The Single Payer Trojan Horse

A heavy weight weighs in, George Will:

Single Health Payer Torjan Horse

To dissect today’s health-care debate, the crux of which concerns a “public option,” use the mind’s equivalent of a surgeon’s scalpel, Occam’s razor, a principle of intellectual parsimony: In solving a puzzle, start with the simplest explanatory theory.

The puzzle is: Why does the president, who says that were America “starting from scratch” he would favor a “single-payer” — government-run — system, insist that health-care reform include a government insurance plan that competes with private insurers? The simplest answer is that such a plan will lead to a single-payer system.

Conservatives say that a government program will have the intended consequence of crowding private insurers out of the market, encouraging employers to stop providing coverage and luring employees from private insurance to the cheaper government option.

The Lewin Group estimates that 70 percent of the 172 million persons privately covered might be drawn, or pushed, to the government plan. A significant portion of the children who have enrolled in the State Children’s Health Insurance Program since eligibility requirements were relaxed in February had private insurance.

Assurances that the government plan would play by the rules that private insurers play by are implausible. Government is incapable of behaving like market-disciplined private insurers. Competition from the public option must be unfair because government does not need to make a profit and has enormous pricing and negotiating powers. Besides, unless the point of a government plan is to be cheaper, it is pointless: If the public option conforms to the imperatives that regulations and competition impose on private insurers, there is no reason for it. Continue reading The stealth single-payer agenda

And this: The Non-Debate over Non-Reform

As the discussion of health-care policy unfolds, what we are seeing is a non-debate over non-reform. The Democratic proposals promise to entrench the status quo, which does not fit with the principles of personal responsibility and fails to allocate resources sensibly.

To show what I mean, hold up ten fingers. Each finger represents 10 percent of health-care spending in the United States. Five fingers — half — represent what is paid for by government programs, such as Medicare and Medicaid. Four of the remaining fingers represent what is paid for by private health insurance. One finger represents what individuals pay out of their own pockets.

To move in the direction of personal responsibility, we have to make more of our health-care system look like the one finger — as was the case as recently as 1960, when the share of medical expenses paid for by individuals out of pocket was 50 percent. This is a radical idea for reform, and neither political party is talking about it. Instead, the Democrats are trying to incrementally make the system look more like the five fingers now represented by government. And in opposing the Democrats’ reforms, the Republicans risk being put in the position of trying to protect the four fingers of private health insurance.

Our health-care system is wasteful. We spend far too much money with relatively little to show for it. That would be of little concern if individuals were wasting their own money. However, because close to 90 percent of personal health-care spending is paid for by third parties, we are wasting each other’s money. This approach has its attractions; as individuals, we all want unlimited access to medical services without having to pay for them.

However, this is not sustainable. Employer-provided health insurance is unraveling, as workers are getting less take-home pay while employers are shelling out more to compensate workers in the form of health care. Medicare is even less viable. It faces tens of trillions of dollars in unfunded liabilities, meaning the gap between what future beneficiaries have been promised and the taxes that we expect to collect to fund those promises. Rather than make hard choices to restrain costs, the political mechanism works to satisfy existing constituencies now and pass the liability on to future generations.

Continue reading, The Non-Debate over Non-Reform


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