Full Version: No Matter What, Single Payer Healthcare is Slavery

“Of ull tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under the robber barons than under the omnipotent moral busybodies. The robber barons cruelty may sometimes sleep, his cupidity may at some point be satisfied; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.” – C.S. Lewis

On September 14th, 2017 Dr. G. Timothy Johnson, the former chief medical correspondent for ABC news, presented an argument for a single-payer health care system in the United States by focusing on three main points: cost, quality, and access. Johnson’s arguments fail because they are unable to recognize certain economic and political realities. A government-run health care system would move towards protecting the most politically influential participants—insurers and pharmaceutical companies—and separate both patient and provider from the economic conditions that assure the best quality care at the lowest possible cost. For America, the most effective health care system would be a first-payer system with no government involvement.

A single-payer system cannot succeed in America for four principal reasons. First, a single-payer system poses a solution to an illusory problem; while many see the health care issue being solely the result of evil insurance companies and greedy drug makers, the actual issue present is the monopoly privileges and third-party payer system currently existing in America. Second, the health of a nation cannot be fixed with laws and regulations. If this were the case, prohibition would have resulted in a complete abolishment of alcoholism. The primary driver of the health of a nation is culture; more specifically the culture’s preference on certain healthier actions over unhealthy actions/decisions. Third, a basic principle of economics is that competition leads to lower cost, and higher quality. When a single institution acts as all parties involved, costs neither become mitigated, nor does the quality increase. Fourth, everywhere where single-payer has been attempted in America it has failed to produce results nearing, even, the imperfect third-party system in the United States.

A single-payer system in the US will do nothing to reduce either national mortality rates, or costs. In the US, mortality rates are affected by factors—primarily drug abuse, smoking, trauma, and obesity—that are either unique to the US, or more prevalent here than in Europe. However, there is no evidence whatsoever to suggest that any given health care system—any system for either paying or providing health care—reduces mortality rates. In other words, there is no causal relationship between health care systems and mortality. Similarly, costs in the US are influenced primarily by indirect pay and extensive monopoly privileges that are more pervasive in the US than Europe. So while some single-payer nations might have lower costs and mortality rates than the US, America must be careful not to accept Dr. Johnson’s fallacy of assuming cause and effect where no evidence supports it. “If you take all the other developed countries in the world: Japan, Switzerland, France, England, Canada, Taiwan, all of them. And lump them all together, and take the average per person cost, it is $5,000. About half of what we spend.” The notion that having a third party system to mitigate health care cost is falls apart after closer inspection. The actual percent of health care costs paid for by consumers in the US is 10.5 percent. This lack of direct pay and increasing government spending on health care (talked about more extensibly further on) contribute to more bureaucracy and inefficiency. When a consumer is not the one burdening the cost—at least the majority of them—that consumer’s regard for lower prices decreases, while consequently, increasing their desire for higher quality.

Simply because one country has a system, and that country has better health care, does not mean that the system in question directly resulted in better health care. Opioid abuse in America is far more prevalent than in Europe. According to CNBC American’s consumer nearly “80 percent of the global opioid supply.” The National Institute on Drug Abuse state that in 2013 $78 billion in costs were related to opioid prescription—only $2.8 billion for treatment. This excessive consumption leads to high mortality and addiction rates in the US. The Washington Post reported in 2014 that infant mortality rates—the majority of which occur during the teenage years—in the US are also higher at 6.1 out of 1,000 births, compared to countries like Finland, Portugal, and Denmark with 2.3, 2.5, and 3.4 out of 1,000 respectively. Forty percent of American smokers consume 20 or more cigarettes a day; that is in comparison to only 9 percent of European smokers according to the European Commission and the CDC. This is not in and of itself an issue with health care in the US; it is an issue with—overwhelmingly—personal choices. Americans are some of the most obese people in the world claiming a staggering 38.2 percent obesity rate. Americans rank on the top of the 2017 charts for obesity compared to all other OECD countries, the average being 19.5 percent obese—this coming from OECD. These are just a few examples, but they help to show that American health is nowhere near the level of other countries. This is not to say American policy is good, far from that actually, but to say that a system in Europe will fix the problems in America based solely on mortality rates is misleading. Culture and desires go hand-in-hand. If a culture values healthier living—less smoking, less eating, less drug use—that culture will, more often than not, have lower levels of mortality. That is what the data shows.

