The barriers to single payer health care

It occurs to me that there are several barriers to single payer health care, among them being huge damage payouts to patients who sue medical practitioners and the astronomical cost of educating doctors, which in turn causes a severe shortage of, in particular, primary care physicians, who are not as handsomely paid as specialists are. These days most medical students choose to go into a specialty, since those fields pay more and young doctors need to start paying back their student loans that amount to hundreds of thousands of dollars. On top of that, they must carry substantial malpractice insurance, so it makes financial sense for a young medical student to pursue high paid specialist jobs. Unfortunately, there remains a serious shortage of badly needed primary care physicians, particularly in underserved areas. Too many low income and uninsured patients end up using expensive emergency rooms for primary care visits since they can't get to a regular doctor's office. Folks like me who carry insurance end up footing the bill for these folks in higher premiums, deductibles and co-pays. So what's it going to take to wrestle health care under control? Well, it's complicated and I do not pretend to have all of the answers, of course. But let's start with the idea that it costs so very much to educate a doctor. I do not know what the answer is there, but I do know that it's a significant factor in driving up the cost of health care, as are the many medical lawsuits and heavy payouts to patients who see nothing but huge financial rewards for their troubles. So perhaps some form of tort reform is needed as well. And then there are the insurance companies who saw a huge profit in selling health insurance and basically calling the shots as to who can have what treatment and at what price and how often. They've essentially taken over for doctors and have the power to tell a doctor, yes, you can use this treatment for a patient, or no you can't, because that treatment is too expensive and we won't pay for it. They basically have medical professionals over a barrel. They call the shots and the health professionals must obey. It sucks, but that's the way the market runs now. So why have we let this happen? Why have we let insurance companies play doctor instead of letting our doctors call the shots and treat our ailments? And why hasn't there been more focus on wellness and prevention instead of waiting until someone is so sick that they require expensive treatments to make them well again? Because there's no profit to be had in a healthy patient, that's why. More is to be made using expensive name brand drugs instead of cheaper generics. More can be made in the fee-for-service mode than in results and outcome. Better to keep the patient sick and seeing doctors than in preventing that patient from becoming ill in the first place. And for crying out loud, let Medicare negotiate for cheaper drugs as well. Big Pharma is also part and parcel of the problem in that they also make handsome profits from patients staying sick and needing their expensive and overpriced drugs. So there are a number of things wrong with our health care system that need to be addressed and it's incredibly complicated and there are no easy answers out there, but getting the rapacious insurance companies and lawyers out of the picture and finding some way to reduce the cost of a medical education to where doctors don't feel so compelled to go into high paid specialty fields is a start. It's a many headed Hydra that is going to need to be wrestled and I don't have the answers on how to fix the problem, just some ideas of what has gone wrong and what we need to look at in order to bring health care under better financial control before it destroys our economy.