Reason.com

Free Minds & Free Markets

The Case Against Single-Payer Health Care

Let the health care market work without government meddling.

America needs single-payer health care, say progressives. That's a system where government pays doctors and hospitals, and no sick person has to worry about having enough money to pay for care. After all, they say, "Health care is a "right!"

"Who pays for it?" asks Chris Pope, "And that's really not a rights question."

Pope studies health care systems for the Manhattan Institute. In my newest video, Pope explains that although many Americans think that Canada and most of Europe have single-payer systems, that's not really true.

"In Germany, employers provide most of the health care…just as they do in the United States," he says. France and Switzerland also offer multiple options, public and private, and most people buy private health insurance. Some of the Swiss government subsidies are similar to those of Obamacare.

But Canada, England, Norway, Cuba, and a few other countries do have genuine single-payer. I'm constantly told that it works well—people get good care and never have to worry about a bill. They spend less on health care and live longer.

Pope says that claim is naive.

They do live longer in many of those countries, but it's not because they get superior health care; it's because fewer of them are fat; fewer crash cars; and they shoot each other less often. "Take out (obesity), car accidents and gun violence, the difference in life expectancy disappears entirely," Pope says.

Also, government-run systems save money by freeloading off American innovation. American drug companies, funded by American customers, fund most of the world's research and development of pharmaceuticals. New drugs and devices are expensive, so oftentimes in Britain, says Pope, "whenever a new drug comes on the market that can save lives, the government just doesn't have the funds to pay for it."

Patients, accustomed to accepting whatever government hands out, don't even know about advances available elsewhere.

Single-payer systems also save money by rationing care. Hence the long waiting times for treatments declared "nonessential" in Canada, Britain, and, for that matter, at American veterans hospitals. The VA's problems are similar to what's happened in Britain's National Health Service.

"In England," says Pope, "rarely a week goes by without a crisis or another in the health care system being part of the news. This year, there was a crisis in emergency room care—people left in hallways for hours and hours."

Critics of U.S. health care say waiting in line is better than getting no care, which is what happens to Americans who cannot afford to pay.

But is that true? Pope points out that America already has "over a trillion dollars a year in public spending, really, to provide health care to people who don't afford it." Also, American emergency rooms treat anyone who comes in.

By contrast, single-payer means taxpayers' funds are spent on everyone—even people who can afford to pay for their own care. That means there's less left for the truly needy. The affluent often escape government's waiting lines and treatment limits by buying private health insurance.

In Britain, millions of people purchase private insurance, says Pope.

At least they still have that option.

In America, Sen. Bernie Sanders says gleefully that he wants to put private insurance companies "out of business."

Hearing that, Pope replied, "makes you wonder whether this is more about spite than it is about improving people's health."

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  • DajjaI||

    I spent some time in London last year and basically it's non-stop mental illness indoctrination. Everywhere you turn, on TV or billboards or in the newspapers or on the radio, it's all talk about autism, anxiety, anorexia and addiction. And that's just the a's. Basically these are fun-to-treat diseases and the system caters to them at the expense of real diseases because they are accountable to no one except politicians. The same thing will happen in the US. Basically the healthcare bullies will sit at home all day badgering their local doctors offices for unnecessary tests and procedures to get declared disabled under various fictional diagnoses thereby crowding out the people with real problems who ironically will be footing the bill. I have a friend from high school who was actually a doctor until he got depressed and a whole bunch of other shenanigans and then ended up getting ECT and now he's 'disabled' and sits at home all day with his mother writing music (and I don't want to know what else). Well both his parents are psychiatrists so it's no surprise. His brother is just as bad (paranoid schizo).

  • Quo Usque Tandem||

    Was he a psychiatrist as well? If so that makes perfect sense.

  • sarcasmic||

    "makes you wonder whether this is more about spite than it is about improving people's health."

    Basically it is. It's spite against insurance companies making profits. The left doesn't understand that profits are the price we pay for efficiency. So they assume that government can take over, eliminate profits, and remain efficient. When you point out the gross waste and inefficiency of government they will invariably say it's better than wasting money on profits. The left would rather have long waits, retarded innovation, and people dying in hallways, than allow someone to make a profit from making healthcare more efficient.

  • Moo Cow||

    Efficiency? The insurance companies dont care what the bills are. They pass on all costs. Plus about 20%.

  • Red Rocks White Privilege||

    Funny how the doctors, who are actually charging the prices, don't ever get blamed for this.

  • Fist of Etiquette||

    I agree with Stossel. We need a national ban on obesity and a full repeal of the Second Amendment. We also need to relocate rural America to urban centers so that public transportation is fully utilized and becomes the only option for non-important people.

  • Daniel||

    Just outlaw dying.

  • BigT||

    Did you really write this, Stossel? What happened to your inimitable style? Isn't the Socratic method cool anymore? And why such weak arguments? Aren't you against government monopolies? Where are the principled, practical deconstructions of the system? Aren't they paying you enough?

  • Overt||

    Aren't you really thinking of Napolotano?

  • JFree||

    it's not because they get superior health care; it's because fewer of them are fat

    There is a fucking link here. Generalist doctors are exactly the sorts of doctors who serve a preventive role. Nagging their patients that they need exercise and to eat healthy and so on. But to fulfill that function, the doctor has to actually be able to spend TIME with that patient and build trust - and there needs to be enough GP's so people can EASILY find a GP who they can get an appointment with and go to and ultimately trust.

    The US has EASILY the worst structure for GP's. Because there's a shortage here, they have to treat patients like hamsters on a wheel - so no patient actually views them as able to do anything beyond a physical. Because their bills are all out-of-pocket/deductible, it means the poor don't go to the doctor when it means a tradeoff with food or rent that month - so they remain ignorant of bad habits they have which turns into FAT and LAZY over time.

    countries that solve that problem absolutely do have superior health care systems.

  • JFree||

    Just to give one example - France has as many pure GP's as the US does - with a population that is 20% of ours. They earn roughly 2/3 of what GP's in the US do - but they have no student loans to pay off and they are able to earn that income with a regular work week and seeing fewer patients but spending more time with them. Because it's so easy to find a GP in France - and those visits are actually covered by their system, the French go to the GP/doctor far more often than we do - 3x per year v less than once per year here. That's means the little stuff and bad habits don't get out of hand - and means the French are far healthier than we are despite smoking like chimneys and seemingly spending all their time eating and drinking with friends.

  • JFree||

    Other countries that 'do things right' re GP's are Ireland, Netherlands, New Zealand, and Australia. Even though every semi-rich country does things FAR FAR better than we do. Our closest comparables re GP's are Greece, Turkey, and Poland. Hell even Mexico does better re GP's

  • ThomasD||

    "That's means the little stuff and bad habits don't get out of hand"

    LOL.