Per the OECD, “the average household net-adjusted disposable income per capita is USD 41,071 a year, more than the OECD average of USD 29,016 a year, and the highest figure in the OECD.” If a country has more disposable income, they will spend more than those that have less. This answer, however, is not satisfactory enough to quell the stated question, “why is it that we spend so much more money on health care in this country than all other developed countries?” The appropriate response requires more history regarding American health care.

Before the 1900s came about, the idea of a health care system would be a foreign concept to the world at large. While medical services were being performed, there wasn’t a system of health services like there is today in most of the developed world. The first physicians came about through apprenticeships. It wasn’t until the 5th century BC that any contemporarily recognizable medical school existed. As time progressed, medical education became centered primarily on Italy. Most British physicians, therefore, trained in Italy. This is an important fact due to “medical education in colonial America” being “strongly influenced by the European apprentice system (McGuff, D., & Murphy).” Two products of medicine in colonial America, William Shippen and John Morgan, established the first official medical school in America. In 1765, Morgan presented a lecture that helped spur the creation of “university-based medical schools” at such institutions as “Yale, Columbia, Harvard, and Dartmouth (McGuff, D., & Murphy).” Shortly after these schools were created, private organizations began to produce medical personnel without any university affiliation. In today’s world of licensure, this idea of private organizations being able to instruct future doctors without government oversight or university backing is frightening to many who see this barrier-to-entry on medical personnel a ‘necessary evil.’ The reasoning behind why this line-of-thought came about began with universities. Many “university -trained physicians organized into county and state medical societies and lobbied to enact licensure legislation, which would ultimately eliminate much of their ‘amateur’ competition (McGuff, D., & Murphy).” State by state, medical societies were being born. The ultimate result of these communities was the formation of the American Medical Association, more widely known as the AMA, in 1847. After the AMA’s creation, new standards of admission for medical schools were enacted which virtually destroyed the less formal means of entry to the field of medicine–utilizing one of the many non-university backed schools. The motives may be pure at heart, higher requirements leading to higher quality of care, but the fact remains that barriers-to-entry only raise prices, and harm lower-income people that can not–or refuse to–pay beyond a certain price for a higher quality of care. The idea here is that if someone cannot pay for a Northwestern-educated pediatrician, why can they not choose to find a doctor that went through an apprenticeship program for a lower price? The risks could be higher, but the cost is less. Can individuals not choose for themselves how much risk they are willing to take?

Upon entering into the early 20th century, a government-sponsored investigation into medical education, known as the Flexner Report, was undertaken and published. Flexner’s conclusions on the state of US and Canadian medical education was that most schools were ‘substandard.’ He recommended entrance and curriculum changes to include at least two years of university education followed by four years of medical school (two of which were to be basic science and two years clinical). Not long after this landmark publication many of his recommendations were adopted into common practice. The aftermath of the report resulted in a decrease in practicing doctors “from about 175 physicians per 100,000 of the population in 1900 down to about 125 by 1930. During this same period, more than 30 medical schools closed (McGuff, D., & Murphy).” Despite all of these happenings in the medical industry, the fundamental doctor-patient relationship remained. This relationship was predicated on the Hippocratic Oath (do no harm) and was based on the compensation of work that was provided by one’s doctor. This began to change with the introduction of health insurance. During the Great Depression, many doctors received payment in the form of food, services, or other tradable items because of the lack of disposable income. To supplement physicians income, many doctors and hospitals decided to organize insurance companies. Like any other type of insurance plan, individuals purchase a policy that one must pay premiums on–that are priced by actuarially sound principles. In tornado alley, for example, a policy for tornado insurance will be higher than, say, flood insurance. This is due to the probability of the former claim being greater than the latter claim. These types of policies covered catastrophic losses for the most part. Minor costs were expected to be paid out of pocket. This can be seen today with car insurance. Car insurance does not typically cover oil changes or brake jobs—or at the very least is never used on them. This idea of catastrophic events being the purpose of coverage helps keep insurance rates affordable. If insurance is to be used more readily, say with everyday wear and tear on a vehicle, or check-ups at a clinic, the cost for policies will increase. This premise was initially applied to the health insurance industry. When someone had a small problem–a checkup for instance–, that person would pay out of pocket for the service, saving their insurance for some catastrophic event. This concept is important because it is what kept policies between insurance companies affordably competitive. As time progressed, hospitals and doctors saw potential opportunities for expansion, so they developed products wherein one could get insurance for routine medical care as well as catastrophic events. This form of insurance coverage became more and more untenable, in part, as hospitals and physicians started raising charges beyond the actuarial soundness of the policies. The insurance issuers then turned to the assistance of the State. It was at this point where Blue Cross/Blue Shield (the Blues) came into existence. Because of the economic predicament and politicians’ desire for a ‘win,’ the Blues received some regulatory relief through tax-exempt status on all of their premiums, thus making those premiums more affordable to the public (McGuff, D., & Murphy).” The catch-22 of this deal with the general government was that the Blues had to engage in community rating. In essence, community rating is where “all applicants within a given geographical region, regardless of the applicant’s age, sex, or medical history” would legally have to be charged the same premiums (McGuff, D., & Murphy). This also brings up the concern of moral hazard. As defined by CBS, ”moral hazard is a term describing how behavior changes when people are insured against losses.” When low-risk people subsidize high-risk individuals, the latter no longer have incentives to stay ‘safe.’ This is because their premiums are legally required to remain the same as those that are low-risk, and vice-versa. This inevitably caused premiums to rise due to lack of personal fiduciary responsibility, on the part of the guaranteed consumers, to keep costs down for the insurer.

