What is missing in discussions of the apparent inevitability of single-payer healthcare (Universal healthcare crosses the partisan divide) is the realization that single payer really equals 300 million-payer healthcare, the same financing mechanism we have today. While we insured live under the illusion that somebody else is paying for our healthcare, the reality is that we are. For those covered by employers, payroll dollars are diverted to healthcare premiums and copays and deductibles are paid explicitly by us. Taxpayers fund public programs such as Medicare, Medicaid, the Veterans Administration and the Civilian Health and Medical Program of the Uniformed Services.
Should single payer come to pass, the difference will be that rather than multiple groups (employers and health plans) competing for the business of 300 million payers, there will be one giant, lumbering bureaucratic monopsonythe federal governmentserving as our purchasing agent. This inefficient, gutless colossus will not have the courage to charge us fairly for services rendered, so it will conduct the usual political shell games used to buy votes with our own money without losing votes by charging ample taxes to sustain the benefit.
The result will be a downward socialist spiral, wherein the government will pretend to cover us and we will pretend to be insured. Rationing, disincentives to innovation, and continual budget crises will send the best and brightest to sectors other than healthcare, deprive us of innovative treatments, stagnant medical progress, create labor shortages and diminished workforce quality, and otherwise distort the healthcare industry into mediocrity at best.
Americans will pay the price for this folly with shorter, lower quality lives, higher taxes and unemployment, and European style economic stagnation. Worse, once the Rubicon of socialized medicine is crossed, there is no going back. In the words of Tony Soprano, Once youre in, theres no getting out.
The best way to avoid this catastrophe is to empower the 300 million payers of America to take healthcare into their own hands with free-market solutions such as health savings accounts, with subsidies for those who need them. But in the current anti-conservative climate, where even Pat Buchanan waves the white flag of surrender to the forces of serfdom, that is unlikely at best.
Terry NugentLa Grange Highlands, Ill.
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