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Dissecting the single-payer healthcare system

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Phi est aureum Posted: Tue, Apr 16 2013 6:03 PM

 

So, today I received an envelope from an activist group that wanted me to sign a petition demanding the criminals in DC give us and force onto us a single-payer healthcare system. I normally just toss these types of things out, but I decided to take a peek at what they sent me. I got a "fact sheet" (that, as it turns out, contains few facts or sources of any kind) which is supposed to help convince those who are weary that a single-payer government-run health insurance is the way to go. I was amused by it, and am working on critiquing these points myself, but I figured that, since this appears to be the next proposal and set of arguments for further state control in the US, it might be worthwhile to post this and have others refute and challenge these claims. So, libertarians and those favorable to the free market, ATTACK!
 
Also, if anyone knows of any Austrians or other scholars dissecting the idea of single-payer government-run health insurance, please post links. I did a quick Google search and found very little.
 
Here is what the "fact sheet" says (I realize there is very little discussed in the means and layout of what they propose, but try to work with it):
 
"MYTHS AND LIES ABOUT SINGLE PAYER...
•Single payer is socialized medicine.
WRONG.
That would be the Veterans Administration. Or the British health care system. Where the government pays for the doctors and hospitals.
Under single payer, you get a health care card and you can go to any doctor or hospital in the United States.
Doctors are not employees of the government.
Hospitals remain in private hands.
You get free choice of doctor and hospital.
 
•Single payer will lead to rationing, like in Canada.
WRONG.
Right now in the United States, the private health insurance companies ration care.
If you don't have health insurance, you don't get health care. 50.7 million Americans currently lack health insurance.
That's why 120 Americans die every day from lack of health care.
There are some problems in the Canadian system, but most of what you hear about long lines is health insurance industry propaganda.
Zero people did every day in Canada due to lack o health insurance.
 
•Costs will skyrocket under single payer.
WRONG.
Single payer is the only health care reform that will save enough money to insure everyone.
By eliminating the health insurance industry, we save $350 billion a year in administrative costs and profits.
We then use that money to insure those who lack insurance and fully cover those who are under-insured.
Yes, more people will be seeking healthcare because they will now have insurance. But they will be taking care of medical problems early, thus preventing more costly treatment later.
 
•Drugs will be more difficult to get under single payer.
WRONG
The drug industry would have you believe that there will be less research and development under a single payer system.
In fact, much medical research is currently funded by the National institutes of Health.
Under single layer, this would grow.
Also, drugs would be cheaper under single payer.
When all patients are under one system, the payer wields a lot of clout.
For example, the Veterans Administration gets a 40% discount on drugs because of its buying power.
This single payer buying power is the main reason why other countries' drug prices are lower than ours.
Now you know why the drug industry is so opposed to single payer.
 
•Single payer will cover less than the insurance I have now.
WRONG.
For the majority of Americans, single payer will be a vast improvement.
All medically necessary care would be funded through the single payer, including doctor visits, hospital care, prescriptions, mental health services, nursing home care, home care, eye care and dental care.
An enlightened single payer will also result in a sharp increase in public health funding to prevent disease.
No more bills. No more deductibles. No more co-pays.
 
•Single payer will cost me more than I'm paying now for private health insurance.
WRONG.
The vast majority of Americans will pay about the same or less than they are paying now.
Instead of paying premiums to a private health insurance company, most of us will pay a similar or smaller amount in taxes.
So, right now, if you are paying $8,000 in premiums for a family of four with a $4,000 deductible, your yearly liability is at least $12,000.
You will probably pay less than that in taxes to fund a universal single payer.
There will be no deductible.
And you can go to see any doctor or check in to any hospital in the United States."

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Neodoxy replied on Tue, Apr 16 2013 6:11 PM

I'm generally indifferent to any argument that isn't free market healthcare vs. any other type of healthcare system. Ultimately, however, there's really no reason to believe that the federal government would be any more efficient at providing healthcare and any less wasteful at this task than it is at anything else

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Wheylous replied on Tue, Apr 16 2013 6:40 PM

Check out http://thelibertyhq.org/learn/index.php?listID=29 for some sources

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Silly question, but is single payer basically similar to a school voucher system?
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Silly question, but is single payer basically similar to a school voucher system?