    Comparing the French lifestyle to American lifestyle is a joke. It's not like the majority of American don't already know that what they are doing is 'bad,' or that the extra visits will somehow leave them convinced to change their ways.

    Obesity is accepted here in ways that in Europe it simply is not. More trips to the doctor here wont mean people getting slimmer and eliminating their type II diabetes, it will mean more people wanting more pills to control their type II diabetes.

  • Don't look at me!||

    People seem less likely to go to the doctor that is constantly nagging them about being overweight. Additionally, people in France eat different and better food than Americans, as well as less of it. On top of that, they walk and ride bikes more.

  • JFree||

    The point is that doctors don't nag them about being overweight just because. The weight starts causing problems in the patient's life. It is the patients self-interest that causes them to make the effort to lose weight. The doctor is just the person who knows what's happening - and as a generalist is more focused on the patient's overall health than a specialist who sees everything as a body part or a disease not as a patient.

    And if there are enough GP's so it's easy to get appointments and find the GP you can trust early on, then the trust can be built up long before the health problems start getting serious.

    Fact is - we had more GP's/capita in the US during the Great Depression than we do now. And the poor had MORE access to them then than now. Employer plans were NOT put in place cuz people had a tough time seeing the doctor. They were put in place cuz charity hospital donors wanted to take their deductions on their corporate returns not their individual returns. Hell a big reason Medicare was put in place was because of pressure from specialists and med schools. The patient base for specialists is overwhelmingly old people even today and they wanted to have their receivables subsidized. Everything about our system is designed to kill off GP's. And it works to do that too.

  • ThomasD||

    " It is the patients self-interest that causes them to make the effort to lose weight."

    You don't actually treat diabetics, do you?

    People jab themselves with needles multiple times a day rather than lose weight.

    They get neuropathies, and foot ulcers (and amputations) rather than stop eating multiple jelly donuts daily.

    They end up on dialysis rather than give up the all-you-can-eat buffets.

    Type II diabetes is mostly self inflicted, and the harm takes years if not decades to accumulate. All the while they have been repeatedly and pointedly warned. All while they spend massive amounts of time, and vast amounts of money to treat their condition.

    You are engaging in wishful thinking to suit your preferred outcome.

  • JFree||

    You seem to be assuming that they are doing that out of sheer willful stupidity. When the reality is that most of them are doing that because that is how we do diabetes in this country because we don't have GP's in this country who spend time with patients before they have full diabetes. GP's get the 10 minutes to discuss screening results (which prob doesn't begin until middle age anyway) and prob roughly 30 secs to say 'losing weight will help. Here's a pamphlet'. And once they are diagnosed with diabetes - here's how we treat it.

    Obviously people aren't making lifestyle changes because a doctor said something once with no follow through. Stop pretending that it's because people actually want it that way. That's just making excuses for a crappy system. I have relatives who are fat - and every one of them is surprised (actually surprised) when I tell them it might be possible to reverse diabetes if they eat differently. It's a screwed up medical system when that info is relayed by relatives rather than doctors.

    Part of that also is the training that GP's get here. GP's are trained like specialists here because 90% of doctors ARE specialists here. So most of them suck at actual old-fashioned 'talk to the patient' stuff - just like specialists do. You can see the difference if you've ever lived overseas. GP's there are trained to deal with patients better. Which means patients can learn to trust them too.

  • BCarter||

    'I have relatives who are fat - and every one of them is surprised (actually surprised) when I tell them it might be possible to reverse diabetes if they eat differently. '

    So what you are telling us is that it does not require a GP with a $300,000 education to tell them this? That maybe a concerned relative or any of about a 300,000,000 articles on the internet could inform them?

    Try a google search on 'how to reduce diabetes'. There are 351,000,000 results

  • Earth Skeptic||

    Fat Shamer!!!

  • Vernon Depner||

    Your weight is whatever you say it is. No one has the right to assign you a weight that doesn't reflect who you really are.

  • JFree||

    It's not like the majority of American don't already know that what they are doing is 'bad,' or that the extra visits will somehow leave them convinced to change their ways.

    Jeezus H. How do you think smoking became unfashionable among the high income here? You think people in higher social groups just woke up one day and decided it wasn't going to be acceptable? No. People who did smoke at those income levels and had a cough did go to the doctor and the doctor said that their cough wasn't cuz flu/cold but cuz smoking. And then talked to their family cuz that's what FAMILY doctor do. And helped them quit and followed up with them cuz they were seeing them regularly (unlike the poor). And once enough people in that social group are trying to quit - then social pressure starts building to reinforce that and soon enough you actually have a healthier population in that class.

    You R's are such assholes. You have no damn interest in solving the actual healthcare problems in this country. This is all just yet another excuse to beat up on 'lesser' people for moralistic reasons masquerading as 'libertarian' hoohaa. Which does actual harm to actual libertarian efforts to try to use markets to solve problems cuz it spreads a notion that 'libertarians' are just assholes.

    Our health problems in this country are very much cuz our healthcare system SUCKS for significant portion of peeps. Not cuz the poor are free to be stupid and prefer that.

  • Overt||

    Jeezus H. How do you think smoking became unfashionable among the high income here? You think people in higher social groups just woke up one day and decided it wasn't going to be acceptable? No. People who did smoke at those income levels and had a cough did go to the doctor and the doctor said that their cough wasn't cuz flu/cold but cuz smoking

    Let me get this right. Our 20+ year obesity epidemic, including among the rich, is because there aren't enough GPs and as proof you point out that these same GPs that are incapable of badgering us to be thin were the same ones who badgered us to stop smoking?

    Reduction in smoking had nothing to do with, you know, all those laws that made smoking almost impossible in any public place, huge taxes on cigarette sales and massive public shaming campaigns. Right? Right?

    "You R's are such assholes. You have no damn interest in solving the actual healthcare problems in this country"

    You "Ds" are such assholes, just making up facts and telling anyone who disagrees that they aren't interested in solving the problem. In fact, I am not an "R" but I tire of idiots proposing massive interventions in the market when they can't even put two posts together that are logically consistent.

  • JFree||

    Our 20+ year obesity epidemic, including among the rich, is because there aren't enough GPs and as proof you point out that these same GPs that are incapable of badgering us to be thin were the same ones who badgered us to stop smoking?

    We had more GP's/capita during the Depression than we do now - declining ever since. so yeah GP's used to be able to do things then that they don't do no more cuz they don't exist no more. And the more medical insurance squeezes the poor, the more what ACTUALLY gets squeezed is GP's cuz their bills are effectively outside insurance coverage. So they wait and wait and -- go to ER's instead. Guess what costs more for everyone?

