Why Single-Payer? And Why Now?
While the rabble on both sides of the aisle in Washington, D.C. and the embedded leftist media sycophants continue to wallow in gossip, tawdry tales, and ridiculous rumors regarding all things Trump, some in swamp are working diligently behind the scenes to not only sabotage all attempts to repeal Obamacare, but ensure that single-payer is the next best thing. The goal is simple: complete capitulation of health care insurance industry, in addition to totalitarian control regarding health care delivery in the United States. In order to accomplish this goal, an angry, fed up, and complicit American public is required. You may ask, why single-payer, and why now?
No need to argue that Obamacare is the precursor to single-payer. Fact is, Obamacare was passed by Democrats in Congress for the sole purpose of failing, in order to usher in single-payer. The Democrats have known this all along. Jonathon Gruber's admission that Americans are "stupid" was affirmed in a video in which Mr. Gruber explains that the "Obama administration passed the so-called Cadillac tax on high-value employer health plans by mislabeling it, calling it a tax on insurance plans rather than a tax on people, when we know it's a tax on people who hold these insurance plans. Americans would not support a tax on individuals, so we just tax the insurance companies, they pass on the higher prices[.] ... [I]t ends up being the same thing." The ruse, Gruber says, was "a very clever ... basic exploitation of the lack of economic understanding of the American voter."
Socialized medicine already exists in the United States. There are three versions: Medicare, Medicaid, and the Veteran's Administration (VA) hospital system. Medicare and Medicaid were the pet projects of President Lyndon Johnson, and in July 1965, Congress enacted Medicare/Medicaid under Title XVIII, tucked up under the Social Security Act to provide guaranteed health care to seniors, 65 and older, and low-income individuals. Medicare is funded by payroll taxes – both the employer and the employee contribute. In 2015, Medicare beneficiaries totaled 55 million people; by 2020, there will 79 million beneficiaries, due to the retiring Baby Boomer population.
Setting aside the explosive rise in the number of beneficiaries, two more overwhelming issues continue to plague Medicare; a reduction in the number of workers contributing to the Medicare fund in relationship to the increasing number of enrolling beneficiaries and an annual $50-million fraud, waste, and abuse price tag. Absolutely no one in Washington, D.C. wants to tackle Medicare fraud; it's simply part of "system."
Currently, there are about 3.1 workers contributing funds to Medicare for every one beneficiary. By 2030, there will be only 2.4 workers for every one Medicare beneficiary. Problem is, by 2020, the total number of Medicare beneficiaries will have increased by 24 million people. As they say, the writing is on the wall: by 2030, it's expected that the government will run out of money in order to cover even half of all Medicare beneficiaries' health care. John C. Goodman succinctly explains the long-range Medicare deficit.
The second version of socialized medicine in the United States is Medicaid. This program provides taxpayer-funded health care for 74 million low-income Americans (as of 2017). It's jointly funded by state and federal tax dollars, but it is managed on the state level. With the passage of Obamacare in 2010, significant changes occurred, impacting the administration, delivery, and number of persons eligible to enroll in Medicaid. As originally written, Obamacare mandated that all 50 states expand their Medicaid eligibility to include adults, dependent children, and qualifying disabled people. Furthermore, the income index was reconfigured at 138% of the poverty line, or $27,821.00 for a family of three in 2016. The mandate was challenged and elevated to the Supreme Court, which resulted in a decision striking down the mandatory state participation clause.
Despite each state's ability to opt out of mandatory expansion of Medicaid, total Medicaid expenditures have increased exponentially. The equation is simple: add more people to the program, and the cost of providing medical care increases. Under Obamacare, numerous tax schemes were supposed to cover Medicaid cost increases; however, the flood of tax money never materialized. In addition to a 50% increase in Medicaid participants, the CBO vastly underestimated the actual cost of providing health care to an expanded patient base. Author Brian Blase breaks down the numbers in his article "Obamacare Medicaid Expansion: A Lot of Spending of Little Value."
Presidents Lyndon Johnson and Barack Obama made unsubstantiated and fraudulent promises about the actual cost of Medicare, Medicaid, and the ironically named "Affordable Care Act." Both presidents lied, and they did it on purpose. Attempting to establish legacies, in truth, both men created financial debacles. It can't be emphasized enough as the national conversation for single-payer grows louder that Medicare, Medicaid, and Obamacare were sold to the American public based on blatant lies, unfounded claims, and woefully underestimated costs.
Finally, the third version of socialized medicine in the United States is the Veteran's Administration (VA) hospital system. It's the most inefficient, ineffective, and cruel form of medical care delivery in the United States. President Abraham Lincoln had good intentions when he lobbied to enact legislation to care for tens of thousands of wounded and injured Civil War soldiers. At the conclusion of the Civil War in 1865, Congress created the National Home for Disabled Volunteer Soldiers. Currently, there are 1,700 VA hospitals and clinics in the United States.
As with the two other socialized medicine programs in this country, the VA is replete with fraud, waste, abuse, and financial impropriety. The V.A. scandal in 2014 exposed stunning levels of corruption regarding appointment scheduling, poor patient care for veterans, and negligence and misconduct on the part of VA administrators, combined with exorbitant bonuses paid to VA staff to hide scheduling issues, negative statistics, and issues related to medical care accessibility. While some of the problems were immediately addressed by then-president Obama, candidate Donald Trump made numerous campaign promises to clean up the VA hospital mess.
In conclusion, socialized medicine is not working in the United States. The insolvency of both Medicare and Medicaid will be realized about a decade from now, if not sooner. The Democrats know this and are pushing a narrative: single-payer is the only solution to solve the looming fiscal disaster. While finally acknowledging that there are "issues" related to Obamacare, Democrats are refusing to work with Republicans in Congress in order to head off the pending implosion.
A handful of recalcitrant Republicans want a full repeal of Obamacare and nothing less; some Republicans will settle for Obamacare 2.0. The Democrats' only answer? Enact more convoluted, financially unsustainable legislation, based on failing socialized medical care programs, which will be insolvent in the near future.
Since the three current versions of socialized medicine in the United States aren't working, what could possibly go wrong by enacting single-payer – a renamed, reimagined socialized medicine scheme?