This lack of financial responsibility was exacerbated through the erosion of the traditional doctor-patient relationship. As discussed earlier, the consumers of health care would, in the vast majority of cases, pay for encounters with their physicians out-of-pocket. This classical system kept prices in check and quality high. This is because the consumer, as the direct beneficiary of this health care, desire the highest quality for the fairest price. Once third-party-payment enters into the equation, consumers are less likely to shop around for the best value. The insurer now is the one paying for the bulk of their customer’s health care. The insurer does not necessarily care about the quality of care as they do about the price at which they can remain profitable. They will actively search to benefit themselves over the policyholders because they know they have control over payments to physicians and hospitals. Once the consumer, relinquishes control over their freedom to barter, they will find that being taken advantage of becomes a regular occurrence. (Consumers should advocate for medical insurance to become more in-line with other traditional insurance products; that is, more direct consumer control and responsibility.)

As if all of these distortions of the classical insurance model were not bad enough, the reality of WWII emerged resulting in wide range wage and price controls. Companies could no longer compete for labor in the traditional, more free-market, way. One way a business could actively attract employees to their place of work was through fringe benefits. These benefits included health insurance. By 1942 the federal government allowed insurance premiums to become a “legitimate cost of doing business and could be deducted from the employer’s taxable income. However, insurance purchased by an individual outside of an employment benefit program was not a tax-deductible expense (McGuff, D., & Murphy).” What this did was effectively attach one’s health insurance with their employer. No one would think twice before saying it would be silly to attach car, home, renters, or any other type of insurance exclusively to their current employer. They know that if they leave that job, for whatever reason, they will have in all likelihood, lost their safety net.

The second of these incursions by the State was in 1986 by President Reagan through the signing of EMTALA (Emergency Medical Treatment and Active Labor Act). As often happens to legislation, noble goals and unforeseen consequences caused more harm than good. What EMTALA did was to require medical screening exams of anyone presenting to an emergency department regardless of ability to pay. Additional Features of EMTALA required stabilization of patients and that no hospital or physician be allowed to refuse the transfer of patients requiring higher levels of care. These requirements ran into many legal and medical hurdles. Due to the broadness of the wording in EMTALA, doctors and hospitals were confused as to what constituted ” medically stable” or ” active labor.” Legal conundrums obviously followed as to what to do with certain situations. Any violation of EMTALA could result in the hospital losing Medicare/Medicaid payments from the government. Violations could result in stiff fines and heavy legal battles to civil rights action. Essentially, EMTALA placed the medical profession on defense with serious legal implications. An example of this would be doctors reluctance to be on-call to come in for patients with whom they have no pre-established physician-patient relationship. They take a large legal risk without the guarantee of compensation for said risk. Many specialists stopped taking call because of this. Surging emergency department volumes due in part to EMTALA along with DRGS made hospitals charge more for basic medications and supplies–like ibuprofen–to cover for monetary losses from uncompensated medical care by those who could not pay to cover the fees. Medical translators, for instance, are required to be used under EMTALA for anyone whose primary language is not English. Furthermore, EMR’s (Electronic Medical Records) became a requirement for hospitals. EMR’s slowed down the time it took for a doctor to see, treat, and document a patient’s medical encounter by almost 50% due to increased time spent performing computer documentation.

