Why The Idea Of Single Payer Heath Care Won’t Die

1) Opposition to “single payer” plans has come from Democrats as well as Republicans.It was the Democratic governor who killed the proposal in Vermont, and a Democratic legislator who killed the proposal in California. Similarly, numerous Democratic voters and politicians spoke out against the idea in Colorado

2) Most of current opposition is based on economic — not moral — grounds.For many on the Left, the high costs are viewed as obstacles to be overcome on the way to a worthy goal, rather than reasons to oppose the idea of single payer as such. As one Vermont single payer activist told the Boston Globe, “It’s an issue of human rights and justice.”

3) Proponents of free-market health reforms will need to persuade voters based on moral grounds, not just economic reasons.There are excellent market-based alternative to “single payer,” such as Steve Forbes’ ideas here. But the idea of “guaranteed” health care for all, independent of ability to pay will continue to appeal to many voters, because they view this issue as more than economics. Supporters of free-market health reforms such as myself will therefore need to address more fundamental issues such as the proper scope (and limits) of government intervention in the economy, the nature of “rights,” and the concept of “entitlements.”

As a physician, I am deeply concerned that giving governments control over medical funding will end up giving governments control over medical care. Whenever “someone else” pays for your health care, inevitably “someone else” will decide what health care you will (or will not) receive. 

4) This issue will heat up in the 2018 and 2020 election cycles.The issue of “single payer” is already a hot topic in the 2018 Colorado, California, and Maryland governor’s races. Many on the Left want to make support for “single payer” a litmus test for 2020 federal office political candidates. We don’t yet know how these discussions will play out. But given that health spending in the US makes up 1/6th of the US economy, at least they won’t be boring

I am a physician with long-standing interests in health policy, medical ethics and free-market economics. I am the co-founder of Freedom and Individual Rights in Medicine (FIRM). I graduated from University of Michigan Medical School and completed my residency in diagnostic … MORE

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