    I tire of idiots proposing massive interventions in the market

    I far prefer the market. But I tire of idjits shouting ideological/political slogans as a substitute for thought. Markets don't actually work just cuz people shout market-'friendly' slogans. FACT is that the three main healthcare problems in this country are not magically solvable by the market.

    The poor don't have money. They never will. Markets require money for a pricing system to work.
    The disabled are too sick to keep jobs. Employers only cover employees.
    Insurance - govt or private - creates freeloading overutilization that drives up costs for everyone else.

    Guess what three issues people avoid talking about re market

  • Sevo||

    "I far prefer the market. But I tire of idjits shouting ideological/political slogans as a substitute for thought. Markets don't actually work just cuz people shout market-'friendly' slogans. FACT is that the three main healthcare problems in this country are not magically solvable by the market."

    Nor are they solvable by appointing the government as director. There is no magic, you fucking idiot.
    Now, I'm still waiting to hear which company forced you to buy there goods, liar.

  • JesseAz||

    Have you seen the malpractice lawsuit rates in other countries? Look especially at gynecology insurance. Now which party is a party of trialawyers stopping medical protections against frivolous lawsuits...

  • Overt||

    Except wellness checkups- you know, where the GP badgers them- are free in our ACA utopia.

    The idea that a GP you see once or twice a year is going to make you stop being fat, or smoking, is silly though. Even if that visit is 30 minutes instead of the current 10 mins.

  • JFree||

    That's the whole point. Defining a GP as for 'wellness checkups' means they serve no function for preventive health over time. Every other country assumes that the GP IS the main health care provider for the 80%+ of the population. Our lack of GP's means that Google becomes the main GP for Americans (who have internet access) with nothing for those who don't even have Google. It's fucking nuts.

    There is NOTHING in the existing US system - not ACA, not Medicare, not employer plans, nothing - that deals with the GP problem -- because the GP's don't exist in sufficient numbers here.

  • Overt||

    "Wellness Checkups" are specifically for preventative health over time. You go yearly or semi annually and the GP vaccinates you, does age-recommended tests, looks at your blood, tells you to eat more healthy, etc etc etc. That is the point. Today, if you have insurance, you get these wellness checkups for free once per year.

    I agree with you that we don't have enough GPs. That is because stupid laws have made being a GP extremely impractical. It was idiots like you who said "Preventative care is going to lower healthcare" (despite plenty of evidence to the contrary) and so most laws and regulations in ACA are around intervening in that PCP/insurer/consumer relationship. For example, the Insurance company is obliged to pay for wellness visits with zero copay, so they put strict controls on how many/how long you can do these visits. Because these very specific visits are free, GPs have no incentive to offer different types of wellness care- because only the strict basics will be paid for by insurance, and customers won't partake if they have a copay.

    The entire system- setup by well intentioned idiots- to poor people to consume GP services, has made GP care so unattractive, that new doctors would rather become specialists.

  • JFree||

    It was idiots like you who said "Preventative care is going to lower healthcare" (despite plenty of evidence to the contrary)

    This is just BS through and through. Preventive care DOES lower costs and that is proven. The reason we don't have preventive care in this country is because of ANNUAL enrollments. Annual enrollments mean that no one on the spending side gives a shit about the long-term trend of healthcare costs. Not employers - not govt plans - not insurers. Just cherry-pick the healthiest people you can for this years plan - fire the unhealthy so someone else picks up their bill.

    The reason I am skeptical about any govt solution in the US is precisely because our govt has that mindset too - and it is pervasive among voters. Until it changes, everything we do will just make things worse.

  • MJBinAL||

    The primary problem with healthcare is actually two things.

    Government regulations, both federal and state, are set up to eliminate competition from the marketplace. This is not a bug, it is a feature. From certificates of need to canned treatment plans everything is set up to force a standardized treatment approach and to reward monopoly providers.

    Government restricts HOW and WHERE you can purchase medical insurance. It used to be that electrical engineers for example, could purchase group medical insurance through IEEE. It was a large enough group to get decent rates and you could keep the same insurance from one employer to the next. Government "fixed" that so that you can't buy group MEDICAL insurance that way any more.

  • MJBinAL||

    Insurance that isn't insurance. All the NOISE about "pre-existing conditions" and insurance. Look, you can't buy fire insurance on your house while the fire department is trying to put out the fire. You insure against FUTURE losses not past ones! Well checkups are not risk losses. Medical insurance is what we used to have that covered your costs when you got sick or injured. Usuall insurance paid 80%, you paid 20% up to a maximum annual out of pocket. This is how ALL insurance works.

    What we call insurance now is actually socialized medicine. Everyone in the group shares medical expenses of any type. Go to the doctor for no good reason ... covered by OTHER PEOPLE. What a surprise that this makes it expensive. Medicare is socialized medicine on steroids with most of the costs paid by other people.

    If you are overweight (and I am) it is your responsibility and so are the associated costs. Grow up and take care of yourself.

  • TexasGirl since 86||

    How does a GP that is over weight or obese talk to a patient about losing weight? Mine is probably about 50lbs over weight. I am 58 years old, very fit, work out daily, eat a WFPB diet an I am thin. That is all me, no doctor was involved. I had gained a few pounds a year ago, I tweaked my diet, lost those few pounds, plus a few more. I have a close friend that is bothered by the fact that I can tweak my diet, increase the intensity of my work out, eat a healthy diet and lose weight, go figure. It makes her uncomfortable. She tells me I'm too thin.

  • The Last American Hero||

    It sure worked to help the French kick that smoking habit.

    Ooops.

  • jerbigge||

    The obese generally have high blood pressure, high cholesterol, high blood sugar. Cost to treat these three conditions will cost $120 a year for medications from Walmart. Once prescription laws are repealed, the obese will be able to obtain the drugs for these chronic conditions for what will amount of $10 a month. Walmart sells Novolin insulin (3 types) for $24.88 a vial. Meaning that insulin dependent diabetics can actually afford the insulin they need.

    It costs "ZERO" to repeal FDR's 1938 prescription laws passed at the wish of the AMA. That alone will drop US health care cost by billions of dollars a year. Of course the doctors won't like it. Like all professionals and licensed providers of services, they earn "above market" incomes thanks to being able eliminate any possible "competitors" thanks to the "protection" they have received from the most corrupt national government of any developed country.

  • MJBinAL||

    "The obese generally have high blood pressure, high cholesterol, high blood sugar" but not always. I am overweight, eat a low carb diet, and have NONE of those things.

  • IceTrey||

    How about because the word health doesn't appear anywhere in the Constitution?

