Last week, Robert Reich, who served as secretary of labor under President Bill Clinton, came out strongly in favor of single-payer health care in the U.S. — referring to a universal health care system in which a “single-payer” fund, rather than private insurers, covers health care costs. In other words, it’s government-run health care.
His argument leveraged insurer Aetna’s recent decision to withdraw from a majority of the state exchanges as of 2017.
We have a single-payer system in this country. It’s called the VA, which has been the epitome of mediocre health care at best.
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After a predictable left-wing screed about rich insurance corporations, Reich laid out a false choice: Continue with a “hugely expensive for-profit oligopoly with market power to charge high prices even to healthy people and stop insuring sick people — or, a government-run single-payer system … dedicated to lower premiums and better care for everyone.”
When reading that, I was reminded of the political allegory of “The Wonderful Wizard of Oz” by Frank Baum. Most Americans don’t realize it was written about the political personalities and events of the 1890s. In it, a scheming politician (the wizard) uses publicity devices and tricks to fool the people (and even the good witches) into believing he is benevolent, wise, and powerful — when he is not.
Reich’s fallacious arguments have the deceptive appearance of being good arguments. They are not.
We have a single-payer system in this country. It’s called the Department of Veterans Affairs, which has been the epitome of mediocre health care at best. There are reports almost weekly about ongoing egregious failures in its operation. Congress wrings its hands, but nothing changes for our vets.
[lz_bulleted_list title=”Veterans Affairs Challenges” source=”http://www.va.gov”]223 Texas veteran appointments were deliberately recorded as patient cancellations vs. system cancellations from July 2014 to June 2015. On average, it was an 81-day wait to reschedule for 42 percent of the patients, 78 days longer than shown in the system, a formal investigation found.[/lz_bulleted_list]
Is this what we want? Because that’s what single payer will mean for most of Americans — except the wealthy elite. Check out what is happening to single-payer systems in other countries: They are struggling financially and that’s with the hidden subsidy that Americans pay. What hidden subsidy? It is the high prices Americans pay for prescription drugs, which result in much lower drug costs in single-payer systems like Canada and the E.U.
Unfortunately, I think Reich may be correct in that we are headed toward single-payer health care. Not because it makes fiscal sense — but out of political expediency. Here is why:
1.) President Obama, Sen. Harry Reid, and Rep. Nancy Pelosi are all on record expressing a preference for single payer. Obamacare has long been referred to as a step already in that direction. I have little doubt that it is the proverbial “Trojan horse” smoothing the way. As with most health care initiatives of its kind, it was concerned with coverage — not cost.
2.) There is an incessant public drumbeat promoting single payer by liberal politicians and left-leaning D.C. think tanks. Remember that think tanks promote the ideas of their donors. Many donors hope to benefit from a single-payer system or mistakenly believe single payer is the best method to achieve access for all to health care. What “level of health care” and how that can be accomplished without destroying the free-market structure that allowed Americans to make so many medical advances — they don’t address.
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3.) The Affordable Care Act is failing. Mandating insurance, restricting individual choice, expanding subsidies, and increasing government control have not lowered health care costs. Premiums and deductibles are rising. Insurers are pulling out of exchanges. The vast majority of health care co-ops have failed. And not surprisingly, healthy people have realized they are better off paying a small penalty than signing up for under-subsidized health care they will likely not use.
4.) Americans have been increasingly conditioned to look to the government — not themselves — for help. This tendency started under FDR and grew under President Lyndon B. Johnson. Too many Americans, even well-educated ones, don’t understand the fundamental aspects of health care, such as the difference between Medicare and Medicaid — let alone the economic issues. Even the majority of my own physician colleagues don’t understand that Medicare and Medicaid are breaking the federal budget and that Medicare taxes and premiums only cover 30 percent of the actual cost of the program.
This shouldn’t be a Democrat/Republican issue but a fiscal/economic issue. Its resolution requires we deal in facts, not emotions and anecdotes. I am afraid that when the inevitable crisis comes, our leaders will point the way toward single payer and that Americans will follow without question.
Mandating insurance, restricting individual choice, expanding subsidies, and increasing government control have not lowered costs.
The two presidential candidates contrast starkly on the future of our health care system.
While Donald Trump is for a more practical market-based solution, Hillary Clinton is for the fiscally insolvent single-payer idea, or “Medicare for All.”
Expanding Medicare eligibility will worsen the current budget deficit. As the budget deficit grows, the feds will likely shift Medicaid costs onto the states in a way that they will be beholden to federal regulations on how that money is spent. Think school lunch programs: If school systems don’t do exactly as the feds tell them, they lose all monetary support.
Drug companies, hospitals, and insurers have all resisted a truly competitive and fair health care market — crony capitalism and a lack of transparency have benefited them mightily. Socializing medicine (single payer) will not fix either the inequities in health care or the rising cost. It will simply shift the cost onto the federal (and state) government.
Taxes can’t be raised high enough to pay for such a system. The result will be fiscal insolvency and/or cutting off services to tens of millions of Americans — who will die as a consequence.
In the book, “The Wonderful Wizard of Oz,” Dorothy (the American people) has the solution to returning to Kansas the whole time — her slippers. We, the people, have the solution in front of us. It isn’t a centralized bureaucracy delivering mediocre health care as crony capitalists take their percentage along the way. It’s a truly transparent and competitive system whose cost efficiency will give Americans cutting-edge health care without bankrupting them or their children.
Dr. Ramin Oskoui, a cardiologist in the Washington, D.C., area, is CEO of Foxhall Cardiology PC and a regular contributor to LifeZette.