A Single-Payer System Won't Work. Period.
Every few years, the media gets low on ammo and decides they’re going to make a collective push to talk about bringing a single-payer healthcare system to the United States. And every few years, people who understand economics and business have to point out to them that it won’t work. This is one of those times.
What is Single-Payer Healthcare, Anyway?
When a term gets used so frequently for so long, it’s easy for there to be some misunderstanding. While the idea of single-payer healthcare gets thrown around a lot, would you be surprised that many people don’t even understand what it is? This results in confusion, misguided statements, and clouded judgment. So let’s clear this little issue up before systematically pulverizing the idea into a million pieces.
Single-payer national healthcare -- or “Medicare for all,” as Senator Bernie Sanders calls it -- is a system in which a single public organization or government entity finances healthcare for the entire population of a country, while the delivery of the care remains in private hands.
Quickly pause for a second and just think about that. Under a single-payer system, the government -- a convoluted, bureaucratic, slow-as-molasses, doesn’t-understand-how-to-spend-money organization of bickering career-politicians -- is tasked with financing healthcare for all. Okay… moving on.
Under a single-payer system, every American would have all “medically necessary” services and costs covered. This would include doctor visits, hospital stays, emergency room visits, preventative care, cancer treatment, dental, vision, and prescription drugs.
The money to support medical expenses of American citizens would be funded by implementing what proponents call a modest tax on the public. There would be no deductibles or premiums and almost every household would save money.
Proponents are also quick to point out that patients would be able to retain their doctors and choose which medical facilities to use. (If you’re scratching your head and thinking you remember a former president telling you the same thing, you aren’t crazy.)
Single-payer healthcare is not the same as Obamacare, which many on the left seem to be confused about. The Affordable Care Act (ACA) expanded coverage by requiring people to buy private insurance policies that were partially subsidized by government payments and an expansion of Medicaid. However, there are still millions of uninsured people, tens of millions of underinsured people, and millions more paying steep premiums, deductibles, and out of pocket expenses.
If you thought ObamaCare was a radical move, a single-payer model would flip the entire healthcare system on its head and change everything.
Here’s Why a Single-Payer System Could Never Work
The left tries to play emotional politics when it comes to healthcare. They tell you that you’re hateful if you don’t believe in the morality of a single-payer system where everyone’s health problems are covered. But what they won’t admit is that we live in a world of constraints, where things like money and resources are very tangible and finite.
Would it be great if everyone’s healthcare needs were automatically fulfilled without a penny ever changing hands? Absolutely! It would also be nice if money grew on trees and Willy Wonka’s Chocolate Factory was a place you could take the kids on a rainy Saturday afternoon.
Here’s why a single-payer system will never work.
1. Enormous Tax Burden
Let’s start by debunking the idea that a single-payer system could be funded by a modest tax on the one percent. According to Urban Institute, a nonpartisan group that looked at Senator Sanders’ proposed health plan, a single-payer system would raise government spending by $32 trillion over a decade. As the Washington Post recently pointed out, this number was so massive that even a socialist like Sanders couldn’t reasonably begin to talk about the plan with concrete numbers.
Even for California, where a single-payer initiative recently passed the State Senate, the cost would be $400 billion annually. It doesn’t matter how you slice it, a modest tax wouldn’t begin to make a dent into the total cost.
2. Lack of Motivation in Medical profession
Motivation is what keeps businesses growing. It’s why innovation is a natural byproduct of capitalism. When the sky is the limit and your earning potential is unlimited, you’re much more likely to work hard. The issue with a single-payer system is that it would destroy motivation in the medical profession. This is something we’ve already had a taste of thanks to ObamaCare.
“As a frame of reference, for every dollar that a private plan would pay, Medicare typically pays 80 cents and an ACA plan will pay 60 cents,” Boost Health Insurance notes. “To add fuel to the fire, many patients with a new plan through the marketplace tend to be sicker and they take up more time from the physician. Not only are they making less money on the new patient population, but they are spending more time with them during the consult.”
As a result, the ACA has caused many doctors to turn patients away and only accept those who allow them to keep the lights on. Can you imagine what a radical single-payer system would do? Every ounce of energy and motivation that remains in the industry would be zapped up.
3. Long Wait Times
Proponents like to point to Canada when discussing why a single-payer system would work here in the U.S. And while, yes, the system technically functions, it’s a total mess. The biggest problem is the wait time.
According to a survey by the Fraser Institute, the median wait time for “medically necessary” treatments and procedures was 20 weeks in 2016. That’s five months! In New Brunswick, the wait time is just shy of 39 weeks. Can you imagine? No wonder so many Canadians come across the border for healthcare.
While medical services aren’t exactly on-demand in the U.S. right now, they’re certainly much faster than a single-payer system.
4. Government Control
Finally, the biggest strike against a single-payer system is that it would give the government full and total control. While the claim from the left is that doctors would still retain autonomy, that’s not entirely true. The government would have a say over what’s considered a “medically necessary” service, meaning they could choose to fund or not fund certain types of procedures, medication, etc. And that’s an incredibly sobering thought.
Stop Fantasizing and Be Realistic
The problem with politics these days is that it’s all sensational. Politicians like Bernie Sanders throw out these whacky ideas, get millions of people to rally around them, and then fail to mention that they’re impractical. A single-payer system may sound great when blasted from a stage with music playing in the background, but it’s nothing more than interesting banter. (For the record, President Trump and politicians on the right are equally guilty of grandstanding and playing to the emotions of the crowd.)
It’s time to stop fantasizing about some sort of single-payer healthcare system. Could it technically be implemented? Sure, anything is possible. But when you look at the negatives and drawbacks, it’s crystal clear that a single-payer system would fundamentally destroy this country in more ways than one.
Can we finally stop with this talk of a single-payer system?