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By Olin Potter
Now that our federal congress consists mainly of a one-party system it would appear that a single-payer system for health care is a shoo-in.
Let's take a look at what we have now and what we can expect from this type of proposed change.
Currently, coverage is "fragmented." For those not covered by employer insurance there are many commercial and government (read "free" or almost free) programs. For the latter, coverage other than Medicare is supplied to the poor and illegal immigrants. Medicare is a hugely expensive government-controlled program for retirees that automatically takes a monthly premium from Social Security payments if enrolled. It pays an allowed fraction of the actual charges (medical/hospital as determined by Social Security) resulting in cost-shifting of the balance to the free market, driving up insurance premiums for those not enrolled. As a result we hear health care is too expensive; we need a single-payer system to cut costs). Very thin thinking.
Private Medigap policies can fill in payments for the balance of the
allowed treatment fraction not covered by Social Security, but these
premiums are expensive and increase annually as the cost-shifting
increases and illegals continue to seek help from hospital emergency
rooms at no charge. Remember, though, these policies rely on the Social
Security program which is a gigantic Ponzi scheme. Those working pay
for those retired and because our health care has increased our life
span so much, there aren't enough workers to support the growing number
of retirees. On top of that the retiring baby boomers are about to add
to this problem. If the federal government doesn't restore all the
money it "borrowed" to help pay for Congress's pork, the whole program
There is also a problem with our tax disincentive, which tends to keep the poor from rising above the point where governmental aid stops. All in all, we need a change, but will the so-called single-payer system do the job? Let's review how Britain and Canada have fared with their socialist system.
In Britain, their system has converted senior physicians into managers (bureaucrats) to set priorities and targets resulting in rationing of health care and the need for more physicians. Stories have surfaced about their need to sweep the wards for patients to release so that government turnover quotas can be met. Costs in Britain are always ahead of expenses with a 300 percent increase in 10 years (reported by a 20-year veteran of the system, Dr. Dalrymple) with very little improvement in delivered services, except for emergency care. He also reports long waiting times for elective surgery. The state takeover of the hospitals eliminated private charitable contributions, along with local pride. Development capital was diverted to meet cost excesses. These are not symptoms that we want to emulate in this country. My reference here is an article entitled "Health of the State, Doctors, Patients and Michael Moore" by Dr. Theodore Dalrymple. He claims to have worked as a doctor in the Britain's health service for 20 years.
The Canadian system is subjected to similar conditions with many stories of patients coming to the U.S. for timely treatment of their elective work because they are not allowed to pay for private service there. Canadians, too, believe that they can pay little or nothing, keep costs down and at the same time be treated to high-quality medicine. This is a fantasy that is impossible to attain.
Those who advocate for national health insurance claim "that America spends more than any other country on health care and that we still have a higher infant mortality rate and a lower life expectancy than other developed nations." This they use as an argument in favor of the socialized medicine Obama and gang are striving for (from an article entitled "Everything you always wanted to know about health care" by Ramesh Ponnuru).
Make no mistake, emulating the mistakes of the existing single-payer system of others is definitely not the way to go. There are many alternative plans being proposed that develop the free competition needed to prevent the endless cost increases attendant to socialist policies. We must get away from the "big brother" government mentality and rely on individual initiative to pick among competing programs. Our government should set up equitable rules and then get out of the way. Remember any single-payer government run program only guarantees enrollment, not timely medical treatment.
Some new proposals have been put forth (not all recommended).
- A standard deduction for health care for everyone choosing a health policy, costing less would allow pocketing the difference. If more, pay for it yourself.
- Modifying the standard deduction to be a refundable tax credit. Good for lower-income workers.
- Allow out-of-state purchase of a health policy. Good if the state policies are expensive. Gives more competition.
- Go for Health Savings Accounts. These exist now.
Whatever we end up with must include and encourage competition; otherwise the country will be constantly doing what the socialist schemes have found. There is never enough tax money to satisfy the demand for free health care. I believe that the old quip is true. "If you think health care is expensive now, just wait until it's free."
Olin Potter lives in Waitsfield.