I don't think it's a silly question; I suppose it is similar to a school voucher program. Single-payer means only one entity pays, or in other words is the customer, for health care, and that entity is the government. Everyone would receive the same care, hospitals and doctors would get paid according to government fee schedules, and everyone would pay more in taxes to cover this program and those that cannot afford the taxes (that is, don't have the wealth to be taxed) will be covered by higher taxes paid by others and, in all likelihood, ever-increasing rationing. It makes the government the one health insurance provider for all compulsorily. 

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We are already moving in the direction of single-payer food system. Almost 50 million people on food stamps

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Neodoxy replied on Tue, Apr 16 2013 8:11 PM

Yea but that's because the 1% are evil and they take all the money away from the 99% and so we're all poor and we need the government to solve it with taxes.

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Blargg replied on Tue, Apr 16 2013 8:28 PM

Presumably it makes it a crime for you to pay another person to administer health care to you. Utterly disgusting.

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Presumably it makes it a crime for you to pay another person to administer health care to you.

That is exactly how Canada works and exactly what you will eventually get.

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Presumably it makes it a crime for you to pay another person to administer health care to you. Utterly disgusting.

As far as I know, this is true. It has to be; it must be illegal to provide or bid for care not sanctioned and through government.

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Bogart replied on Wed, Apr 17 2013 9:57 AM

Who pays the single payer?  They never get around to mentioning that. 

What I find most interesting is there are 4 single payer healthcare system running in the USA right now at the Federal level: VA, Native American, Medicaid and the largest single payer health system in the world Medicare.  They curiously mention only one of these four.  I wonder why?  And of all four, Medicare is by far the most popular, why not advertise the benifits of it?  I will give my reasons:

1. VA is the most consistent and provides the best care at the funding rate of the system.  The issue with the VA is normally that people need/want a higher level of care and would be/are willing to pay more for it.  Also not mentioned is that the users in the VA do not get to pick their doctors or hospitals.

2. Medicare although popular faces a multi-trillion (Like over $50 trillion) dollary unfunded liability.  But more over the legions of old people know that if the govenrment expands this program or worse expands medicare, there will be less for these legions of old people.

3. The Medicare drug system is a complete financial disaster and entirely unfunded.

4. The other two systems suck: The Native American is not known for its level of care and has not gotten better over the decades.  Medicaid is falling apart as medical professionals in areas like Detroit leave the system.

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Jargon replied on Thu, Apr 18 2013 9:42 AM

@ Blargg

does the fact that it prohibits some people to individually contract each other unmolested necessarily effect the outcome, meaning the final result of the quality and quantity of medical care which citizens recieve?

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Jargon replied on Thu, Apr 18 2013 9:55 AM

@ Phi

In all honesty it probably wouldn't be much worse than our present system, which doesn't really say much about it. I believe that it would be easier for people to get care, but since all the costs would be socialized, a lot of unnecessary things would be insured and their prices would go up. People also would probably take care of themselves less thoroughly. It's a system which forces for some people to pay for the lifestyle choices of others. People probably wouldn't be stabbed by such manipulative insurance companies as they are today, but the Treasury would be on the hook for all of it, which means a sure recipe for yet more inflationism/borrowing.

There is another system which allows people to pay for the amount of risk which they accept in their life and also provides a good standard of medical care for anyone who works: a free market in medicine. Which we do not have today. Ours is a system riddled with artificially restricted supply (licensure in all things medicine, price-fixing, arbitrary bureaucracy, patents, unionism in medicine, prohibitory regulations) and artificially subsidized demand (mandatory insurance requirements, medicaid fueled by inflation, subsidy to non-profit hospitals).

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Autolykos replied on Thu, Apr 18 2013 11:17 AM

MYTHS AND LIES ABOUT SINGLE PAYER...
•Single payer is socialized medicine.
WRONG.
That would be the Veterans Administration. Or the British health care system. Where the government pays for the doctors and hospitals.
Under single payer, you get a health care card and you can go to any doctor or hospital in the United States.
Doctors are not employees of the government.
Hospitals remain in private hands.
You get free choice of doctor and hospital.

So their implicit definition of "socialized medicine" is "where the government pays for the doctors and hospitals". Okay. It would be nice if they made that definition explicit. Also, there's no correct definition of "socialized medicine", only different definitions.