It is also important to take note of the monopoly privileges that government bestows upon drug manufacturers. The hallmarks of a monopoly firm are barriers to entry and exclusive possession or control through legal privileges. This is exactly what the FDA does for Johnson & Johnson, Pfizer, and Roche; the general government exercises their monopoly on force to ensure that smaller companies or start-ups can not enter into the marketplace. According to Forbes the average costs for “bringing a new drug to market is $1.3 billion, a price that would buy 371 Super Bowl ads, 16 million official NFL footballs, two pro football stadiums, pay for almost all NFL players, and every seat in every NFL stadium for six weeks in a row.” This is an outrageous cost that can not be explained by simple research costs alone. Regulation that only the ‘big guys’ can afford help keep revenue up, and competition down. The average individual forgets that institutions, like big business, are profit-seeking entities. If eliminating competition helps achieve that end, the businesses in question will not hesitate to lobby for regulation on the part of the FDA to ensure stability in their respective markets. To further quote the Forbes article, “a single clinical trial can cost $100 million at the high end, and the combined cost of manufacturing and clinical testing for some drugs have added up to $1 billion.” These costs can not be absorbed by small start-ups. This means that for the average consumer, the price of a drug will only go up due to little to no competition until generic copies of the drug in question are allowed by such agencies as the patent office and the FDA.

Author Donny Miller says it succinctly “in the age of information, ignorance is a choice.” Public libraries are free to use; physicians are required to present your information. When a patient is dismissed, they will frequently receive a packet discussing anything and everything relevant to their visit. Unless external circumstances arise, such as the patient being unconscious, or inebriation, any significant action prescribed by a physician can be overridden by said patient. Any inclination towards an argument that a free-market system on health care is based on uninformed consent is, therefore, dead on arrival.
This elongated explanation shows that “the newest thing” in health care is not a primary cause of increased costs. If America’s true desire is to “control unnecessary spending,” as was the overarching point of the lecture, the United States should return to a system wherein insurance is actually insurance.

Ensuring cost control is neither the function of American governance, nor is government even needed in the action of cost control. The “mechanism to ensure that the quality of care, no matter where you go, is going to be the same, and of high quality” is called capitalism. In a capitalistic environment, quality businesses (i.e., the business that have provided service and quality to the standards of the marketplace) succeed and thrive; while bad businesses fail, and their resources reallocated towards profit-making firms in the economy. To be fair this system has been corrupted, as shown in previous passages; however, the idea being proposed already exists.

Consider this hypothetical, pursuant to new regulation, all tires are required to have holes in them—thus making the tires a hindrance to vehicular movement. The appropriate response from those that state a new system is required for cost control would be to lobby for a square tire—seeing that cylindrical tires have apparently failed. As this hypothetical shows, the issue is not cylindrical tires. It is the regulation hindering the tires from properly doing their job. In a capitalist economy, if the mechanisms are manipulated—as is the case with government influence into the economy—the system will not run properly or efficiently.