  • Caddyshack||

    True, it's not the perfect document.

  • MJBinAL||

    Oh, I think it is pretty much perfect. Pay for your own shit parasite.

  • Semantix||

    1787, dude. They had just decided that barbers should probably stick to shaving and haircuts and leave the bloodletting and amputations to the surgeons.

  • Brian||

    Prediction:

    Single-payer healthcare will become a reality within 20 years.

    They'll be a honeymoon, "new dawn" phase as everyone is excited about medicine, even though, in terms of actual medical care, nothing really changed very much for practically anyone.

    As the reality sets in that government healthcare isn't exactly a health spa, people will grumble about multiple issues:

    1. Limited choices: government doctor says "Here's your treatment, and if you want a second opinion, go fuck yourself or get your wallet out."
    2. Wait lists
    3. Rationing

    etc. In short, people will notice that their actual healthcare has either roughly stayed the same or declined, but they pay more in taxes now, and keep hearing about the wonderful "security" they have as most of them continue to consume the same thing in exactly the same way as they did beforehand, or worse, than they did when they were "insecure."

    However, the true believers will always content that we are "one election away" from glorious health spa healthcare, as politicians and media talking heads discuss reforms and more money, with higher taxes, that are always being thwarted by whichever political party they don't like.

    And the only real winners will be:

    1. Shitty doctors
    2. Politicians

    And it will go on like that indefinitely. And people will act like they're totally shocked by how it turned out.

    Go go, Bernie Sanders.

  • Quo Usque Tandem||

    But it will get them votes in the short term.

    Votes are like money; if they tell it's not about that, it most certainly is [about that].

  • Semantix||

    Every country that has better healthcare outcomes than we do does NOT use a free market approach to healthcare. Every one. Look at any important metric. We suck. http://www.oecd.org/els/health.....h-data.htm

    Which means your "negative" scenario above is still significantly better than what we have today. I'll take it.

  • Red Rocks White Privilege||

    How about we just get rid of Medicare and Medicaid instead?

  • MJBinAL||

    How about we cook the stats like all those places with "better healhcare outcomes" do?

    So, when children are born, let's not count them until they live past one year. Bingo, all those children who die in the first year (a large number in the first few weeks) don't show up and average lifespan shoots up!

    We can eliminate all those "Quality of LIfe" treatments like replacement knees, elbows, etc for people over 50. Easily done like in those other places, just make the waiting list long enough and money gets saved! They don't actually DIE, so no stats are disturbed.

    So Semantix and the rest of you parasites, if you want to live in the UK, why don't you just pack up your shit and go live there? It always pisses me off that you useless dregs have to convert every place you encounter into a shithole rather than just moving to the shithole of your choice.

  • Last of the Shitlords||

    My prediction is for a bloody conflict that ultimately results in progtards occupying landfills, face down.

    Then unobstructed freedom.

  • MJBinAL||

    You are an optimist my friend.

  • Enjoy Every Sandwich||

    When people talk about how much money Americans spend on healthcare, what is included in that figure? Because if it includes gym memberships, buying vitamins, cosmetic boob jobs, and things like that, that spending isn't a sign of a "broken system" but rather a sign of first-world affluence.

  • Semantix||

    Nope. That ain't it. We simply spend more (much, much more) for core healthcare services. http://www.oecd.org/els/health.....h-data.htm

  • Red Rocks White Privilege||

    Which would be fixed instantly with price transparency and enforcement of existing anti-trust and price fixing laws.

  • MJBinAL||

    And we purchase lots more "quality of life" heathcare as well. Those other wonderful places don't replace knees for "old" people for example. We DO spend more, and we GET more as well.

  • Vernon Depner||

    waiting in line is better than getting no care, which is what happens to Americans who cannot afford to pay. But is that true? Pope points out that America already has "over a trillion dollars a year in public spending, really, to provide health care to people who don't afford it." Also, American emergency rooms treat anyone who comes in.

    That is absolutely not true. Unless you have a condition that is immediately life-threatening, hospitals will turn you away if you are uninsured and can't pay in advance for procedures or surgeries. Yes, if you're in the middle of a heart attack, the emergency room will treat you first and ask questions later. But, if you are doubled over in pain from gallstones or blind from cataracts and don't have insurance, you'll have to show them the money before you get treatment.

  • ThomasD||

    Emergency rooms triage everyone who comes in and stays - so yes everyone gets treated.

    That they do not freely provide everything you want does not mean they didn't give what was needed.

  • Vernon Depner||

    So, being told to go away because you're not in enough danger is being "treated". Thanks, Mr. Orwell.

  • ThomasD||

    The only people told to "go away" are annoying assholes who don't have a legitimate health issue (hint, hint.)

    That you have been assessed, determined to not be in an unstable condition, and then referred to the appropriate care is being treated. It's an emergency department, their primary role is not treating non-emergencies.

    That you don't like the absence of free shit but cannot be honest about it is what is Orwellian.

  • Vernon Depner||

    It's an emergency department, their primary role is not treating non-emergencies.

    That's what I've been saying. It's not a place where uninsured people who can't pay get free medical care, contrary to popular belief.

  • Vernon Depner||

    "...you don't like the absence of free shit..."

    What I don't like is people repeating the falsehood that free medical care is available for those who are uninsured and can't pay at any emergency room, and so everyone in the US gets needed medical care whether or not they can pay. It needs to be understood that there are people doing without needed medical care because they can't pay for it in order to have a fact-based conversation about US medical care.

  • ThomasD||

    " the falsehood that free medical care is available for those who are uninsured and can't pay at any emergency room"

    Horse. Shit.

    What you do not like is that there are limits on what is provided to the indigent.

    Tough. Shit.

    Now fuck off slaver.

  • Vernon Depner||

    Learn to read. What I have repeatedly said I don't like is people falsely claiming that there are NOT limits on what is provided to those who can't pay.

  • MJBinAL||

    Learn to think. There are limits on EVERYTHING. No one says they the ER will provide any healthcare you want. They will provide emergency care whether you can pay(or will pay) or not. No one has claimed any different.

    It is YOUR foolishness that keeps you from recognizing that.

  • The Last American Hero||

    What world do you live in where Medicaid doesn't exist? Because I'd like to travel there.

  • Vernon Depner||

    There are plenty of people who make too much money to qualify for Medicaid but can't afford medical care or decent insurance.

  • Lester224||

    This is the population that no one likes to talk about. These are working people, not "free loaders" but they can't afford the profits that the hospital monopolies and insurance monopolies (local monopolies) stuff themselves with.

    We need more doctors, especially GPs, and more competition in hospitals rather than these endless consolidations.

