Reply #140: It's about the incentive structure and not having the 100% reimbursement is a good idea [View All]

Basically, the sicker you are, the more your expenses are reimbursed by the government. Thus, essential treatments get reimbursed at 100% and less essential treatments get reimbursed at a lower rate. Under single-payer everything that is covered would presumably get reimbursed at 100%.

There's a good article about it here. http://abcnews.go.com/Health/Story?id=4647483&page=1

The woman was saying that because she had cancer, her expenses were 100% paid for by the government. This ensures that anybody who needs these essential cancer treatments gets these essential treatments. Less essential treatments are not 100% covered, probably closer to 80%. The private supplementals pay part of the difference, I believe. I think the government also subsidizes those that can't really afford private insurance.

But the point is that if you want a non-essential treatment, you still have to pay something and that is a good incentive structure because some people will choose to save their money and not get the non-essential treatment. This means that fewer doctors, nurses, and hospital equipment will be used for non-essential treatments and more used for essential treatment.

The biggest cultural problem is the fact that doctors make a lot less in France and also that they don't pay for medical school. But that would be a problem if we implemented single-payer as well because doctors probably wouldn't make as much, either.