I was challenged by a friend about finding a “real” downside to having a single payer health care system. My problem was… where do I begin. They even have this 10 Point Meme that is circulating the web promoting Single Payer. The problem is that 9 of the 10 points are completely false, or at best refutable.
First I will start with the philosophical construct of single payer fails at the start. Not everyone will ever be receiving the same level of services nor paying the same level into the system. This is something that some of their supporters only learn after a SPHS has been put into place. I have investigated many of the systems in place throughout the world today, and this always holds true.
Next, almost all of these systems involve total participation with aggressive government penalties for non-participation. Non-participation is rarely, if ever, an option in those countries that institute SPHS. To Libertarians, like me, our porcupine spines bristle at the thought of being denied choice of participation and being forced to hand-over more of our personal earnings.
The concept of lowered health care expenses is ludicrous, on the face of it. We are talking about a group that purchases $1200 hammers and loses Trillions of dollars in undocumented transactions. I am hard pressed to find any precedence showing a government entity being able to control costs in any sector nor en-devour. Where is the history to substantiate this claim?
The apex of health care standards maybe disputed by those with an ax to grind, but an article in Der Spiegel in the 1960’s was the gold standard in espousing the American health care system. I only wish that I could find the original article, but it has stuck in my mind 50 years later. Every time I would read about another pharmaceutical or medical advance from Germany; I deduced it was from the desire to meet and exceed our former greatness. While many of the Western European countries struggle with their public health care programs, the more loosely regulated private heath care industries thrive.
Not surprisingly, I found that almost all of these SPHS’s had a much hidden free-market loop-hole in their regulations. This loop-hole allows for those to go outside of their system and pay out-of-pocket for services… if they choose. Often, government officials are provided a health care stipend so that they can purchase premium health care for outside services. So, once again, government insiders and the wealthy get better care… with our money.
Most of the data on standards of care omit a key factor, time. These systems all had convoluted triage procedures further complicated by access and availability problems. This is where theory, often, does not meet reality. The government’s could not build in an incentive for private industry to build and staff medical centers and labs to meet demand. Often, they unwittingly created disincentives and facility closings critically hamper services.
Finding usable and factual data concerning SPHS’s is frustrated by biased recording and reporting. Most of the data is supplied by the actual departments, bureaus and agencies that oversee these programs. Casting themselves in the best light is of greater priority than bench-marking for measuring patient care quality and time-of-care.
I am not going to say the obvious, that the benefits of Single Payer is virtually non-existent. However, any and all of the proponents of the plan are either misleading… or have been mislead, in their talking points. Any, and all, of their points can be successfully challenged. Therefore, you will seldom find a civil discussion about the matter.
My parting concern to all, is my tired example, of the problem with 3 wolves and 2 sheep voting on what to have for dinner. If we ever are confronted with another unpopular passage of health care legislation, like we were 8 years ago, the sheep could become lions. Especially if it is a Single Payer type of legislation. The Libertarian hearts would come alive. My fear, is that the government would become more aggressive and totalitarian in response.
So, let us try to squash the idea of Single Payer by disseminating pamphlets, creating public service advertisements and educational videos to inform the populace. Again, when aggression is exercised… it is usually a sign of a weak position.