What is Single Payer?

What is Single Payer?

It is a national health program. The government taxes earnings. The people go to doctors. Doctors bill the government. The government health agency pays the doctors with the money they took from the earners. The government is the “single payer”, the only way for doctors to get paid. Government is the big cahuna, the only game in town. Australia, Canada and Taiwan have it. Other nations have other versions of socialized medicine.

Is it socialized medicine? Yes. Margarita McLarty denies it. She wrote a letter to the editor in the Bozeman Daily Chronicle. It appeared May 25 or 26. She wrote: “What is ‘single-payer health care’? It is not ‘socialized medicine’. You get to choose your health care providers.” In doing so, she parrots the Physicians for a National Health Plan (PNHP) statement.

I disagree. It is socialized medicine. Whenever the government takes money from you, pools it with other peoples’ money, and spends it according to their choices, that is socialized medicine. Imagine a similar system in the provision of food. The government takes $400 a month out of your paycheck. You go to the grocery store. You walk out with food. The government pays the grocery store for what you took. When taxes collected are not enough, what you’ll be allowed to carry out will be determined by the government. This system is not voluntary. It does not empower individuals. It is a collective system. Thus, it is socialized medicine. Collective systems are socialized systems.

McLarty and PNHP claims people will be able to “choose your own health care providers.” Pick your doctor. Stand in line. If he or she is too busy, what then? Stand in line. No, that will not work. The doctor will say, “Not accepting new patients.” This happens in Canada all the time. So you go to another doctor. But he or she is busy. You get to choose any doctor who is not overwhelmed by the huge new demand created by people not paying their own bills. Good luck finding one.

Image a cine-plex. You have a movie voucher. You can choose any movie you want as long as there are seats. When all the seats are full, how much choice do you have? Unlimited “access” to the movie theaters will cause demand to burgeon. Good luck getting in. Get in line. That will be the nature of single-payer. Get in line. Try to find services. Wait. Take a number. Some person with a sniffle takes the doctor’s time, while you need a tourniquet.

The government will have to step in. They will decide how this scare resource, doctor’s time, will be fairly apportioned. They will limit what doctors can treat, so as to put some constraints on demand. They will figure out ways of getting people in lines and waiting lists. This is rationing. It’s the way they did it with meat and cheese during WWII. If voluntary market-based systems are not employed, someone has to ration to satisfy the amplified demand. That falls to the single-payer, the blessed, all-wise government.

The American Medical Student Association, AMSA, definition for single payer is: “Where both the collection of funds and the reimbursement are the responsibility of one entity: the government”. Comforting isn’t it? The government does everything. A few clarifications are needed. “Collection of funds” means taxes. Taxes are taken from workers. One way not to pay is not to work, a course some will take. “Reimbursement” means payments to doctors, hospitals and pharmacies. The government sets the amount. If the amount is set low, doctors will become farmers and researchers will not invent new drugs. “Responsibility” is a strange word to invoke in a system which shifts responsibility so radically away from individuals, families and providers, to an enormous, politically vulnerable entity. Government will make life and death decisions based on the politics of the moment.

Government sets the tax rates workers pay. Can workers opt out? No. If you want a service the single payer doesn’t cover, and if it is still legal to choose it, you will pay for it directly, in addition to the taxes taken from you.

How much will the tax be? No one knows. Advocates say it will be a modest increase in expense so that the presently “uninsured” will get coverage.  How much will single payer cost? Since $2 trillion was spent on medical services in 2006 (Kaiser Foundation), and there are 120 million private, non-farm employees, the cost per employee would be $16,666 each. Promoters of single payer are talking much lower tax rates. That’s promotion. Don’t believe them. Do some long division yourself.

Who pays? Workers. That leaves out youth, the unemployed, the very old, retirees. The incentive to choose unemployment increases.

Is it fair? Unemployed people will love it. A fat smoker will cost the system four times as much as an exercising non-smoker. They will pay the same tax. Fat people will think it’s fair; fastidious people will not. Fatness will pay.

How much will doctors be paid? Much less than nw. No one knows how much less. Bureaucrats will decide. They will frequently change their minds. Fewer people will choose medicine as a career.

Who loses their jobs? 3.2 million people in the health insurance industry. Also hurt are workers throughout the economy as economic activity slows down.

Are all Democrats in favor? No. Senator Max Baucus’ proposal is not a single payer plan, though it is socialized medicine of another flavor. It allows private insurance companies a role, at least until government decisions make them uncompetitive. Single payer advocates are livid. They want the whole enchilada. They attack Obama, too. He promised single payer but now supports the Baucus plan. Advocates are even mad at their comrades in the unions, the SEIU, Service Employees International Union. (The word International in their name signals their solidarity with international workers. Recall the Comintern, which was shorthand for Communist International. To know the enormity of communism’s crimes, consult The Black Book of Communism.) SEIU workers are going door-to-door drumming up support for the Baucus plan.

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One Response

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