The Problems with Single Payer

Never mind Obama Care, the chances of it passing are rather slim.  Why?  Single-payer.   This is the end game of both the administration and its somewhat confused and anxious followers.   The true liberals in the Democratic Party are uneasy that Obama Care is essentially a gift of up to 47 million uninsured to the insurance companies and a back door “if it were Cheney doing it, there’d be blood in the streets” quid pro quo deal with big pharmaceutical companies.   I should say that it’s not impossible, but there could be hell to pay for liberal Democrats who vote for the bill as is and moderate Democrats who don’t.   But it is true, the more Democrats learn, the less they like.   In fact, it’s hard to find anybody outside of Washington that does like the bill in any version.   The only hope the left has is that ObamaCare will be a back door for single payer.

Even use the words single payer in a sentence and the left swoons as though they just heard the words Barack Obama.  Or how they used to swoon, at least.    It seems so elegant to them.   One big, benevolent, caring government writing the checks, no need to worry, all the care you’d ever want for free.

But even with this absurdly rosy scenario, there are, indeed problems in paradise and just about all of them apply to ObamaCare as well.   Errr, sorry, KennedyCare.   (Under Kennedy Care, all ambulances will be a commemorative  Oldsmobile Delmont 88 and will come with an installed bar and condoms.  Bridges sold separately.)

1.  Bureaucracy.   This means that there is no method of bringing prices under control, let alone bringing them down, any more than we can build an inexpensive, let alone less expensive, bomber.    In a monopolistic system, there are two outcomes, either suppliers rebel and leave the system or they get to charge more or less what they want by any number of methods, including fraud, bill padding or unnecessary work.  Which leads to….

2.  Overcare.   Once installed, both systems incentivize overcare.   That means extra testing, extra pills, extra surgeries.   If you’re overweight, why starve, get your stomach stapled.   Sexually active?   Why use a condom when abortions are free?   High cholesterol?  No need to change that diet, we’ve got all the pills you need.    Why, we can even test you for alien microchips at no extra charge.    That is, until……….

3.  Rationing.  Number 2 leads to number 3.   Now that patients are demanding and using as much free service as they can get, the government has no choice but to start audits, clamping down on care and, well, rationing.  Death panels.   Of course, this is not until after the federal budget is in the dumps.   Sorry, 2 leads to 4 which leads to 3.

4.  Federal budget destruction and military collapse.   This is as much as 10-15 years away, but at some point, something will have to give.   If Democrats remain in control, the military is going to be squeezed as never before.   To some this is not a downside, but Obama is already setting us up for some future ugliness from Asia and the Middle East that will require a strong military in the future.     This will also mean a whole lot of other rationing with government services including healthcare.

5.  Sick care.  Under these plans, there may be incentives for prevention in the health care industry, but that doesn’t mean that customers, getting services for free will go along.  More likely, they’ll have that cheeseburger and wash it down with free Lipitor, then pop several Viagra to squeeze more blood through those DC traffic arteries.

6.  Paperwork.  Aside from just general government bureaucracy, someone still needs to handle all the paperwork to get paid.   While this may not increase current staffing, it certainly won’t shrink it much.   Unless the doctor can’t afford to pay for the help due to fee cutting.

7.  Doctor Malaise and Corruption.   Let’s face it.   You’re now an employee of the government.  They can tell you pretty much what to do, how to do it, when to do it and why.  They can ram ‘guidelines’ down your throat like  ‘waffer thin mints’ until your honesty and sanity explodes.   You’ll get little reward for working harder, but you will get rewards for waste, fraud and abuse.   The overwhelming concern won’t be for caring for your patients, but how to pay off your student loans while getting $150, no, sorry, $120 for a surgery.   You think doctors have addition problems now?  Just wait.

8.  Constant Congressional Tinkering.   Prepare to have your healthcare change every year because politicians can’t stop messing with it.  Just like the tax code, the ‘health code’ will be under an endless regime of tweaking until it is so corrupt and so incomprehensible that it needs to be destroyed and recreated.   Entire careers will be made or broken based on health care tweaking promises.

9.  Declining practitioners.   Thinking about being a doctor or nurse?  Not any more!  Better to become a lawyer and sue the government to get someone the ObamaCare benefits they deserve.   Or a bureaucrat.    After all, there’s no way of paying the increasingly high cost of becoming a doctor with the increasingly low amount of money you will earn over your lifetime.

10.   Inability to respond to changing times.    Do you know why school gets out in the early afternoon and why there’s summer vacation?   Not only because kids have to milk the cows, but because air conditioning hasn’t been invented yet.  What do you mean everyone lives in the city?   We HAVE invented air conditioning?  When did THAT happen?

Oh, give me a few more days, I could think of more problems with single-payer, but I think 10 is enough, especially when these problems do not exist under a self-insurance type program such as cash/catastrophic insurance, HSAs, MRSAs or USAs.