When government runs hospitals, clinics, and other health-care institutions, people get worse care for more money.
Sen. Bernie Sanders’s presidential campaign is exceeding expectations and drawing large support from young and blue-collar voters. At the center of his policy platform is a plan to completely socialize the U.S. healthcare system, turning it into a “single-payer” program, or a single government fund that pays for all citizens’ health costs.
The argument for this kind of system is simple. Supporters say it will enable everyone to access health care and cost less than our current mix of private and public health expenditures. Most of all, they argue this system would be morally superior to others.
All of those claims are dubious, but the last is the biggest whopper. In fact, socialized medicine is immoral. It relies on coercion and results in shortages and long wait times, which means worse care. It is rife with inequality and inefficiency, leading to serious harms.
This Would Ratchet Up the Doctor Squeeze
Consider how a socialized system would cut costs. Single-payer advocates brag that having one, national fund for health costs would allow the government to “negotiate” health-care prices down because it would essentially have prevented everyone else from bidding to pay for them. In other words, government would have control of an entire industry and be able to dictate the terms of work and trade for everyone within it. How is this morally superior to allowing free people to negotiate arrangements on their own?
Unfortunately, America hasn’t had a truly free, market-based health system for decades. Many people feel the outsized power of insurance companies has allowed them to dominate and unfairly control doctors and hospitals. This is true: Insurance companies, thanks in large part to regulations from the Affordable Care Act, are consolidating and using their growing market shares to bargain, and perhaps bully, health-care providers and dictate the terms for everyone.
We already see the bullying of providers in the single-payer systems that exist in the United States, including Medicare. Doctors consistently complain about the ways Medicare makes practicing medicine hard, from bureaucratic paperwork and compliance burdens to low pay.
Socialism Means Force, and Force Is Wrong
In fact, each year more and more physicians opt out of the Medicare program altogether. It’s become so bad in Hawaii that legislators have proposed a bill that would force providers to accept Medicare or else lose their medical licenses! This is always the end of government-controlled health care: coercion.
As Dr. Jim Geddes, a trauma surgeon near Denver, CO, recently told Medscape.com, “The only way physicians can afford to participate in Medicare is that they get higher payment from commercial insurers. Single-payer advocates talk about ‘Medicare for all,’ but if Medicare were standing alone, it would fall flat.”
But at least some choice remains: Doctors today can still choose not to participate in certain plans or programs. If single-payer were the law of the land, no health-care provider could engage in his profession without having to bill the government, as government would be the only payer for these services in most cases.
Health-care providers would be forced to accept a government-set price for their services. This would inevitably harm the quality of care we receive by locking in current ways of doing things instead of allowing people to try new ones, and discouraging people from pursuing grueling, expensively learned work in the medical field because of low pay and bad working conditions.
We’ve seen how a similar standardized compensation system has worked for public-school teachers. It effectively punishes excellent teachers and rewards mediocre ones. It’s helped create a bifurcated education system, with private schools delivering higher quality to families that can afford to pay tuition on top of taxes, while too many families are left to attend low-quality public schools.
The same phenomena would take place in medicine. Under a government-dominated system, excellent health-care providers wouldn’t be rewarded and would suffer new burdens, while mediocre and even poor providers would receive the same payments as those that provide high-quality care.
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