>>>> If the government is guaranteeing it'll pay, why give them a price break?
>>> Because you want to stay in business and there are other healthcare providers the government could use instead?
>> Okay, now suppose that you have a patent on a particular drug or device or procedure and as a result are the monopoly provider of it. Where does the government go to get the lower cost alternative? Where is the downward pressure on your prices?
> Please refer to my points re subsides, loans and limits. These are not insurmountable problems.
So first you say that market forces will still be in play because the government could always go elsewhere. Then when provided with an example of a situation where market forces cannot come into play, you suggest that legislation can fix it. That is EXACTLY what tptacek was the problem, the loss of MARKET incentives and information.
> I'm not sure I follow. Price signals are based on demand.
No, no they're not. They're based on supply AND demand. This is literally econ 101. http://en.wikipedia.org/wiki/Supply_and_demand
Normally demand goes down as price goes up because more and more entities get priced out of the market. With the government as the sole (or very nearly sole) buyer demand is constant because the government quite literally has a mandate to supply healthcare to the citizens. That means that suppliers have no incentive (short of avoiding legislative action aimed at them which they can cheaply and easily dodge through lobbying) to bring prices down. It's in their interests (read profit motive) to supply as much as they can at as high of a price as they can. This is the problem that people are talking about.
> 1. If the government is guaranteeing it'll pay, why give them a price break?
Why indeed? The threat of legislative action? See my comments above re: lobbying. Got a way around that? Most of the population of the US would be VERY interested to hear how you circumvent it. So far the only halfway viable strategy is what Lawrence Lessig is doing with mayday.us and that's a long way from making it a solved problem.
2. If the reason is passing laws saying you have to give them a price break (as you imply in paragraph 2), how is that not price fixing?
Again, see comments re: lobbying. Unless there is no possible way to circumvent the lobbying problem you're simply proposing that we replace one broken system which you dislike -- and rightly so, it's not that great -- with another broken system which you like. Sure you like it better but others do not. We're at the point of arguing about opinions.
"But other countries do it just fine!" you say. Okay sure, but which other countries with single payer systems have the kind of demographics that we do here in the US? Answer: none. They're all relatively small countries (relative to 310mm people) with rather homogeneous demographics (again at least compared to the US).
It MIGHT work OK and it MIGHT not be more broken than the system we have now but those aren't guarantees.