I'm guessing most folks on this website love the idea of single payer health care. It's simple. The government sets a pay scale for procedures and so the individual is free to go to any doctor or hospital he wants to go to because they have nothing to gain or lose by seeing a new patient.
No worries about how much different patients' insurance plans will reimburse. A vastly stream lined billing system for providers. No limited choice due to insurance industry networks. Every doctor is part of the same network and we, the patients, will have seemingly infinite choice in which doctor's we'll see.
It sounds great, but there's a case a strong case against single payer health care in America. A very American centric case as to why we shouldn't go down that road in this country. Follow me below the fold.
Single payer works under one critical assumption: Government will adequately budget to make sure the health care needs of its people are met, since it's the government who will be footing the entire bill for health care.
As we all know there really isn't a liberal political party in America, which will go balls to the wall for government funded social programs.
There are some liberal Democrats out there, but not enough to effectively change the political landscape in America. Most Democrats, especially those running for state wide offices who have to get the votes of disgruntled suburban Philadelphia ex-Republicans, for example, can't drift too far to the left. And these are the "good guys" we're counting on to implement and adequately fund and manage a single payer plan.
I just don't trust our government enough to trust them with paying for my health care. At best our government under funds social services, like Social Security, food stamps, welfare and unemployment benefits. At our worst, our elected officials are openly hostile to the whole idea of government funded social services and like to follow Grover Norquist's suggestion that we should make these programs so small, we can drown them in our bath tubs.
As much as we bask in the glow of a seeming implosion of Republican and conservative ideology in this country, we need to realize this has more to do with Republicans and conservatives tearing each other apart and driving people away from their Party and ideology on narrow social issues and ideological litmus tests, rather than an overwhelming embrace of liberalism and government funded solutions by the American electorate.
A Republican ticket of John McCain and Sarah Palin, though seemingly doomed, incompetent, and incoherent, still got a little over 45% of the vote, in the 2008 election. Sure Obama got a solid victory and a pretty clear mandate for "change", by a majority of the electorate, but 45% of the people, who voted against him, make a pretty good, large, and receptive audience for anyone, who can find a rational, coherent and articulate voice for wanting to undermine a single payer plan, if we choose to go down that road.
Right now the only thing keeping those 45% of Americans from becoming an effective opposition Party, is the fact there isn't a coherent, rational, and articulate set of points being put out there by anyone, who is supposed to be in the opposition. I just can't see this situation of incoherence lasting from the conservatives.
The suburban Philadelphia voters, who were loyal Republicans but are now Independents haven't changed their views on wanting a balanced budget or limited social programs. The national Republican Party has kicked them to the curb on social issues. They'll support President Obama, because he's a level headed man and isn't going to shift the country far to the left. They haven't given up their belief in balanced budgets and their skepticism of government solutions.
As great as single payer sounds in theory, it rests entirely on the trust the government will be wisely spending money to properly fund health care. Even in Canada, you can have budget issues and conservatives curbing health care funding by legislative decree:
There was, to be sure, little in the way of deviation from Conservative script. But then, Prime Minister Stephen Harper made it clear from the time he began campaigning for the nation's highest office that he wanted his government to be known for tax relief, enhanced security and a sort of salt-of-the-earth accountability and predictability in which politicians unleash few surprises on unsuspecting Canadians.
From that perspective, the new minority government's first budget, delivered May 2, was a resounding success in that it ventured nary an inch from oft-repeated Conservative priorities, delivering a projected $26 billion in tax relief over 5 years, while reserving the bulk of its new spending for security measures.
It was, as Canadian Medical Association president Dr. Ruth Collins-Nakai noted, immediately apparent that it wasn't "a health-focused budget, [but rather] a tax cut budget."
Still, Finance Minister Jim Flaherty's fiscal blueprint for 2006–07 had its health moments: new monies for pandemic preparedness, a national cancer strategy and, potentially, international AIDS and polio initiatives. But it offered nothing to alleviate the chronic shortage of health care professionals, Collins-Nakai said. "We would have liked to have seen some specific targeted money in terms of health human resources. We have a tremendous shortage here and it is patients who are going to continue to wait until we address that."
Flaherty did, however, re-affirm Conservative intentions to honour federal commitments under the September 2004 federal/provincial/territorial 10-year Plan to Strengthen Health Care; to iron out a Patient Wait Times Guarantee with the provinces; and to re-open intergovernmental negotiations to redress the so-called fiscal imbalance to help the provinces fund delivery of health care.
Although the budget offered little insight into how the imbalance will be addressed, it clearly positioned the Conservatives by asserting that health care is a strictly provincial jurisdiction. Canadian Health Care Coalition President Sharon Sholzberg-Grey lamented the stance, inquiring "Where does that leave the federal government as the guardian of comparable services and in charge of the Canada Health Act?"
http://www.cmaj.ca/...
Before America should even think about single payer health care, we need to have a truly transformative period in American politics, where the electorate makes a significant shift to the left and wants to have government solutions to social problems.
Rushing into single payer, without a country fully willing to embrace the concept, will only lead to a mangled, under performing, government agency, since the political will, will not be there to properly implement single payer.
There are other solutions and models out there, which will better fit what Americans are willing to accept, to move us towards universal coverage and a kinder, gentler, healthcare system in our country.