The Senate healthcare bill now on life-support may, like RyanCare before it, be revived through the injections of public money and minor policy variations needed to move recalcitrant conservatives off Stop. Unfortunately, both the House and Senate versions of the bill accept the idea that government has a natural role in health care delivery and therefore pave the way to single-payer health care -- and, politics aside, an American single-payer system would be a disaster for the world.

The problems with single-payer are neatly captured by two well-known sayings: that he who pays the piper calls the tune, and that power, particularly absolute power, corrupts.

Single-payer systems replace the health care customer with the government customer -- and the government customer cares about meticulously completed paperwork, not health care outcomes. In effect, what happens when government gains control of the payment stream is that the payment stream is then used to control health care delivery, and that control soon reflects bureaucratic needs at the level of expenditure control and political needs at the level of program approval.

The resulting incentives produce a system that has built-in cost escalators (Canada's system now runs about $4,700 USD per person per year); is highly routinized, instinctively secretive, unresponsive to patient issues, and stripped of any recourse within the system for those it fails to serve -- like the VA, only much worse.

In countries like Canada and the U.K., however, where the public has easy access to information about drugs, procedures, and expertise available in the United States, the nationalized health services cannot long deny a widely available American breakthrough therapy regardless of its cost or undesired organizational consequences because patients with adequate resources can seek help in the United States -- and those with access to media can then embarrass the government by publicizing this before or after their return home.

Take that control away, however, and these nationalized systems would more generally look like Cuba's: widely heralded in the press as cheap, caring, and wonderful, but really offering 1950s medicine for all but those few with the resources to moor their yacht in Miami harbor or access a special clinic staffed by people from United States or Switzerland.

It is competition-driven American innovation that drags nationalized health care in the rest of the free world forward -- and that reality works both ways: if the complete list of successful (i.e. effective and widely accepted elsewhere) health-care innovations in the English-speaking world outside of the United States that were not driven by the potential for access to the American market would leave empty space on a postcard. How long do you think American medical, surgical, or organizational innovation would continue under an American single-payer plan?

The answer to that is pretty clear -- and that's the key reason thinking people around the world want Republicans to actually kill; not extend, improve, or fix, the disaster that is ObamaCare.