    We also need to stop paying for the lower drug prices of the rest of the world. I don't care if allowing Medicare to negotiate drug prices with pharma companies will "reduce R&D". Those pharma companies can just charge the rest of the world more to get their R&D money back. The U.S. shouldn't pay for R&D for the whole world.

  • MJBinAL||

    Oh yes,"can't afford" meaning would prefer to spend the money on something else. And "decent insurance" meaning insurance that will be subsidized to provide basic healthcare at someone else's expense.

    Basic Heathcare is not really insurance anyway. It is like maintenance on your car. Your auto insurance does not pay for oil changes, and radiator flushes. And that is what you REALLY mean, "insurance" that will pay for basic maintenance. Because what you want to have it paid for by someone else.

  • Incredulous||

    Yes, Thomas is correct. As an expert in this area, I can assure that EVERYONE who comes to the ER is treated for their legitimate health issues, life threatening or not, emergent or not. They are even given food and beverages for free, often a cab ride and even given guidance on getting coverage or low cost medications.

    But, because of government rules (EMTALA and other meddling), the ER is barred from giving prices and sends you a ridiculously overpriced bill.

  • Semantix||

    Hmmm...where in EMTALA does it state that they ER isn't allowed to give a patient an itemized bill if the patient requests it?

    EMTALA doesn't excuse insane markups for products and services. That's capitalism at work.

  • Red Rocks White Privilege||

    Then it kind of says something that you fuckos don't want to see existing anti-trust laws enforced and price transparency implemented, doesn't it?

  • TuIpa||

    "But, if you are doubled over in pain from gallstones "

    You get free gallbladder surgery because they know turning you away is a huge risk if it ruptures and treating it is only temporary. Your assertion that you get ignored is just plain wrong. In some simple cases for other ailments what you're saying is true, but that example is wrong.

  • Vernon Depner||

    You get free gallbladder surgery

    Bullshit.

  • ThomasD||

    'Bullshit.'

    It's only bullshit in the sense that there is no such thing as a free lap-choly. Too many people, and too much materials involved. Somebody will always pay.

    But, if it's not an emergency that someone is more likely to be the patient.

  • Vernon Depner||

    Yes, if it's not an emergency, the patient will pay, but he won't get the surgery until AFTER he pays.

  • ThomasD||

    Boo hoo.

    Not every bartender will let you run a tab either.

  • Vernon Depner||

    You keep agreeing with me in argumentative language. Are you confused or just inarticulate?

  • MJBinAL||

    He just realizes that you are nothing more or less than a frustrated parasite.

  • Weigel's Cock Ring||

    The instant I saw the title of the piece I knew it had to be either Stossel or Harsanyi who wrote it.

  • C. S. P. Schofield||

    Everything I feel I need to know about 'Single Payer' is summed up by the following;

    Giles (Carl Giles) was a cartoonist and a cultural institution. Starting during WWII and continuing until his death in 1994, Giles produced single panel cartoons that combined comedy and social commentary, three times a week in the Daily Express. And every year a collection of Giles cartoons would be published.

    Giles was a Lefty. A member of the Socialist Party in the 1930's, he got his start in a Leftwing newspaper before he came to the attention of the more mainstream Express.

    And by the mid 1950's he was already mocking the failures and inadequacies of the National Health.

    He should have been a fan, but less than a decade in, he was mocking it.

    If the English can't make it work, the odds are very good we can't either. And the English couldn't make it work for even a decade.

  • Semantix||

    Brexit. The English are actually pretty good at bollocksing up something that should work pretty well.

  • Longtorso, Johnny||

    The UK instituted their health care system while people were still used to WWII rationing.

    We pay a lot because we want a lot because we're used to a lot. Sending us all to the VA won't fix that.

  • Mithrandir||

    People say America has free-market health care, but we don't, and we haven't since World War II. Government and government-subsidized insurance companies currently spend most of America's health dollars. If politicians here really want to improve things, they should try letting the market function.

    Mostly this. How people can consider the US Healthcare system a free market system is beyond me. Ideally I would want to see the middlemen (insurance companies) cut out as much as possible. Make preventative care almost exclusively out of pocket, let doctors advertise pricing for services in order to increase price transparency, and have a primarily catastrophic insurance coverage system with supplemental insurance for those who couldn't afford to set aside money in an HSA.

    Anything like this would help open up the healthcare market and would see a reduction in pricing due to real price visibility. Cut out the middle man as much as possible.

  • Overt||

    Yup. If everyone could save in an HSA pre-tax, and the government deposited money to buy High Deductible plans for the needy, you would likely get rid of the problem of being uninsured. This would also result in the market becoming vastly more price sensitive, since they would have to start price-shopping their healthcare up until the deductibles.

    That just leaves pre-existing conditions as the big issue. However, the way to go there is to do something like "insurer pays no claims for pre-existing conditions for the first 6 months if the customer did not have continuous coverage" and it would deal with most of the moral hazard of covering pre-existing conditions.

  • The Last American Hero||

    Risk pools could be created for the uninsurable. But sending everyone to the VA shit system because of a small number of cases is insanity.

  • C. S. P. Schofield||

    I suspect that at least half of what is wrong with the 'system' is the consequence of one layer of regulation slapped on top of another for decades. Yes, in legal theory each round of legislation is supposed to completely supplant the previous round. In practice? I have serious doubts. What needs to happen is a general repeal of all 'healthcare' and 'health insurance' legislation passed since the inauguration of Franklin Delano "Never met an example of Government overreach he didn't love" Roosevelt, followed by a five year (minimum) moratorium on further efforts fro 'fix' the problem, so that things can settle out. Then we could have a look at matters and see if something needed to be done.

    Of course the OTHER half of what is wrong with the 'system' is hyperbolic bullshit made up by mountebanks and grifters who are incensed that we won't hand over out wallets RIGHT NOW THIS MINUTE and how DARE we ask questions of our betters!?1?1?!

  • jello.beyonce||

    "Libertarianism" is an ideal dream.
    Sadly, that's all it is....an idealists dream.

    "Libertarianism" is not steeped nor based on reality.

    There is absolutely no thing as a "Free Market".
    Every market is manipulated....by someone.

    "Let the health care market work without government meddling."
    Yeah, problem is, others, private individuals will always seek to meddle in markets, for their own selfish purpose.

    The Writers and Contributors at Reason are seemingly wholly ignorant of the multitude of Philosophers of past whom have pondered this same subject.
    They are seemingly wholly ignorant of factors such as the Pareto Principle, the 80/20 rule.

    They are seemingly oblivious to the actions of powerful groups like the AMA, the PRMA, the AHA, other lobbying org's, even the .001 percent, whom consolidate and gain control of industries, like the medical industry, to use it as a means to direct more wealth their way.

