Single-Payer Sucks


Proponents of universal healthcare hold one of the most morally attractive political positions of present day: healthcare is a natural human right and should be readily available to all, regardless of socioeconomic standing.  On top of their moral high ground, they pile on supposed proof of single payer’s merits by pointing to Canada, Scandinavia, and various other countries.  It’s their belief that if only such a system were implemented in the US, the problems associated with healthcare would largely be alleviated.

It’s a very emotionally pleasing opinion to hold.  Single-payer advocates pat themselves on the back for being so benevolent to the poor and insurance-less, claiming that if it weren’t for their efforts, countless people would unnecessarily die.  Unfortunately, positive emotions for its proponents is the only good thing that comes from single-payer healthcare.

When subjected to reason, the only way for a single-payer system to look attractive is to analyze it solely with emotion.  Logical and economic reasoning, along with an honest moral assessment, serve to show such a system to be the epitome of ugliness.

Economically, when the cost of a good or service is artificially dropped to $0, the demand for it will skyrocket.  When demand skyrockets, supply will fail to keep up.  When the supply of healthcare cannot meet the demand, the only way to solve the problem is through rationing.  Rationing inevitably leads to an increase in wait times, extended pain and suffering, and even death.

It’s widely accepted that rationing is the natural consequence of government managed healthcare.  In an article that is supportive of single-payer, the author says,

“Canadians have made a conscious decision to hold down costs. One of the ways they do that is by limiting supply, mostly for elective things, which can create wait times.”

It’s tough to identify the most concerning aspect of that statement, but the limitation of supply “mostly for elective things” is certainly at the top of the list.  In a single payer (or otherwise government controlled) system, who defines “elective”?  Whether or not a particular method of treatment is elective is a decision that can only be made by doctor and patient.  When this decision is placed in the hands of distant politicians and bureaucrats, the relationship between doctor and patient – and their ability to use free will to make healthcare decisions – is irreparably harmed.

The word “mostly” in the above quotation is perhaps even more concerning.  Is one to conclude that even when central planners determine a treatment to be necessary – it can still be subject to rationing?  Supporters of universal healthcare cannot truly say that necessary procedures would NOT be subject to rationing.  If the demand for that procedure exceeded supply, logic and basic economics indicates that rationing would be unavoidable.

The Canadian single-payer system is notorious for wait times.  A particularly troubling anecdote involves a man who needed both knees replaced.  The arthritis in his knees became so bad that he had bone grinding on bone.  It took him 4 months to get an appointment with a specialist, and then he was put 290th on a waiting list for the procedure.  While waiting, he became so desperate that he offered to purchase someone’s place in line ahead of him.  Needless to say, the provincial healthcare minister forbid that, calling it “unethical.”

Wait times and perversion of the patient-doctor relationship are just two of the major problems with a single-payer system; patients’ ability to seek second opinions is another.  Imagine having waited several months to see a doctor.  You’ve never met the doctor before, and went to them only because it was the available appointment when your number was called.  The doctor makes a recommendation that you’re unsure of.  You’d like to get a second opinion.  But are you really going to wait in line another several months for that?  Not likely.  Because of this, the patient’s options suffer, as well.

Yet another major single-payer problem is that healthcare decisions and policies are based on political rather than economic considerations.  It is a dangerous game to place this level of trust in the hands of corrupt politicians and inept bureaucrats.

Single-payer proponents won’t readily admit that Canada’s healthcare system is a mess.  If they do, they’ll only go so far as to say that there are various reforms necessary to improve the situation.  Within Canada, they’ll point to Saskatchewan (which holds the lowest wait times among Canada’s provinces).  Internationally, they’ll point to Switzerland, The Netherlands, Germany, Japan, and Australia.

Virtually all of the proposed reforms involve moving healthcare in the direction of the market.  Saskatchewan chose to “partner with private medical providers”.  The international countries encourage “competition between regulated private insurers,” and require “patient cost-sharing through copayments and deductibles.”  Since shifting toward the market leads to better healthcare, the logical conclusion is to continue in that direction.

The alternative to single-payer healthcare is not a “mixed” system.  It is not the system that currently exists in the US.  Principled opponents of universal healthcare argue that the only proper alternative is a completely free market.  No government intervention of any kind.  Elimination of all healthcare associated taxes.  Allowance for the exercise of free will and placing all decision-making responsibilities back in the hands of patients.

In the US, useful steps forward would be the repeal of the Affordable Care Act, reduction of income taxes, elimination of healthcare regulations, and allowing individuals to “opt out” of Medicare, Medicaid, and Social Security.  Eventually (and ideally sooner rather than later) the US Federal government needs to abolish the Department of Health and Human Services and get itself out of the healthcare industry altogether.  Decisions related to healthcare policy should be moved down to the state and local levels – closer to the individual.  When this happens, there will be competition among systems, and individuals will be free to “vote with their feet.”

Is there anyone who would oppose the goal of seeing all people have easy access to high-quality healthcare?  Of course not.  Unfortunately, that goal has not yet been realized anywhere in the world.  The debate comes when speculating about the best way to achieve this.  There are only two sides to this debate.  One being the use of force, coercion, and central planning; the other being freedom.  Allowing individuals to exercise free will is always the economically, logically, and morally correct path to take.

Jared graduated in 2009 from Rensselaer Polytechnic Institute with a Bachelors Degree in Mechanical Engineering. He is currently employed as an energy efficiency consultant in New Jersey, drives for Uber in his spare time, and is an aspiring entrepreneur. He came to the philosophy of liberty through the Ron Paul presidential campaigns, and has evolved into a voluntaryist anarchist through reading and listening to the Tom Woods Show.

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