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Commentary: Single-payer system a bad idea

by on November 24, 2013 1:19 AM

The progressives’ single-payer solution to Obamacare won’t work any better than the president’s delay of policy cancellations, but there are some ideas that should be pursued.

As Americans left and right were losing insurance policies because of the Affordable Care Act, some progressives reiterated a plan that would make things worse. In imitation of a slew of European and other countries, they want the United States to adopt a so-called single-payer system in which insurance companies go hang and the government funds all of health care,

It’s not that they dislike all of the Obama health law or even that they are entirely wrong about some of the problems we’ve had in health care delivery. They are right that our health costs are too high and that we’ve long needed to insure people struggling without success to get insurance for both bodily and financial self-protection. It’s still gibberish that micromanaging, all-controlling, hubristic Obamacare or single-payer models in Europe and elsewhere are the solution.

While Obamacare pluses exist, the minuses we have seen so far are nothing compared to what we will very likely see in lost jobs, spiraling premiums for the nonsubsidized, governmental overspending, fewer doctors, crippled hospitals and millions still without insurance at the end of the day. And, not so incidentally, none of this was set right by the president’s illegal pretense of supposedly doing something meaningful about insurance policy cancellations.

His pledge was that insurance companies can forget Obamacare standards for a year so that people might keep their old policies. Excuse me, but he is obliged under the Constitution to execute the laws, not rewrite them solo. It is true that presidents are given flexibility in putting them into effect, but there was three years preparation for this and a temporary delay likely creates more problems than it solves, assuming it truly creates a delay. What we have here is pure politics to prevent Congress from a substantive reshaping of Obama’s pride and joy and a further dangerous step into executive branch autocracy.

The single-payer alternative for one and all is also more razzle-dazzle than realistic remedy. Experts from various think tanks have shown it actually can have such bad effects as reducing the quality of care. Among their points is that it leads to long waits for care, often affecting the elderly most of all. One critic argues it only saves money through rationing Americans would not like a bit, and large majorities in some countries with single-payer systems don’t like the extensive controls much, either, as polls show. That’s one reason many of those countries have been allowing far more private insurance and care than in the past.

Of course, if you don’t do the rationing, you have runaway costs with single-payer systems. Our own federal Medicare and Medicaid programs are already in deep trouble, and, without reform, will be unsustainable over the long run. Make Obamacare essentially another version of Medicare (or even leave it alone) and there might be no ark that can save us from the flood of red ink of the sort now drowning so many European welfare states.

Many progressives note we Americans have shorter lives on average than in those welfare states, but that’s more likely because of accidents, homicides, lifestyles and genetic inheritance than anything having to do with health care. One expert notes that 90 percent of U.S. adults report themselves as healthy, which is higher than in any other country in the world, and when you look at such a major matter as treating cancer, you find no one does it better.

I am not saying all is rosy or that it is enough for Republicans to just keep kicking the Democratic deed of Obamacare. They need to focus on such possible answers as vouchers for catastrophic coverage, health savings accounts, curbing malpractice suits on a state level, encouraging imitation of some first-class clinics and promoting interstate health insurance competition. And, if they get a chance, they need to address such matters one small, prudent step at a time, not with a leap into a vast unknown that then reveals itself with unending pain.



Jay Ambrose is an op-ed columnist for McClatchy-Tribune. Readers may email him at speaktojay@aol.com.
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