    Historians, such as Plutarch, T Jefferson, Adam Smith, etc. have noted the tendencies for capital to naturally concentrate into the hands of the few.

    Combine that when the ultra-wealthy then use their wealth to form special-interest lobbying groups designed solely to influence lawmakers solely to increase their wealth.

    All markets are manipulated, often by governments, in response to manipulations by others.

    "Libertarianism" is a complete farce.

  • jello.beyonce||

    "Libertarianism" is a complete farce.
    It is increasingly being used as a tool of the ultra-wealthy to gain ever-more wealth.
    The "Libertarian" creed has devolved to "freedom for me, but nor for thee".

    So, shall we call for the dissolution of all forms of protectionism?
    The end of patents?
    The end of copyrights?
    The end of protectionist laws like licenses......like Medical licenses, Legal licenses, licensing of Electricians, all professional licenses?

    After all, these are all nothing but forms of government meddlings.

    Prior to the 1900's, 90 percent of all "patent-medicines" were wholly bunk.
    Nothing but phony concoctions.
    Soft drinks were born of former "patent-medicines".

    Jesus, do a minute amount of reading and research of the Free Banking Era between 1837 and 1866, when almost anyone could issue paper money, and where most of those "Wildcat" currencies failed.

    Try reading "Phishing for Phools: The Economics of Manipulation and Deception".

    There is likely a better way, but complete deregulation ain't it.
    You people are fools.

    The public at-large eventually call for regulations because deregulation of the past has resulted in utter failures.
    Then, powerful interests learn to exploit that regulation.

    It becomes a mere exercise of futility, stupidity, complete idiocy.
    The constant drifting from one extreme to another, then back again.

    "Those who cannot remember the past are condemned to repeat it."

    FOOLS!

  • Enjoy Every Sandwich||

    Kinda reminds me of Hihn.

  • ThomasD||

    He's looney tunes, but a different sort of looney tunes.

  • MJBinAL||

    Very like Hihn .... but at an even lower IQ.

  • Eric H.||

    Seriously? I consider myself more of a classical liberal than libertarian, but why split hairs. I am new here but who exactly wants complete deregulation? It would be nice if we could get to that point where everybody in the country had the moral chops to pull that off but as far as I know it's an ideal and reality would dictate that we need some laws and some regulation. If you put away the straw men we may get to a point where we could have an intelligent conversation.

  • Last of the Shitlords||

    Hey Jello Bouncy, if you don't like libertarians, maybe you should go back to Mother Jones or wherever the hell you crawled out from?

  • Earth Skeptic||

    "Take out (obesity), car accidents and gun violence, the difference in life expectancy disappears entirely," Pope says.

    Hmm, sounds like the progressive agenda.

    1. Ban guns.

    2. Ban cars.

    3. If health care is a right, and provided by Big Brother, then certainly food will be next. And Big Brother will decide how much People Chow you get every day.

  • Semantix||

    Of course, the data is complete bollocks. Here's something that has nothing to do with cars or guns that we completely suck at: infant mortality. Every other developed nation kicks our ass in this. We're third-world bad. How does Pope explain away this unfortunate data point?

  • Red Rocks White Privilege||

    We're third-world bad.

    No, we're not even close to "third-world bad." This is why shitlibs can't be taken seriously, because you freaks make things up all the time.

  • MJBinAL||

    Easy, most countries do not count infants in their stats until they survive the first year. That REALLY helps the average lifespan numbers and the "infant mortality" numbers too.

    Since you brought this up I assume you already knew this and are a lying sack of shit.

  • damikesc||

    Yeah, that is fairly common knowledge. I'm shocked he is parading such a laughable stat.

  • D-Pizzle||

    "Also, government-run systems save money by freeloading off American innovation. American drug companies, funded by American customers, fund most of the world's research and development of pharmaceuticals."

    Like most on this site, I'm not one to say, "there ought to be a law." However, I'm tired of European freeloading from the U.S. One of the clever things that European governments do (via price controls or other means) is offer to pay only the manufactured cost of newer drugs plus a bit of profit. This is a better deal for the pharmaceutical companies than getting nothing at all since it's manufactured cost plus, therefore still more profitable than not selling the drugs at all, while leaving Americans to pay all of the R&D costs. What we need to do is pass a law forbidding pharmaceutical companies from charging substantially more for their drugs here than they do in other developed nations, say 5-10% tops after exchange rates are factored in. This will force the freeloading Europeans to either do without these advanced drugs or to finally share in the R&D costs. They'll be up-in arms about this, but to hell with them.

    If there are any Europeans reading this who have a problem with this proposal, you can fuck off and die (perhaps literally).

  • Sevo||

    "One of the clever things that European governments do (via price controls or other means) is offer to pay only the manufactured cost of newer drugs plus a bit of profit."

    Without the financial support from the, they (and Canada) are 3rd-world countries.

  • Earth Skeptic||

    Some are heading that way regardless. Been to Paris lately?

  • CGN||

    The best reason to kill single payer health care is that the government SCREWS EVERYTHING UP!!! It would be easier for the feds to make cat bark than to assemble a decent health care law.

  • Eric H.||

    I've lived in three countries with public healthcare. Portugal, Singapore, and the UK. I used public and private in all three. Private was better in all three. The private healthcare was similar to what I have experienced in the US, the public healthcare was hit and miss.

    I don't believe that health insurance is a right. I don't believe that healthcare is a right. I do believe that as a country we are better off if people that can't afford insurance or healthcare can get it. This means that it will need to be subsidized somehow and that calls for some type of rationing system. An expanded medicare system with sliding payment scales based on household income that costs taxpayers no more than we are paying now (the gov. currently pays about half of all expenditures) is an idea that I have been thinking about for awhile. The care could be privatized to group health clinics and be limited to cut down on costs. So those that cannot afford the cost of insurance to go to a private provider have a way to get needed healthcare but wouldn't be up to the standard of most private providers. Then we get the government boot off the neck of private providers and insurance companies and let them compete with each other and the government system. The government system could also help those with pre-existing conditions that have trouble getting private coverage.

    Would this work?

  • Qsl||

    One of the difficulties with Medicare is you have Diagnostic Related Groups, which sets the price (price control) for any given treatment, and the rest of the industry falls in line with that as a base. That also means most innovation is just to a point slightly above what Medicare pays. Also, Medicare tends to look at treatments as what is the least cost right now vs. what has the lowest costs overall. As with most insurance, you've heavily distorted pricing mechanisms. And without clear indicators on price, not even medical billing has any idea of what the cost is beyond what medicare pays until the bill comes due.