A system where universal, and singularly imposed, checks and regulation will not, and has not, produced increased quality or lower cost for the average consumer. As will be shortly explained, the US aviation industry is tightly regulated and controlled by the general government. This is, in fact, a common point made by those in the affirmative for universal health care. The points often made do not take into account, as famous 19th century economist Frederich Bastiat said in his treatise, The Law, “what is not seen.” This is the abstract from the 2011 aviation institute’s report on Consumer Regulation and Taxation of the U.S. Airline Industry. “ In the face of economic recession, new security costs, volatile fuel prices, and an ever-expanding array of federal and local taxes on air transportation, U.S. airline passengers have enjoyed a decrease in base fares over the past 10 years. Because of government action, that is not likely to continue. All airlines have unbundled their products, expanded into new markets and shifted to direct distribution via the web to keep base airfares low and to remain competitive. Yet the combined impact of new aviation taxes and consumer regulations has negatively impacted passenger demand and local tourism spending nationwide. Airlines pay an average of $59 per ticket sold in taxes across domestic and international flights. This tax burden suppresses both tourism and business travel, through both higher fares and lower airline capacity. Conversely, AAI estimates that a $10 per ticket reduction in federal air passenger taxes would stimulate new service and lower fares that would benefit local economies nationwide by $13 billion annually. Under the current administration, consumers have also faced a gauntlet of new regulations designed to “protect” the consumer that has been rife with unintended consequences. Since 2009, consumer regulations have increased airline costs by $1.7 billion annually, or $5.39 per round-trip ticket. Higher airline taxes drive a combination of service loss and higher fares. Both result in a decrease in business and leisure traffic to cities nationwide. This paper (1) reviews and quantifies the federal tax burden, (2) reviews and quantifies the burden of new consumer regulations (including both one-time and ongoing costs to airlines) introduced in 2010 and 2011, and (3) quantifies the local impact on airports, cities and states nationwide. Given the ongoing impact of high regulatory on and taxes on air travel demand, we recommend an immediate review and moratorium on new consumer (non-safety) regulations and aviation taxes.” The full report can be found in the citation section below.

Further points can be made, however. Many of the intelligentsia advocate for a singular system of health care, just like a single system of airline regulation. This can not be further from economic reality. One provider does not decrease cost and increase quality, quite the contrary. A singular provider has no incentive to protect or help the consumer. This is why if the general government ever attempted to institute similar policies to health care as they have to the airline industry it would be a disaster—this can already be seen with the financial fallout for companies enrolled with the ACA. The thought of a single plan versus even only 50 plans (not ideal but better than one) is frightening. Plans by the many are far better than plans by the few. Take a look, for instance, at the TSA. Would anyone truly say that the TSA is an excellent agency that is the gold standard for air-travel protection? No. No-one in their right mind would say that after the countless cases of grouping and, as reported by NBC, a 95 percent failure rate in detecting contraband. If the TSA and the FAA can’t be effective at providing better costs and higher quality service to consumers, how would health care be any different?

While the idea of an omnipotent and omniscient general government is heart-warming to many, nothing could be further from reality. Many believe that national advisors are such, that in the case of individual regulation, they somehow would not—or could not—be implemented for advice or council. This begs the question, where do these ‘experts’ reside? Do all of the experts only live in DC, or any other federally owned land, and are not allowed to leave? Is it impossible for experts to be flown out to each state and give recommendations on quality and regulation? No, of course not. These experts live all across the 50 US states and subsequent territories. If the safety standards of Arizona are inadequate, anyone is more than welcome to not visit that particular state. If enough people do this, the state in question will change its standards. If, however, people decide in the aggregate that these lesser regulations are sufficient enough for their business, the market (the collection of individual people) has then spoken. However, when the general government imposes regulation, it forces all people to revoke their ability to enter into entirely consensual agreements based on the idea of safety and price. This means that one more aspect of voluntary association is taken away from consenting adults.

Why do some choose not to buy into a health insurance plan? Most individuals that choose to forgo health insurance are the young-adults that are entering and exiting college. This group of people, overwhelmingly, feel as if they do not need it. Most young adults are in this boat, deciding to risk hospital bills for more cash on hand to perhaps pay off student loans, or to buy groceries. In the aggregate, this is a wise bet. Most 20 year olds don’t require a physician. In the rare cases that young adults need a physician for a serious issue, there are countless ways—through charity, crowdfunding, and religious organizations—to address costs. It is also important to realize that theft, the forceful taking of another property, is an unjust action. Therefore, it becomes clear that forcing people to pay for another’s insurance is not just immoral, but is wholeheartedly unnecessary. Why steal from Peter to pay Paul when private entities, such as churches and non-profits can—and already do—provide services and monetary support for those in need? This was the way things were before the Roosevelt’s New Deal. Churches and charities used to be the primary provider of “public welfare.” The difference, however, was that the individuals these altruistic entities assisted were not given a blank check. Many times work would be exchanged and a solid work ethic would then be established. No one expected anything and therefore utilized resources to the best of their abilities. That is no longer the case with present-day public welfare. According to the Washington Times, under the previous administration “federal welfare spending has grown by 32 percent.” These numbers only increase over time. A private system of welfare is far more moral, ethical, and cost-effective and moral than forcibly taking from the working people, and giving it to those that have/can not. This is not meant to be callous—as so many claim the position to be—because history shows that private entities can more than assist those in need. People like giving to causes and groups that help others, yet for one reason or another, the narrative is that no one would give. This activity can be practiced to prove this false narrative wrong. Ask any group of people “would you give to charities that help the disenfranchised, sick, and homeless if there was no government program to do so?” The answers you will receive will be a resounding yes.

