Here is a fundamental problem with the debate that Matthew is having with Amy Ridenour and David Hogberg: Matthew (and single payer advocates generally) focuses his attacks on the general ‘injustice’ that might exist in the healthcare system. In the face of such injustice, the theory goes, the government must step in to ‘even out’ the system (another way of saying that the ‘risk pool’ for unhappiness ought to be as big as possible—or, put another way, misery loves company).
“Free marketeers” (presumably an effort on Matthew’s part to turn those who believe that less government intervention actually is good for economies—for which the evidence is incontrovertible—into a pejorative) are generally no more happy with the current system than ‘healthcare-by-lobbyist’ activists (my own pejorative for bureaucrat run healthcare). However, people who believe in markets want to introduce free market reforms, recognizing that this process must be incremental.
Put another way—single-payer advocates speak in broad generalities of fairness and justice and risk pools—which sounds great to the public, but is short on actual policy implementation. Limited government advocates have, thus far, been focused on actual concrete steps to improve the system.
Which is easier to criticize? Of course you can attack an HSA more easily than an ‘everybody in/ nobody out’ risk pool.
To learn about the details of single-payer advocates, you actually need to read the legislation they are promoting. Here’s the basics: unelected bureaucrats are given complete control over budgets that
far exceed individual state spending (i.e. in Arizona, the single-payer plan would give a 9 member unelected group complete control over a budget ($30 billion) nearly 3 times the size of the entire state budget (about $11 billion)). It is not ‘socialized medicine’ because doctors and nurses and therapists and hospitals are not
employed or owned by the government—but government is the only legal purchaser of any services. Patients are explicitly banned from paying, with their own money, for any treatment, test or service, that has not been authorized by the faceless bureaucracy. In other words, it is Medicaid for all. Funding mechanisms for the single payer scheme are sketchy, at best (and given the recent failure in Illinois,the difficulties in Mass and Maine—single payer advocates need to keep it that way).
So, at the risk of putting my nose into Matthew’s post, let’s look at Matthew’s questions and Amy Ridenour’s responses:
“Why are you so happy to have a health care system that kills so many more people who have heart attacks, and amputates the feet of so many more diabetics?”
I don’t accept either of the two premises of the question.
I do not speak for Ms. Ridenour, but the premise of your question is that a single-payer, universal scheme in the USA would magically solve disparities in these statistics. Correct us if you disagree, Matthew.
“Ask the free marketeers to explain why they feel comfortable with a financing system that causes at least 25% of all the nation’s bankruptcies.”
Same answer as above.
At least, Matthew, you are not buying completely into the propaganda from PNHP authors Himmelstein and Woolhandler. A more complete critique of the failings of the original study are available from George Mason law professor Todd Zywicki, but the fundamental flaw is not the 50% number, but the fact that there is no ‘control group’. That is to say, the authors make no attempt to provide context as to other sources of debt, or the rates of households that have the conditions described in the paper, but DO NOT file for bankruptcy. Again, your premise is false and cannot be proven.
“Why [do free marketeers] espouse even greater cost sharing even though it’s been shown yet again this week that increased payment at the point of care reduces people’s likelihood of following their
One argument for “letting” people control more of their own health care spending is that the people who earned the dollars have the highest moral right to decide how they are spent.
Here, single payer advocates like to have it both ways. On the one hand they speak of inability to get care, while simultaneously decrying that up to 50% of care is unnecessary. Which is it? Or is it both? And, again, how is it that an unelected bureaucracy, given complete authority over what care you can choose to purchase with your own money, do a better job of both MAKING people take the doctor’s advice, while simultaneously preventing the 50% of care they think is uneeded? Again, single payer advocates have no answer for this other than a ‘panel of experts’ that will be immune from criticism from individuals, but highly susceptible to the money and efforts of aggressive lobbyists.