A Look at the Single Payer System

Posted on October 25, 2013. Filed under: Government, Obamacare, Socialism, Taxes | Tags: , , |

Centers for Medicare and Medicaid Services (Me...

Centers for Medicare and Medicaid Services (Medicaid administrator) logo (Photo credit: Wikipedia)

After many discussions with my friends on the left, I can say with certainty that they are not happy with Obamacare, either. They aren’t happy with it, because it isn’t a single payer “public option”.

It’s a word that gets bandied around by groups on both the left and the right, but what is it exactly?

Single payer refers to the government paying for everyone’s healthcare costs. A great idea on the surface, right?

Single payer is only the funding mechanism, not the delivery system. Medicare, for example, is a form of single payer healthcare.

So, let’s assume for a second that the US were to adopt a single payer system. What would happen?

The government would decide how much it was willing to pay for certain things, as it does with Medicare/Medicaid. They would also be able, through this mechanism, regulate the entire industry, making doctors jump through hoops in order to get paid.

Don’t think this could happen? It already is.

It isn’t that the doctors don’t want to treat the patients. It’s that, through regulation and mounting rules, the government makes it more difficult for them to get paid what they feel their services are worth.

According to the Wall Street Journal, the number of doctors opting out of taking Medicare patients in 2012 has tripled from the number of doctors who opted out in 2009. While this is still a small amount of healthcare professionals in this country, it shows that the number is increasing, but it doesn’t stop there. Many more are limiting the number of Medicare patients they will see. The article goes on to say that even fewer doctors are taking on Medicaid patients.

So, under Obamacare, what good does it do you to be eligible for Medicaid if you are unable to find a doctor that will accept you?

A growing number of doctors are also opting out of the private insurance game, not because of Obamacare, but because insurance companies are a pain in the ass to begin with.

However, it gets more insidious than that, if you look deeper into the article.

Other doctors are dropping out of Medicare to avoid deeper government involvement in medicine, much of which is occurring in Medicare. For example, Medicare is now paying incentives to doctors who switch to electronic medical records and who send data on quality measures to the federal government. Doctors who are part of the Medicare program who don’t do so will face penalties starting in 2015.

In other words, the government is data mining doctors for your confidential information. It has been well documented that the government has more than a few databases with information on us, and are constantly trying to create more databases to gather as much information on us as they possibly can. They claim it is for law enforcement purposes, but I say it is the creation of an enemies list. Why should the government have access to your medical records?

Moving to a single payer system will remove any barriers from the government having access to your records. After all, they’re paying for it, so what harm could it do?

I’ve heard people say that a single payer system would be best because the government would not pay $2000 for an MRI. Why is an MRI scan so expensive?

A high end MRI machine can cost as much as $1.2 million. At $2000 per MRI scan, the facility would have to perform 600 scans in order to pay the machine off.

The direct costs for running the machine are minuscule in comparison, the electricity costs, the technician’s pay, the computer costs, etc., but they do add up over time.

So, assuming an average of four tests per day, the machine would perform about 1000 scans in a year. Plenty to cover the cost of the machine, right?

It is, if you don’t account for interest payments, taxes (Federal, State, local), building costs, maintenance, insurance (both liability and property) and the fact that the healthcare field is still a for profit business in most cases. Yes, doctors are trying to make a profit.

Why should they not be able to make a profit? Even “non-profits” are for profit businesses. The difference is that they hold their profits in a reserve fund, and don’t distribute it to shareholders.

Let’s take a brief look at other countries and how they do healthcare.

According to the World Health Organization, France provides close to the best healthcare, and the government pays for nearly 77% of healthcare costs, while having the highest healthcare costs in Europe. They have certainly done nothing to control the costs of healthcare.

France also charges a 33% corporate tax. The highest individual tax rate is 75% (up from 45%). They also have payroll taxes of 15%, and a sales tax of 18%. Based on what I earn, I would be subjected to a 30% income tax in France. So, if I lived in France, the government would take almost half of my money every time I got paid. That’s not even including local taxes, of which there are a lot.

But why did France increase their highest tax rate to 75%?

France is in deep debt. Could it be because they pay for 77% of all healthcare?

In Britain, they are broke. Period. The top income tax rate is 45%. If I lived there, i would pay about 20%, but my wife would be paying 40%. They also have a 20% sales tax, There is also a National Insurance contributions, similar to our payroll taxes, but much higher. So much higher that it accounts for about 21% of the United Kingdom’s revenues. In return, the UK pays for about 81% of all healthcare costs.

But they are still broke.

In Japan, the government pays for about 80% of all healthcare expenditures. Costs are much lower in Japan than most places, because the government has fixed the costs. Japan still has some of the highest taxes in the world. Homemakers (women) in Japan make enough money that they are not allowed to take certain deductions on their taxes, meaning that most women in the country only work part time.

Under the surface, the single payer system is all about wealth redistribution, taking from those who have, or those the government perceives to be among the haves, and gives to those who don’t. The problem is that often, those who were not meant to be swept up in such a system often are. Look at the alternative minimum tax. That has swept up many middle class families, and while the government has acknowledged that is a problem, they have done nothing to fix it. Obamacare uses this system, penalizing those who are young and health to subsidize the elderly and those who are sickly. The rest of us pay higher premiums to subsidize “the poor”, and in many cases, the premiums for the elderly are jumping as well.

When Obamacare collapses, the push will be on for a single payer system. The only difference right now between Obamacare and the single payer system is that we are being told to purchase our own health insurance policies, in many cases including coverage that we don’t need (for example, I’m a guy who will have to purchase maternity care insurance) or face a tax penalty from the IRS.

A single payer system would force us to contribute (like we do with Social Security and Medicare) to a national insurance program, which would then be subject to budget cuts and government raiding, and political brinksmanship in Washington.

We have an obsession with creating lists and comparing ourselves to other countries. Maybe our problems with healthcare is that the US only has 2.4 doctors per 1000 people. Maybe that is a contributing factor to high healthcare costs.

By extrapolation, there are only 753,600 doctors to cover 314,000,000 people.

So, if more and more doctors refuse Medicare and Medicaid, that number begins to shrink. Many of these doctors are opting for cash only or offering concierge services. If the number of doctors that accept insurance, or Medicare/Medicaid shrinks to a point where people can’t find doctors, then the government would be forced to hire their own doctors, to establish their own hospitals.

In the age of no bid contracts, does anyone but a fool honestly believe the government is competent enough to run healthcare for the entire nation?

They couldn’t even get a website up and running on time.

Liberty is when the people are allowed to decide for themselves. Tyranny is when the government forces the people to do something, whether they want to or not.

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