“Morally, should health care be considered a right or a privilege?” This is a pervasive question around the world. The short answer to it is no; it is not a right. The average individual agrees that cars should not be a right, but why not? Many people need transportation to work in certain jobs, should that cost not be a right of every American? No one is entitled to the service or labor of another. A human can not, and should not, force another person to get up, go to the institution they belong to, work for 12 hours a day, and then demand that that person pay for the service that was just provided. The simple question arises, what difference is there between slavery and universal health care? Most doctors, particularly in the emergency department, have despised what their ED has turned into after the ACA. An example from a high-trafficked midwestern ED follows. A middle-aged woman called an ambulance for a hangnail, and then while being checked on in the ED, she demanded that her kids be given their check-up because the physician was there. All the meanwhile this was not being paid for by her, it was being paid for by that physician through taxes and fees imposed on him. This is not right, not moral, not ethical. In no way can it be thought as such. When you impose a service as a right onto society, you impose the labor of those that make the service run as an implied right. A counterpoint often brought up was that most physicians would be more than happy to serve still. This rationalization is irrelevant for multiple reasons. Doctors may be content in certain workplace scenarios, but according to recent surveys of practicing doctors, 71 percent of physicians are happier in independent practice than in a traditional hospital setting. This is true in almost all fields. The more independence an individual has, the happier they will be. This applies for government interference. The less a physician is dictated to by the commissar—in essence the more free a person is—the more content that physician will be with their work. The idea that someone is happy working under these conditions shows an incomplete knowledge of workplace environments. If someone believes that they are serving their fellow man, they will certainly feel elated. If this is done in a more free way however—as shown in America—their contentment with their job will rise. The fact, also, that a human likes his or her job, does not mean that human is no longer a slave. A slave is “one that is completely subservient to a dominating influence.” Physicians are completely subservient to their government in nations that have universal health care. Only in countries without nationalized health care can physicians truly be considered free. If labor is compulsory, then that human is a slave. This is not to be conflated through the American lens/expectation of the word, however it is important to realize that the physician is still, definitionally, a slave nonetheless.

Take this argument for universal health care to its logical end. If health care is a right, why should the United States not provide health care for all of Africa, Asia, South America, etc.? Why does this right for all to have health insurance stop at an imaginary border? If, indeed it does not stop, why is it specifically the United States’s obligation to provide this service? The answer, of course, is that it is not. Those that propose universal coverage do not take their reasoning to its logical end, and that is a major issue that seldom is mentioned in the discussion.

It can often be heard that no one wants Medicare touched or meddled with; that this government-run program is good. The reasoning is obvious after an observation of the data. According to Politifact, “a two-earner couple receiving an average wage — $44,600 per spouse in 2012 dollars — and turning 65 in 2010 would have paid $722,000 into Social Security and Medicare and can be expected to take out $966,000 in benefits. So, this couple will be paid about one-third more in benefits than they paid in taxes.” Why wouldn’t someone like to receive 1/3rd more on original investment? The issue is that as with all public welfare programs, they are Ponzi schemes. The general government must take from the young to give to the old. This, as birth rates alone suggest, cannot sustain itself. To the acknowledgment of the speaker, it was said that Medicare does contain “issues.” This does not, however, cover how immoral the program is to begin with. The previous generation’s earning were taken from them by their predecessors, the present generation’s earnings taken from them for the previous generation. Why not let everyone manage their money as they like, and promote healthy financial habits?

