Single payer health - an objective analysis
Upon close examination the single payer health system model exhibits several hidden flaws, as well as insidious undercurrents. I originally set out to examine ways of funding single payer, which has been a principal hurdle of existing attempts. For instance Tennessee has their Tenncare plan that, in the few short years it has been available, has all but bankrupted the state's treasury.
A basic step in trying to find a solution for a problem is to first see if anybody else has already done so. I set about doing this, and to my astonishment I immediately found a number of organizations that have successfully run hospitals for decades that provide first class, and often ground breaking service at no cost to any patients. The most glaring example, especially available to the Tennessee folks, is St. Jude Children's Hospital in Memphis. As a boy growing up in that city I remember often hearing, in the TV and radio adds for St. Jude, Danny Thomas's voice saying "no one may pay". St. Jude shines as a beacon the world over, offering their cutting edge knowledge on curing cancer to any institution or doctor. It is simple to extrapolate that St. Jude would also share their expertise in running a "free service" hospital to any serious organization that asks. I have not asked them myself but it would stand to reason.
Now I started to worry. Tenncare could not help but trip over St. Jude. It does not take a rocket scientist to figure out that St. Jude is easy to access. Anybody in the health biz knows them. So we must infer that they did not do so because they did not wish to.
Peel an onion, there are lots of layers. If they did not want to emulate a hospital that has succeeded in setting up and running, for decades, a successful "free" health service equally available for all then what do they want?
Next layer: Let us for a moment examine a couple of well known examples of "successful" government health care systems commonly used by single payer advocates:
England - This is actually a two tiered system. The "single payer" or "free" level is for the "have not's" or those that do not want to pay for their health care. The hospitals generally work well enough, if you do not mind beds perhaps lined up in wards. The upper crust that can and want to pay for their health care have a number of first class hospitals that take cash, or perhaps insurance. This keeps the "riffraff" out of "their" hospitals.
Canada - This is also a two tiered system, with the USA providing the upper level. Like England the "single payer" or "free" level is for the "have not's" or those that do not want to pay for their health care. Again the hospitals work well enough, if you do not mind major waits for certain services or operations. The Canadians that can and want to pay for their health care bring their cash to the good ole USA. You can bet the hospitals welcome them, and their cash, with open arms - much less paperwork than with insurance.
So, we come to Single Payer as pertains to any particular American state. Given the top level proponents have not modeled themselves after St. Judes, or the Shriners, etc. is it not easy to presume they too want a two tiered arrangement? What would they get? First, they would get a different, and possibly more affordable insurance for those wanting to avoid the "free" hospitals or doctor visits. Also they would get less cluttered hospitals that prefer to cater to private cash wielding clients. Even more curious is the idea that big business would start offering insurance intended for the top line hospitals and doctors as benefits for attracting highly valued management personnel. They also would not have the expense of insurance for the lower level employees as these people would be expected to use the freebie plan. This is a big plus for big corporations, which pretty much promises they will be behind the single payer efforts, though probably carefully inconspicuous.
Onion time: The "first onion layer" has the poor and folks unwilling to pay their own health care or insurance wanting it "free", ie paid for by taxpayers. These people are probably easily enlisted for petitions and such.
Another layer has big business pushing, and perhaps paying for, the main organization behind the single payer movement.
Our conclusion is hard to avoid. Single payer is quite possible, and the "how to" is as near as the telephone. This may be a system incorporating vast donations by corporations (deductible of course). They may require fund raising campaigns, like St. Jude uses. All they have to do is ask those who already do it. Avoiding this nearly guarantees that a two tier system is the hidden agenda. Class separation, funded by tax payers, that brings a windfall savings combined with a terrific new employment benefit for large corporations, is nearly unavoidable.
I do need to add one more item. It is presumed that a single payer health care system would be paid for by the government. I would like to ask you, when was the last time you complained about pot holes in the streets? When were you last irritated about bad trash pickup? well, do you really want the same government that you don't trust to fix pot holes to fix you?
A couple of years ago a remarkable woman, an activist for welfare recipients, was awarded the Humanist of the Year designation. One of the things she was instrumental with was a bill of rights for welfare recipients. This was as a result of her and other welfare folks, in the offices to get their allotments or otherwise engaged in the offices of that office, having been refused use of the restrooms while there. Single payer advocates, do you want your very lives entrusted to the same mentality that would refuse such a fundamental human, and health need?
Peel an onion, there are lots of layers.
Respectfully submitted by Marlin Mackley 2-20-2003
To Marlin's home page
Click here to send email to: Marlin Mackley
509 Main Street
Fenton, MO 63026-4169