Saturday, October 22, 2016

Single-Payer Healthcare: ‘Wouldn’t it be Nice’

Here are excerpts from a letter advocating single-payer healthcare for America that appeared in the New jersey Star-Ledger last February. It is titled Single-payer health care would be a big improvement:

  Wouldn’t it be nice if losing your job had no impact on your health insurance? Wouldn’t it be nice if all doctors participated in your insurance?
  Regarding cost, let’s consider that we already pay for everyone’s health care. A business that pays for health insurance for its employees passes that cost to its customers. We pay as a consumer, or we pay as a taxpayer.
  If we take the for-profit middle man out of our system, we immediately cut costs by almost 20 percent. If we get a system like those in a number of other countries, hospitals and doctors don’t need much in the way of billing departments that now have to deal with many insurance companies.
  We spend more on health care than countries that have single-payer systems. We don’t cover everyone; they do. I hope others will join me in explaining the benefits of single-payer. Convincing people voting for members of Congress is important.
  John S. Smith

“Wouldn’t it be nice if losing your job had no impact on your health insurance?” You mean like auto, life, and homeowners insurance? That’s the way it would be if the government hadn’t interfered in the health insurance market. The third-party-payer, or employer-based, health insurance system is a government-created setup. If we got rid of the government policies that favor employer over individual health insurance purchases, as well as regulations mandating only government-approved insurance plans, people would buy their own health insurance directly from insurers competing directly in the consumer market.

The profit motive is not the culprit in the cost of health care. The government is the problem. In America today, almost 90% of healthcare is paid by third parties, not the consumer. This disconnect between consumer and provider eliminates the necessity for providers to keep costs down and consumers to shop price. The profit motive is actually a huge cost reducer when it is allowed to operate in a market free or relatively free of government interference. The need to turn a profit combined with competition for the consumers’ business creates natural incentives to raise quality and reduce prices, leading to continual improvements on both counts over time. You see this process going on throughout the economy, wherever real competition operates. It is the lack of real profit incentives—i.e., consumer involvement in paying—that leads to runaway costs in healthcare. That’s why governments that pay the bill always must control who gets what healthcare, when, and at what price.

Your own doctor? That’s a laugh. Under single-payer, the doctor works for the government, not the patient. The people who most love single-payer are the people who are overall healthy. Better not to get really sick under government-paid healthcare.

Healthcare providers “don’t need much in the way of billing departments?” Another laugh. The narrative of Medicare’s lower administrative costs is a myth. With only the government as the single payer, where’s the incentive to cut administrative costs when providers have no alternatives? In a private, free market environment, healthcare providers can refuse to accept insurers with unduly burdensome administrative costs. Once again, the profit motive in a competitive free market is a natural cost reducer.

In a free market, which is what we should have, everyone is responsible for his own health insurance and health care. It’s true that employers who cover their employees reflect the cost in their pricing, as they do all costs. So, in a very loose sense, you might say we pay indirectly for that business’s employee health care. But, there is a crucial fundamental differences between single-payer health care and employer health care—We are not forced to buy the product. We are forced to pay for single payer. When we buy the product, we are still free to make our own healthcare decisions, as the business and its employees are left free to make theirs. These are not just practical differences but deep moral ones as well, because the difference between private transactions and government programs is voluntary agreement versus force. Statists like Smith are unable or unwilling to acknowledge the difference between voluntary association and living by the sword.

It’s easy to say “wouldn’t it be nice” to have this or that out of context and without having to take personal responsibility. But then some people would say, “Wouldn’t it be nice if I could rob people on the street at gunpoint to pay for my stuff without fear of punishment?” That’s exactly what Smith is saying when he flippantly asks, “Wouldn’t it be nice if we had single-payer healthcare,” which is the same as saying “wouldn't it be nice if I could run to whatever doctor I want for whatever healthcare I want, and stick others with the bill?” Or, “Wouldn’t it be nice if all doctors were forced into servitude to government dictates, rather than retain the inalienable right to choose which insurance to accept or not accept?” That’s exactly what Smith is advocating when he says “Wouldn’t it be nice if all doctors participated in your insurance?”

Wouldn’t it be nice if we could force my ideal onto everyone else, with the government as the hired gun? Wouldn’t it be nice if we regard only my choices and disregard those who disagree? Wouldn’t it be nice if we didn’t have to take moral responsibility for our own lives? Wouldn’t it be nice if I didn’t have to be moral at all? Welcome to the moral jungle, where everyone is responsible for everyone else’s healthcare, but not his own—and everyone is legally chained to the system.

To which I ask, wouldn’t it be nice if we all respected everyone else’s right to control their own healthcare decisions, and had a government that reflected that? Smith’s collectivist “we” signifies Smith’s stone-cold cruel disregard of other individuals’ lives and liberty. Wouldn’t it be nice if we once again had true constitutional protection from heartless predators like John S. Smith and his ilk?

Related Reading:

American Healthcare's Great and Powerful Oz


Mike Kevitt said...

In all seriousness, my ideal is to have individual rights enforced under law, without exception, with government as the hired gun, under law. And seriously, it's nice to know we have the moral right to force THIS ideal onto everybody. Then, within that realm, the realm of individual rights, everybody is free to make their own choices, and the majority even has the right to rule. I seriously think we have the moral right to force this, but only this, ideal onto everybody.

Michael A. LaFerrara said...

It's important to distinguish between initiatory (or aggressive) force and defensive force. Freedom is the absence of force, except in response to intiatory force. I don't think you can characterized freedom as an ideal to be forced on anyone. Otherwise, Smith is on equal moral footing with supporters of a fully free society.

Mike Kevitt said...

I've distinguished between initiatory force and defensive force, here. Freedom is responsive(defensive, or retaliatory)force against initiatory force, then, freedom is the absence of force, thus, the unimpeded freedom to act as response continues without stopping, against initiation which never stops, in other words, as law and government continues.

Maybe freedom can't be forced on anyone, but we, by law and government, can leave 'em free, on their own, as we leave US on our own(if we have law and gvt., which we don't have, now). If they seek something else, they seek crime. If they get it and DO it, they're crooks, subject to fine and/or incarceration by law and gvt. Then, we DO IT to them. That's the ideal you say can't be forced on anyone. It can be forced on everyone, as we did, for awhile, after 1776, beginning to end about 1880.

Government by law, strictly defined, leaves everyone free, but forces no one to be free. Whoever chooses enslavement, gets it for himself, by law and government, in jail. So, we're moral, and Smith ain't, no equal moral footing.