    And there is the overhead cost of essentially running two (or more) different systems under one roof.

    In short, you really want to remove Medicare from the equation as much as possible.

  • Last of the Shitlords||

    If you want subsidies, utilize willing charitable organizations. Keep government out of it.

  • Uncle Jay||

    We must have government healthcare otherwise the evil insurance companies might lower their premiums and increase benefits for the ignorant and intrinsically stupid masses.
    Besides, what a better way to control the unenlightened, filthy rabble than through healthcare?
    The possibilities are endless!.
    Who needs a gulag when our beloved ruling elitists can assign the doubters to an insane asylum?
    Who needs a firing squad when the government can deny a dissenter life-saving medicine?
    Who needs an army of policemen when you can deny life-saving surgeries to counter-revolutionaries.
    Who needs a re-education camp when you can deny healthcare to anyone and their families who dare to question our brave, enlightened and humane socialist vermin who take the time and trouble to enslave us all?
    I'm sure the Politburo and the Soviet Supreme Senate who work so hard to fuck up our lives would agree.

  • Loup-Bouc||

    John Stossel's article & Pope's blather epitomize the religion of Libertarianism.

    Reality belies Stossel's & Pope's hallucinations --- in this case, whole cloth like the "always-superior" virtue of the free market combined with individual freedom & individual choice/financial responsibility.

    Since this journal will not permit my posting a sufficient deconstruction of Stossel's & Pope's religious hallucinations & related anti-factual assertions (because the deconstruction would be "too long"), I shall cite an excellent essay published by a conservative journal, The American Conservative: www.theamericanconservative.co.....healthcare

  • Eric H.||

    You're cited article sites lifestyle caused health issues as a failure of the healthcare system in the US compared to other developed nations. Can you provide any evidence that shows that socialized medicine can and will change the rates of obesity, HIV, drug overdoses, and teen pregnancy? Also, does any other country produce as many new pharmaceuticals, better cancer treatment, or better cardiovascular treatment? Why is that?

  • Loup-Bouc||

    Eric H.|11.14.18 @ 5:44PM

    Your reply is interesting, but utterly irrelevant.

    The matter is NOT the quality of treatment, medical knowledge, or research.

    The matter is SOLELY the retail cost patients must bear & the public (macroeconomic) cost driven by that retail cost.

    Also, the matter is NOT whether "socialized medicine" (or socialized financial support of retail medicine-delivery). The matter is a single-payer-like OR OTHER GOVERNMENT CONTROLLED, FINANCED, OR REGULATED means of cutting retail cost of medicine-delivery.

    In Canada, Denmark, Norway, and Sweden, health insurance is publicly administered, but most physicians private. The U.K. and Spain have national health services, and salaried physicians predominate &hospitals; are publicly owned/operated. Germany & France have universal health insurance (all-payer systems) involving sickness funds. Sickness funds pay physicians & hospitals uniform rates negotiated annually. Germany's method includes a heavily regulated multi-insurer system.

    Oh, but respecting your irrelevant inquiry respecting obesity, HIV, drug overdoses, and teen pregnancy: Germany has fewer lethal drug overdoses than the U.S. Canada has less obesity and type II diabetes. Netherlands has less teen pregnancy and fewer HIV infection cases.

    I must wonder whether truly you READ the article I referenced.

  • Red Rocks White Privilege||

    The matter is NOT the quality of treatment, medical knowledge, or research.

    The matter is SOLELY the retail cost patients must bear & the public (macroeconomic) cost driven by that retail cost.

    I suppose you could be right that Americans would accept sub-standard healthcare if it was "free," but the problem is that they're used to health-spa healthcare.

    Regardless, your proposed solution ignores the fact that laws exist right now to curb price escalation, in the form of anti-monopoly and anti-trust laws. They're simply not enforced. Price transparency would be part and parcel of this, and help lower costs through competition. And before you respond with the standard, "You can't shop for healthcare when you're bleeding to death in a car wreck!" that lefties always seem to think is a clever rejoinder, these incidents constitute healthcare at the margins. The vast majority of care is not provided in emergency situations.

    You claim to be concerned with the cost, but your stance indicates the exact opposite.

  • Loup-Bouc||

    Red Rocks White Privilege|11.14.18 @ 7:24PM

    Astounding are: (1) your capacity of irrelevant thought; (2) the depth (or height) of your illogic; (3) your ignorance of economics; (4) your ignorance of antitrust law (statutory and judicial) and its history (including the history & incidence of its enforcement, civil & criminal).

  • Loup-Bouc||

    Red Rocks White Privilege|11.14.18 @ 7:24PM

    Also:

    See, E.G., all three links put at

    who.int/gho/mortality_burden_disease/life_tables

    You may need to add the term
    /en/
    to the end of the preceding link

  • Loup-Bouc||

    Red Rocks White Privilege|11.14.18 @ 7:24PM

    You wrote: "You can't shop for healthcare when you're bleeding to death in a car wreck!" that lefties always seem to think is a clever rejoinder, these incidents constitute healthcare at the margins.

    I am not a "lefty." I am not a conservative, liberal, socialist, libertarian, Democrat, Republican, or any other such.

    I am, and since 1972 have been, a law professor, and also a mathematician, statistician, logician, linguist, and sometimes-antitrust-litigator (schooled and published in macroeconomics and microeconomics). Most important, I am an individual who concerns himself with ascertaining the most utilitarian solution of a problem — NOT the most liberal, conservative. libertarian, socialist, or any other such politically biased and near-certainly BAD treatment of an issue.

  • Loup-Bouc||

    Red Rocks White Privilege|11.14.18 @ 7:24PM

    I use the term "utilitarian" to reference the Utilitarianism of Jeremy Bentham.

  • Red Rocks White Privilege||

    Funny how absolutely nothing in your shitposts refuted a thing I said.

  • Semantix||

    He didn't need to refute you because your question to him was irrelevant. Still is.

  • Semantix||

    He didn't need to refute you because your question to him was irrelevant. Still is.

  • Red Rocks White Privilege||

    I didn't actually ask a question, dumbshit.

  • Last of the Shitlords||

    Has Hihn established a new pair of socks?

  • MJBinAL||

    Looks that way.

  • Last of the Shitlords||

    I find your use of the word 'ascertain' to be an annoyance amongst the commentariat. You will henceforth limit your statements and responses to the following:

    Yes
    No
    Hand me that thing
    Boy, this work is hard

  • Loup-Bouc||

    Eric H.|11.14.18 @ 5:44PM

    I forgot one point.

    You wrote: " Also, does any other country produce as many new pharmaceuticals, better cancer treatment, or better cardiovascular treatment? Why is that?"