This system of single-payer that so many describe already exists in America; specifically for Native Americans and Veterans Affairs. Native American peoples get single-payer health care through the IHS (Indian Health System). To quote a 2016 Forbes article, “The problems with the Indian Health Service (and the Veterans Administration) cannot be blamed on ‘greedy’ insurance companies or the private sector. The federal government sets the budget, personnel, and policies for the agencies. The U.S. government functions as the de facto ‘single payer’ health insurer for these patients.” Further on in the article, Forbes mentions a Newsweek piece noting that “government funding of the IHS is based on what is “politically expedient,” rather than what the Indian tribes were promised by formal treaties. This is an inevitable consequence of any government-run health system. Whenever politicians take over health care, then health care will become hostage to politics. If you’re part of a constituency with political clout, you’ll get good health benefits. If you don’t have political clout, then too bad.” The situation is so bad for native peoples that it is better to commit a crime and be sent to prison for the health care alone.

According to the Washington Times, “a VA employee in Puerto Rico was reinstated with back pay last month after she was fired upon being arrested for armed robbery. She pleaded guilty, but her union got her job back by arguing in a grievance that a VA manager at the facility is a registered sex offender and another VA hospital manager was once arrested for drunken driving and found in possession of pain pills.” The unionization and government nature of these services make it nearly impossible to get rid of individuals. This is an issue not just in the United States, but in government union jobs across Europe. The VA is massively in debt and wait times can be months-on-end for a simple appointment. The news site, Dailymail, reported in 2015 that “more than 6,100 forced to wait at least a year for operations or treatment. In the worst examples, the delay has been nearly three years.” The wait times are only going up in the United Kingdom. Single-payer has failed in providing adequate cost, quality, or service in America. These are all things that Americans are told will be resolved under single-payer.

The parable of The Good Samaritan, found in the Biblical book of Luke, is oftentimes in imposed on those opposing universal health care. It is unfortunate that when brought up, the point and context of the parable is often lost. The parable’s point was that individuals should lend help to their neighbors in need, no matter who they are. The irony in this parable is that the embodiment of the state, the religious leaders, passed over the man. It was a private person, who did not run to the temple to advocate for money to pay for a hated man’s health. The loving Samaritan took it upon himself to lend a hand. He did not need to steal the product of another to give to the man on the road. That was the point of the parable; that every individual should both love, and show love to all of God’s children. To take it, most importantly, upon themselves to help those in need.

As it has been shown, the cost, quality, and service of single-payer is nothing to be desired. First-party payer is the system America used to have, and should move towards once more. The more disassociated the individual becomes with where their money is going, the worse the end product will be. In ever instance where universal health care has been attempted, it has radically failed in its pursuit of mitigating cost and increasing service quality. When it comes to health care, the goal should be to go for the best system, not a failed one.

Note from the Author: This was a relatively long response article, and, as previously stated, was nowhere near as comprehensive as it needs to be for the whole health care discussion/debate. It is important to consider these questions, “will I be able to keep my physician and hospital? Will private research organizations and health-oriented philanthropic institutions be shut down and their assets seized by the government, as was the case in the United Kingdom after the NHS was implemented? Will crony capitalism still play a major role in lobbying the government for more monopoly privileges? Will the government be able to put out competitive bidding in a fair manner for drugs, medical devices, and services? Will what happened to the VA and the IHS be carried over to the entire American single-payer system if universal health care was implemented? Will everyone be required (politicians, movie stars, government employees, the well-connected) to partake in the single-payer system unlike with the ACA? Will you, as an individual, have the autonomy to make decisions regarding your own health care? Will those that reach 65, as is the case in the vast majority of countries that partake in universal health care, refuse to provide procedures/treatments such as kidney transplants and dialyses?” These are all things to consider. I applaud all those that made it this far and encourage everyone to look into this for themselves. Read The Primal Prescription by Doug McGuff and Bob Murphy. Read Economics in One Lesson by Henry Hazlitt. Read Human Action by Ludwig von Mises. Listen to personalities like Tom Woods. Whatever you do, please read and become educated because in the society we all live in now, the more educated you become, the better prepared you will be when those that want your property come for it. Have a blessed day.











McGuff, Doug, and Robert P. Murphy. The primal prescription. Malibu, CA, Primal Blueprint Publishing, 2015.