Single-Payer Siren Song

George Rebane

If you don’t do numbers, the numbers will inevitably do you.

[This is the addended transcript of my regular KVMR commentary broadcast on 31 May 2017.]

With Obamacare crashing and burning everywhere across the land except in the leftwing media, the Republicans are still tangled up with their promised ‘repeal and replace’ legislation.  In response, the Left has doubled down, alternating between claims that Obamacare is working fine, but then calling for a badly misnamed ‘single payer’ nationalized healthcare.  Under single payer, it is the multitudes of taxpayers who pay the government to provide healthcare for those who need it.  And it’s the opinions about single payer that divide the folks who pay and those who don’t pay taxes, including the many who also depend on government checks.

As Congress tries to get its act together, the healthcare debate in the hustings is growing louder by the day.  But before people get too worked up rehashing their dogmas about the future of America’s healthcare industry, I invite everyone to consider the answer to this –

What right does any American have to draw on his neighbor’s pocketbook to pay for the repair of his health, the preservation of which he may or not have taken any prudent steps to safeguard?  At this point I’ll spare you the horrendous stats that describe the behaviors with which we Americans knowingly and willingly damage ourselves.  So what kind of healthcare would you accept knowing that you, and not me, will pay the price?

Here in Nevada County the voices of socialism are loud and clear for single payer.  The national attitudes toward government participation in healthcare are mixed and varied – not everyone wants the same kind of single payer coverage even though Pew Research reports “60% of Americans say the government should be responsible for ensuring health care coverage for all Americans, compared with 38% who say this should not be the government’s responsibility.”

But what almost no one in the land understands is how well single payer works in the, mostly European, countries where it is practiced.  And not that many more of us understand how Medicare and Medicaid actually works or, more importantly, what care you get and don’t get.  None of these ‘government pays’ programs are sustainable.  Today countries are cutting services, extending already long wait times, and going into unbelievable levels of debt to keep up the face of socialized medicine.  Others forsake their own defense in order to support their single payer programs.

Those who do the numbers know that single payer, at best, will provide a dismally low level of healthcare for the country to be delivered by a growing bureaucracy of incompetent, uncaring, and hubristic government workers – VA’s medical care is your perennial Exhibit A.  And those who don’t do numbers continue posing questions like, ‘My daughter (or any other relative) has a dreaded disease, and the treatments cost more than I can afford, so what do you want me to do?’  The correct answer is ‘Your problem is not mine to solve, since I too will have to face it in the context of risks I am willing to take if and when I am in your shoes.’

But a deeper conundrum arises when we are made to pay for something that will be used in common.  When you have to pay, you want to be sure you get your ‘fair share’ while no one else gets more than their fair share.  Since agreeing on ‘fair share’ is impossible when many people are involved, we then have to set up rules, and more rules that few will like, yet all will have to follow.  And then even more government employees will be required to enforce the rules.

It doesn’t take rocket science to see the mounting overhead costs, so that what is left over for the distributed product or service is greatly reduced.  This will inevitably call for more funding (through taxes or borrowing) for what was promised, or to quietly reduce what was promised.  We have seen this happen a hundred times with government provided ‘benefits’.  Fifty years ago UC sociologist Garrett Hardin explained the matter to us in his classic essay, ‘Tragedy of the Commons’.

There are many important details to be understood about the siren song of single payer systems.  When considering yet another massive government giveaway, recall the roads to hell that have been incrementally paved with such mandates to care for each other’s welfare. 

My name is Rebane, and I also expand on this and related themes on Rebane’s Ruminations where the addended transcript of this commentary is posted with relevant links, and where such issues are debated extensively.  However, my views are not necessarily shared by KVMR.  Thank you for listening.

[Addendum]  My apologies if readers are afflicted by yet another post on healthcare that follows its extensively debated prequel ‘On Healthcare – one mo’ time’.  There I gave some of my attributes for a more suitable healthcare industry for America that are premised on the seminal question of a citizen’s rights to a (single payer) healthcare system that is delivered by the government as a social commons.  In this piece I revisit the feasibility and advisability of such nationalized healthcare systems the performances of which have been largely misrepresented by the Left.

As or more importantly I re-emphasize that in all such commons the participants become natural antagonists with one another in seeing how much of it they can consume viz how much others are consuming.  (Read the histories of life in communist countries in which commons were comprehensive.) The numbers tell the real story as we have presented here over the past years – this barn has been circled many times and, as is clear, none of the circumnavigations has sufficed to settle the matter.

To begin, we should first dispose of the unimpressive 30may17 Union Other Voices by Milan Vodicka, PhD, a stalwart of the local Left whose contributions have decorated many of the newspaper’s op-ed pages.  (The good Dr Vodicka is an “Independent Education Management Professional” with an academic pedigree from the California Institute of Integral Studies that prides itself with academic departments such as ‘Ecology, Spirituality, and Religion’, ‘Integral and Transpersonal Psychology’, and ‘Drama Therapy’.)  In this latest he excoriates Congressman LaMalfa as being dishonorable(!) and delivering him a “personal insult” for voting for the recent Republican House healthcare bill.  The man seems to be totally ignorant of the single payer systems’ performance in the OECD countries, regurgitating for us the Left’s well-worn propaganda about the glories of socialized medicine.

