Single-Payer Health Care Would Enslave a Nation

Published June 1, 2001

Single-payer health care systems are frequently proposed as the solution to the problem of the uninsured. In theory, such arrangements would guarantee that all citizens have a health insurance policy. While that may be accurate, the reality is single-payer health care doesn’t guarantee everyone will have access to medical care, nor does it guarantee the delivery of quality health care on time and to those who may need it the most.

Lessons learned along with documented statistics from other countries struggling with government-run health care show that such plans are tied to global-budgets which lead to medical rationing and limited access to cutting-edge medical technology. Further, the single-payer system has shown it short-changes not only the patient, but physicians and other health care providers as well, creating further negative consequences on the quality and the accessibility of health care.

When contrasting the free-market health care system with single-payer, we become aware how market-based plans are open to inspection and full disclosure while the government-run system is entangled in a faceless bureaucracy wrought with hidden administrative costs and constant demand for additional tax-payer supported funding.

While the idea of government-run health care has its roots in nineteenth century European socialism, more recent single-payer initiatives at the state and national level derive their inspiration from the Health Security Act of 1993. This major policy effort was championed by Hillary Clinton and failed to make it past the approval of Americans. Nevertheless, numerous states have continued to test for the level of interest in single-payer health care based on its universality.

The hypocrisy is that single-payer health care is anything but universal in its approach or its implementation. In the design of any single-payer plan there is a group of employers exempt from a single-payer health care tax. Typically singled out are public schools, colleges and universities; shelters for the homeless; community food banks; churches; local fire and police department, the city council, county council or other governing body; a port, water or other junior taxing district; the governor’s office and any mayor’s office.

Given the selective way the tax is applied, a large portion of the taxable workforce is exempt from helping finance the single-payer system. This workforce or the entities described above would be fully eligible for benefits, with the cost-shifted for their coverage to private employees and individuals who are not public employees.

During the last two legislative sessions at the state level, grass-roots single-payer activists attempted either legislation or ballot initiatives in Alaska, California, Colorado, Florida, Illinois, Maine, Maryland, Massachusetts, Minnesota, Missouri, New York, Oregon, with Washington state being the most recent failure where activists could not collect enough signatures to place it on this years ballot.

Advocates of the single-payer system seek to blame free-market health insurance as the source of all our problems while they conveniently ignore the fact that the “free-market” is not free — having been over-regulated by the very supporters of single-payer legislation.

The common denominator of all single-payer plans should be repeated over and over when defending market-based health care.

Single-payer systems rest on the theory of collective logic – that there is a single uniform best health benefit plan for every individual. The weakness of this one-size-fits-all theory should be argument enough.

If the revenue of health care institutions and professionals, as well as the rules controlling the institutions and the care providers, are determined by government policies, single-payer would be nothing more than Medicare for all.

The corollary to increasing government in health care is a diminished role and voice for individuals. Individuals would have no voice in the choice of care and only a faint voice when dissatisfied. There would be no need for patient consent in the use of private medical records as they would belong to the government for the government to use.

Once established, a single-payer plan would be almost impossible to undo. If we choose such arrangement, the very infrastructure of the health care financing and delivery systems would be dismantled. We could not easily rebuild them if the system fails us the way it fails everyone else.

Some countries with single-payer have had lower cost-growth than the United States. However, in order to restrain cost, single-payer systems require centralized government control of health care prices and use of services – and the intrusiveness that goes with it. Our current experience with heavy regulation at the state level should be significant warning that centralized controls create dysfunction and havoc.

The structure of single-payer discourages diversity and therefore the robustness and resilience.. Organizations must continually revitalize themselves lest they become stagnant, unproductive and useless to consumers.

To date, no true single-payer plan has been either legislated or even passed the ballot initiative. Some of the credit goes to an electorate, that while possibly uninformed on the finer points in health care policy, are savvy enough to know that losing one’s autonomy in the health care decision process is equal to enslavement by government.