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The single-payer failure

Published: March 5, 2010
Section: Opinions


Last Thursday, President Obama and leaders from both parties deliberated for seven hours to espouse their talking points and delve into the intricacies of health care policy.  They discussed a multitude of topics, ranging from health savings accounts to medical malpractice reform to the “Cornhusker Kickback.”  What they did not mention, however, was the possibility of establishing a single-payer health care system.  This failure of Congress to consider the plausibility of this policy has been the underlying tragedy of the health care debate.

Several months into the Obama presidency, the Democrats took on the challenge of fixing the broken and convoluted structure in which the American people acquire health insurance.  Believing they possessed a mandate for change after their gigantic 2008 victory, the Democrats yearned for a major legislative victory.  And, more importantly, they ultimately wished to make history where presidents from Theodore Roosevelt to Bill Clinton could not.

But right from the start of this initiative, the Democrats did not even entertain the thought of a single-payer option.  They dismissed it as too radical and politically infeasible, viewing it as a fringe issue and a pet project of the far left.

This is foolhardy. The creation of a single-payer health care system would only extend Medicare coverage to every hard-working, tax-paying American citizen.  Medicare is not a perfect institution.  Indeed, the program contains its fair share of fraud, abuse and waste.  However, its administrative costs are generally far lower than those associated with private health insurance companies, and seniors who are recipients of Medicare’s federally-mandated benefits overwhelmingly approve of the quality and treatment associated with the care they receive.  This program is familiar, a household name from the political lexicon and popular.

So why can’t people younger than 65 be so fortunate?  According to conservatives, single-payer is socialism, government takeover and communism, to name a few.

Despite the conservative histrionics, advocates of these views are at least partially right.  Under a single-payer system, every person would receive coverage that is funded by the federal government.  Consequently, the market for private health insurance would, if not dissipate, erode significantly.

But that shouldn’t be counted against the single-payer system.  People like their doctors and the care they receive and don’t like   the intermediaries they need to deal with as the beneficiaries of this care.  This is especially the case when said-intermediaries escalate premiums by up to 39 percent, as Anthem Blue Cross in California did recently, when said-intermediaries deny people coverage based on previous medical conditions and preexisting conditions; when said-intermediaries haggle and squabble over nearly every single medical claim they get.

As long as for-profit insurers are dominant, the American people will suffer.  Even if the current health care reform bill passes, this will still be the case.  These companies will presumably find loopholes that they can exploit in order to elude the prospect of truly abiding by new regulations.  At the same time, due to an individual mandate, millions of more Americans will be forced into the greedy clutches of these insurers via a virtual marketplace, or exchange.  There will not even be an alternative for these individuals—no public option, no Medicare buy-in, no health care cooperatives, nothing besides a Medicaid expansion for the poor.

While the current proposal is better than nothing, the American people shouldn’t have to settle.

It is a shame that the Democrats did not take the single-payer, Medicare-for-all route.  Quite simply, they do not have the guts to defend significantly expanding government, even when doing so is manifestly in the public interest.  The irrational, paranoid stigma attached to big government looms over their every move.