The Europeans have already taxed their people to the limits to provide a panoply of social programs including single payer.  Like a man plummeting from a high building, they seem to be enjoying the transitory weightlessness and breeze while sharing their exhilaration with all who care to listen and believe.  All single payer systems are unsustainable – they take up more of national budgets and/or reduce services to make ends meet.  All of them perform poorly in that citizens who can afford private or out-of-country healthcare avail themselves when the occasion arises.  The rest grin and bear it, and say they like it when they are healthy and not in need of healthcare.  (See also ‘Misreading the Nordic Model’.)

The greatest incipient insanity in the pursuit of single payer is happening in California with SB562 threading its way through the Sacramento asylum.  If the Lord’s sense of humor persists, the bill will become law and quickly demonstrate to the nation (and the world?) the true meaning of ‘unsustainable’.  But the real joke will be on those of us in California not yet on the dole.

Nationally, the Left is screaming that President Trump’s budget is ‘gutting the safety net’, especially when it comes to the travesty known as SSDI which pays out $150B (plus $80B for Medicare) annually to nine million ‘disabled’ Americans.  Modern times, it seems, have made people more injury prone thereby tripling the number of qualifying disabled since the 1980s.  For a more sobering assessment, please take a glance at this.

Finally, for the serious students of government handouts, I direct their attention to a monogram by the very impressive Michael Greve, professor of law at George Mason University, entitled Federalism and the Constitution: Competition versus Cartels (download from here) wherein he introduces us the forms of federalism, specifically cartel federalism, now rampant in the land.  You can read a summary of this work here.

Comments

[Account Deleted]

Love that opinion piece by M Vodicka. Typical left wing rant filled with personal insults and comical nonsense.
Money quote - "Where everyone participates, indeed must equally participate."
As the great sage of Warner Bros was wont to say - "watta maroon!"
No, my good Mr Vodicka, everyone most definitely does not participate equally. In any communist or socialist system, the more productive provide most or all of the value or money that goes into the system and the rulers take first dibs on any value coming out of the system as well as skimming a percentage off the top. Then there is the 'participation' of those receiving care among the hoi polloi. Those that attend to their personal health and take care to diet properly and exercise regularly will not ever receive as much care or value out of the system as those living a debilitating life style.
But these are all facts and they don't mean a thing to those who want 'health care' to be one more virtue signalling exercise.
Then he lays this line on us - "Therefore, I wish to state respectfully, yet unequivocally and firmly, that the so-called healthcare system in the U.S., in comparison to what it could and should be, is atrocious."
This, after he just got through defending the current health care system.
It could be Mr Vodicka suffers from some sort of problem that keeps him from remembering what he actually thinks from one minute to the next. I don't know.
And of course, there is the appeal to our Christian religion, parsed out in sound bites and carefully sanitized to be something of value at this time only, and administered by Rev Vodicka - high priest of a religious belief that has been declared to be necessary.
Please save us from such blather.

[Todd Juvinall]

The decent into socialism and communism is at hand in California. Looks like to fools under the dome in Sac are moving the 400 billion tax on us forward. Amazing.

[Bill Tozer]

Oh Todd, it's only a 15% payroll tax on workers that the po folk don't need to worry about. It's only another business tax that is the least of the po folk worries. Sees to me that if CA is struggling right now to pay for Medi-Cal, why not quadruple down and all will be well. Middle class workers will actually save money. Hmmm. Now where have we heard that before? Wonder it they will save $2,500 a year. Guess they will have to pass it to find out what's in it.

People want it....as long as somebody else pays for it. The "other dude" strikes again.

Money quote:
“It’s offensive to the people who have to pay for it,” he said.

http://www.latimes.com/politics/essential/la-pol-ca-essential-politics-updates-single-payer-healthcare-plan-advances-1496361965-htmlstory.html

[Account Deleted]

"Despite the incredible progress California has made, millions still do not have access to health insurance and millions more cannot afford the high deductibles and co-pays, and they often forgo care,” Lara said during a floor debate on the bill."
So - millions did not have access to health care and then there was 'incredible progress' and now millions do not have access to health care.
Uh, OK - so what kind of progress do we need if 'incredible progress' is not enough?
We need SUPER DOOPER incredible progress!
C'mon, folks - it's a frickin' joke. All the lefties said we needed Obama care and everything would be groovy. But now it's not groovy and we need the NEXT SUPER DOOPER BIG THING.
Now we need SINGLE PAYER!
That is, some one other than me.

[Todd Juvinall]

GeorgeR did you read that article in the Union today regarding single apyer? IMy take away is they are mixing apples and oranges with the dollars. Counld you staighten me out with a review?

[George Rebane]

ToddJ 834am - Sorry Todd, that little piece of journalism left me as confused as you. What did SacBee report?

[Paul Emery]

I think 15% is ok as long as EVERYBODY pays it. No exceptions.

[Todd Juvinall]

The Union article was hooey. They somehow do not know the difference between private and public money and purchasing. Unbelievable they would print that crapola.