    Your assertions are quite FALSE.

    Also, see these online references all three links put at

    who.int/gho/mortality_burden_disease/life_tables

    You may need to add the term
    /en/
    to the end of the preceding link

  • PG23COLO||

    Give people free health care and there will be no limit to the demand for health care. Ration health care and people's lives and health will be even more in the control of bureaucrats.

    Freedom drives innovation in health care and elsewhere, but that drive will be substantially suppressed if innovators can't reap economic rewards for their success.

    Putting politicians in charge of health care is showing disrespect for human life.

    Putting politicians in charge of anything is a bad idea.

    Paul

  • mtrueman||

    "Give people free health care and there will be no limit to the demand for health care."

    Why? Since when do Americans like to spend their time waiting around doctor's consultation rooms? I've always found the experience almost as bad as visiting the dentist. Is it a race thing?

  • DirkT||

    PG23COLO's comment reminds me of all the times bitter *conservatives* have told me that Atlanta's commuter train only encourages blacks to sit and ride all day instead of work. Well, life would have to be pretty bad to pay and ride that thing all day every day ...

  • Loup-Bouc||

    TO PG23COLO|11.14.18 @ 5:28PM

    Your premises are myths, junk economics, and pop-psychology.

    See also my earlier posts and the American Conservative article I reference.

  • Semantix||

    "Putting politicians in charge of anything is a bad idea." That's a tired and lazy stereotype. Do better.

  • DirkT||

    I participated in the Japanese healthcare system for 16 years. Being self-employed meant I was in a different plan than those who worked for others. And I could buy all the supplemental private insurance I could afford, like everyone else. The system wasn't perfect but it is certainly preferable to what I found in the USA upon my return.

  • Red Rocks White Privilege||

    What would be wrong with simply going back to the system we had in the 1950s, when medical services were about 10 percent of the current inflation-adjusted cost, prices were listed, and you could pay for most services with cash?

  • DirkT||

    Costs are capped in Japan to the extent that co-pays are affordable and supplemental insurance can take care of anything else. The system there isn't as plush as the American system. And sure, if you need the VERY latest drug or device NOW then America is a better place to be sick, but most people never need that.

  • Red Rocks White Privilege||

    You didn't answer the question.

  • DirkT||

    Going back to the 1950's way of doing things? I don't think that is possible. And I don't think you would want to go back to 1950's medicine.

  • Red Rocks White Privilege||

    Going back to the 1950's way of doing things? I don't think that is possible.

    Why not, exactly?

    And I don't think you would want to go back to 1950's medicine.

    That's a different issue than how healthcare is paid for, correct?

  • Semantix||

    What, exactly, is "the system we had in the 1950s?" Outline specifically the composition of that system. I'd like to know if you can explain how it operated.

  • Red Rocks White Privilege||

    Try improving your reading comprehension, sometime, shitlib.

    What would be wrong with simply going back to the system we had in the 1950s, when medical services were about 10 percent of the current inflation-adjusted cost, prices were listed, and you could pay for most services with cash?
  • MJBinAL||

    The system in the 50's was based on Major Medical Insurance. Insurance typically paid 80% of medical costs due to illness or injury with the insured paying 20% until the "out of pocket" deductible was reached.

    Insurance did not typically send checks to the doctor and the doctor did not send claims to insurance. The patient files claims to insurance and paid the bills.

    For most people in a good year, insurance did not pay much and the patient had an incentive to control costs since he or she was responsible for 20% of the cost.

    In most cases pre-existing conditions were not covered under new insurance for a year unless you were transitioning from another insurance plan.

  • Semantix||

    What, exactly, is "the system we had in the 1950s?" Outline specifically the composition of that system. I'd like to know if you can explain how it operated.

  • mtrueman||

    "Pope says, "If we move towards a health care system where individuals were more responsible for shopping around…people would choose a better system."

    Those with medical degrees and knowledge of the industry, yes. The rest of you schmoes are relying on guess work or responding to advertising.

  • Semantix||

    This is just intellectual dishonesty from Pope. He would know better than most just how complicated healthcare has become. He would also know that even healthcare professionals rely on experts in areas of healthcare outside their disciplines. The amorphous "market" is not always the answer. How reductive and simple-minded.

  • Red Rocks White Privilege||

    Yes, healthcare is so complex now, we need to introduce layers of bureaucracy into it to make it less so!

    Talk about reductive and simple-minded thinking.

  • Spookk||

    Lame. While we are at it, get private industry out of the infrastructure/utility business.

  • Pedro Martinez||

    The Nordic countries and most of Europe can afford their Capitalist propped social programs because they don't spend a lot on defense. WE defend them! Pull our troops from Europe and make them pay for deterring Russian and China, those programs will evaporate in a hurry.

  • DirkT||

    Healthy white men with lots of money like Stossel think that not "letting government meddle" is sensible. Those who aren't so young and healthy and rich get a little nervous at the suggestion ...

  • Last of the Shitlords||

    Government meddling cost me my affordable insurance coverage. Now I have less choices and only overpriced garbage coverage available. Perhaps the core problem is the surplus in the population of progressives, and not the healthcare industry itself.

  • coolth||

    So obesity is a health problem, but if you just omit American healthcare's inability to deal with it then everything's hunky-dory! I guess people in other countries have skinnier genes, eh? As a Canadian I can assure you that we are no more capable than Americans at deciding how to live our lives. We probably see doctors more often, though, and are more likely to be aware that we have health problems related to obesity.

    Well, maybe I'm wrong, but so is just excluding a major failure of American health care from international comparisons. Excluding gun violence and car accidents is more to the point. But excluding obesity is like Canadians deciding to exclude wait times when they compare themselves to other countries.

  • pro bonobo||

    Yes, equalize the tax treatment of employer provided health care once considered a fringe benefit and never was taxed. This was the great distortion of the healthcare market and the ONE THING that Obamacare never had the courage to implement, not wanting the wrath of public employee unions and other large unions faced with having to deal with members pissed off at a freebie going away.

    A one time change of the tax tables that provide an overall revenue neutral adjustment... the money paid to insurers for the "insurance" they've provided employees becomes taxable from then on.

    I suspect high paid employees, once they don't get a free ride, will not be clamoring for ever more sumptuous Caddilac/Rolls Royce plans, reducing the dollars chasing health services rendered. And folks who aren't currently covered from an employer plan would have both a nice reduction of taxes paid and some even a refund to purchase their insurance or directly buying care from a physician group (wow, what a concept... paying a fee for a service)... plus there would then actually be a market for private health plans.

GET REASON MAGAZINE

Get Reason's print or digital edition before it’s posted online