Socializing Medicine Through Single-Payer Will Lead To Rationing And Bankruptcy

Socializing Medicine Through Single-Payer Will Lead To Rationing And Bankruptcy

Therein lies the choice with government-run health coverage: Huge (and regular) tax increases or rationing. Or both.
Margot Cleveland
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With the Senate’s failure to pass legislation to repeal and replace the Affordable Care Act, the future of Obamacare and, more broadly, the crumbling American health care system remain uncertain. While the president has threatened to end cost-sharing payments to insurance companies to force Congress to act, even though the law requires him to do so regardless, moderates of both parties are instead floating measures to bail out insurance markets.

Also gaining voice are proposals from the Left for a single-payer system, or an entirely government-controlled health-care system. Claims that a single-payer system presented a better option emerged even before Republican efforts to repeal and replace proved futile. At the time, The Daily Wire highlighted five Democrats who admited they want a single-payer system. And in the closing hours of debate, the Senate rejected a single-payer amendment to the now-obsolete Republican plan, but only four Democrats (and one Independent) crossed the aisle to record their opposition to the proposal. Sen. Bernie Sanders and 42 democrats instead voted “present,” with Sanders later encouraging Republicans to work toward entirely socialized medicine in America.

This development comes as no surprise to those on the Right who, in opposing the Affordable Care Act, warned that Obamacare merely represented another lurch towards the Left’s ultimate goal of government-run health care. But what is shocking to see are claims that socialized health-care is conservative. Yet that’s just what Chase Madar proclaimed in “The Conservative Case for Universal Healthcare” in The American Conservative, writing: “Socializing healthcare is the only demonstrably effective way to control costs and cover everyone. It results in a healthier country and it saves a ton of money.”

There Is Nothing Conservative About Socialism

However, contrary to Madar’s claim, there is nothing conservative about socialism. Like the fictional utopia his compatriots on the Left concoct, such as Sanders’ Medicare for All, low-cost universal care exists nowhere in reality, and never will. It’s economically impossible.

Instead, what does exist proves that government-run health care is not the promised panacea. Consider, for instances, the disaster of the Veterans Administration, which is a socialized system: Veterans dying because of chronic delays in the diagnosis and treatment of diseases. Medicaid, another socialized system, likewise lays bare the truth: Government price controls—capping reimbursement rates to physicians at about 52 cents on the dollar of the insurance rate, which is the only way to make this program even pretend to be financially sustainable—leave Americans without access to doctors and with health outcomes no better than those who are uninsured.

Yet as is often the case, when socialism fails, proponent of government-controlled economies proclaim that we just need more socialism. If only the United States adopted a single-payer system. Get rid of the private insurers who “suck up a lot of money without adding any value,” and add to that the saving wrought from the federal government flexing its monopolistic bargaining power, and voila—huge cost savings sufficient to fund universal care. And look not to Medicaid—Medicare is how you do it. Medicare for all.

Socialism Means Poorer Quality and Higher Prices

But, as Ezra Klein would say, this is “a puppies-and-rainbows approach to single-payer”—a promise of universal care based on fanciful promises of cost savings and soaking the rich. Nor could a Medicare-for-all approach work, as Susann Moy expertly explained in Newsweek, quoting none other than socialized medicine proponent Paul Krugman: “It’s not something most Americans want to hear about; foreign single-payer systems are actually more like Medicaid than they are like Medicare.”

As Moy detailed, the only reason Medicare works—and that is debatable given the fast-approaching fiscal cliff and the increasing number of doctors refusing to accept Medicare patients—is: “Medicare simply doesn’t pay the bills of hospitals and doctors. Medicare exists at its current high level of care because a significant part of the care is cost shifted from the 170 million Americans who have employer based health insurance.”

Get rid of private insurers, and gone too is the level of care older Americans enjoy through the Medicare system. Instead, we will all experience a much different reality—that socialized medicine controls costs by rationing care: some directly, such as seen with states severally rationing hepatitis C treatment. Louisiana only treated 324 of the nearly 35,000 infected with this deadly disease and only then once liver damage had occurred.

Other rationing occurs more subtly, as Moy explained: In the United States you’ll see the rapid construction of new medical facilities and comparatively rapid adoption of the latest high-tech equipment. But “the UK and Canada slow things down with budget creep. They can’t commit political suicide with huge tax increases that would hurt their economies so they incrementally pass increases. It’s a form of government rationing because budget restrictions create a shortage for everyone in the system, resulting in waiting lists that some patients never get off.”

This gives us more patients like Richard Bonehill, an actor in two Star Wars films who died of an enlarged heart while awaiting surgery in the United Kingdom after two earlier operations were canceled because the hospital “was put on black alert—the highest level which means it can no longer cope with demand.” Bonehill’s death is but one example of the failures of the UK’s system of socialized health care. Avik Roy’s article in Forbes on Friday provides a more complete compendium on the extent of the problem.

Therein lies the choice with government-run health coverage: Huge (and regular) tax increases or rationing. Or both. And once the government assumes this role, every dollar of health spending will be a dollar away from another government-funded program. Louisiana perfectly illustrated this trade-off when it created an interactive budget allocator to show the effects of fully funding treatment (as opposed to rationing care) for hepatitis C.

It is not just conservatives who recoil at these choices, but Americans of all political stripes. Of course, politicians pushing a single-payer system will promise a utopia, but after the “if you like your doctor, you can keep your doctor” con, no one is likely to believe the duplicity. But with the Republicans’ failure to repeal and replace Obamacare, the high taxes and rationing of socialized medicine may seem a veritable paradise compared to the shambles that will remain of our health care system once the death spiral concludes its destructive path.

Margot Cleveland is a senior contributor to The Federalist. Cleveland is a lawyer and a graduate of the Notre Dame Law School as well as a former full-time faculty member and current adjunct professor for the college of business at the University of Notre Dame. Email her: [email protected]
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