer IQ Test Question Archive: https://aapsonline.org/category/hcriq/

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