•Single payer will lead to rationing, like in Canada.
WRONG.
Right now in the United States, the private health insurance companies ration care.
If you don't have health insurance, you don't get health care. 50.7 million Americans currently lack health insurance.
That's why 120 Americans die every day from lack of health care.
There are some problems in the Canadian system, but most of what you hear about long lines is health insurance industry propaganda.
Zero people did every day in Canada due to lack o health insurance.

It's not true that a person doesn't get medical care in the United States if he doesn't have medical insurance.

The above also seems to contain a sleight of hand. First it says "120 Americans die every day from lack of health care". Then it says "zero people die every day in Canada due to lack of health insurance". Lack of health care and lack of health insurance are in no way the same thing. So that seems dishonest to me.

•Costs will skyrocket under single payer.
WRONG.
Single payer is the only health care reform that will save enough money to insure everyone.
By eliminating the health insurance industry, we save $350 billion a year in administrative costs and profits.
We then use that money to insure those who lack insurance and fully cover those who are under-insured.
Yes, more people will be seeking healthcare because they will now have insurance. But they will be taking care of medical problems early, thus preventing more costly treatment later.

In fact, a single-payer healthcare system won't eliminate the health-insurance industry, because a single-payer healthcare system is equivalent to a national health-insurance monopoly. It's also equivalent to a national monopsony in the healthcare-services market, as all healthcare providers will now be getting paid by the same organization. That's where the profit-seeking will go. If the single-payer healthcare system dictates to healthcare providers the prices it will pay them, then healthcare providers are employees of the government in all but name. I think it's highly likely that a single-payer healthcare system will end up dictating how much it pays healthcare providers for everything.

Furthermore, healthcare costs will tend to rise under a single-payer healthcare system because of the political desire to charge everyone the same rate. If healthcare taxes were raised on people with higher health risks, the hue and cry of "health discrimination" would likely arise. Also, the fact that no one is directly paying for any healthcare services would likely reduce their perceived scarcity, with the result that people would have greater demand for healthcare services without any corresponding increase in their supply.

•Drugs will be more difficult to get under single payer.
WRONG
The drug industry would have you believe that there will be less research and development under a single payer system.
In fact, much medical research is currently funded by the National institutes of Health.
Under single layer, this would grow.
Also, drugs would be cheaper under single payer.
When all patients are under one system, the payer wields a lot of clout.
For example, the Veterans Administration gets a 40% discount on drugs because of its buying power.
This single payer buying power is the main reason why other countries' drug prices are lower than ours.
Now you know why the drug industry is so opposed to single payer.

It doesn't follow that a single-payer healthcare system would necessarily lead to more medical research being funded by the National Institutes of Health. It also doesn't follow that drugs would necessarily be cheaper under a single-payer healthcare system. If drugs were cheaper under a single-payer healthcare system, that would be because the single-payer healthcare system (i.e. the government) is dictating how much it'll pay for drugs. However, drugs being cheaper doesn't mean their supply will increase. In fact, it may even make their supply decrease due to the drug manufacturers becoming financially unable to maintain their operations.

•Single payer will cover less than the insurance I have now.
WRONG.
For the majority of Americans, single payer will be a vast improvement.
All medically necessary care would be funded through the single payer, including doctor visits, hospital care, prescriptions, mental health services, nursing home care, home care, eye care and dental care.
An enlightened single payer will also result in a sharp increase in public health funding to prevent disease.
No more bills. No more deductibles. No more co-pays.

Instead of paying for health insurance or healthcare services directly, you pay for them through your taxes. You still pay. But just because you're now paying through your taxes doesn't necessarily mean that a single-payer healthcare system will cover as much or more than private health insurance. That's another non sequitur.

•Single payer will cost me more than I'm paying now for private health insurance.
WRONG.
The vast majority of Americans will pay about the same or less than they are paying now.
Instead of paying premiums to a private health insurance company, most of us will pay a similar or smaller amount in taxes.
So, right now, if you are paying $8,000 in premiums for a family of four with a $4,000 deductible, your yearly liability is at least $12,000.
You will probably pay less than that in taxes to fund a universal single payer.
There will be no deductible.
And you can go to see any doctor or check in to any hospital in the United States.

A single-payer healthcare system in no way necessarily means that "the vast majority of Americans will pay about the same or less than they are paying now". That simply does not logically follow. Furthermore, even if the vast majority of Americans did pay the same or less under a single-payer healthcare system than they're paying now, that in no way necessarily means that they'll actually receive as much or more healthcare services than they do now.

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