Posted on 07/28/2017 6:25:40 AM PDT by Colonel Kangaroo
Don’t tell anyone, but American conservatives will soon be embracing single-payer healthcare, or some other form of socialized healthcare.
Yes, that’s a bold claim given that a GOP-controlled Congress and President are poised to un-socialize a great deal of healthcare, and may even pull it off. But within five years, plenty of Republicans will be loudly supporting or quietly assenting to universal Medicare.
And that’s a good thing, because socializing healthcare is the only demonstrably effective way to control costs and cover everyone. It results in a healthier country and it saves a ton of money.
That may seem offensively counterintuitive. It’s generally assumed that universal healthcare will by definition cost more.
In fact, in every first-world nation that has socialized medicine–whether it be a heavily regulated multi-insurer system like Germany, single-payer like Canada, or a purely socialized system like the United Kingdom–-it costs less. A lot, lot less, in fact: While healthcare eats up nearly 18 percent of U.S. GDP, for other nations, from Australia and Canada to Germany and Japan, the figure hovers around 11 percent. (It’s no wonder that smarter capitalists like Charlie Munger of Berkshire Hathaway are bemoaning the drag on U.S. firm competitiveness from high healthcare costs.) Nor are healthcare results in America anything to brag about: lower life expectancy, higher infant mortality and poor scores on a wide range of important public health indicators.
Why does socialized healthcare cost less? Getting rid of private insurers, which suck up a lot money without adding any value, would result in a huge savings, as much as 15 percent by one academic estimate published in the American Journal of Public Health. When the government flexing its monopsony muscle as the overwhelmingly largest buyer of medical services, drugs and technology, it would also lower prices-–that’s what happens in nearly every other country.
So while it’s a commonly progressive meme to contrast the national expenditure of one F-35 with our inability to “afford” single-payer healthcare–and I hesitate to say this lest word get out to our neocon friends–there is no need for a tradeoff. If we switched to single payer or another form of socialized medicine, we would actually have more money to spend on even more useless military hardware.
The barrier to universal healthcare is not economic but political. Is profligate spending on health care really a conservative value? And what kind of market incentives are working anyway–it’s an odd kind of market transaction in which the buyer is stopped from negotiating the price, but that is exactly what Medicare Part D statutorily requires: The government is not allowed to haggle the prices of prescription drugs with major pharmaceutical companies, unlike in nearly every other rich country. (Both Hillary Clinton and Donald Trump pledged to end this masochism, but the 45th president has so far done nothing, and U.S. prescription drug prices remain the highest in the world.) Does anyone seriously think “medical savings accounts” with their obnoxious complexity and added paperwork are the right answer, and not some neoliberal joke?
The objections to socialized healthcare crumble upon impact with the reality. One beloved piece of folklore is that once people are given free healthcare they’ll abuse it by going on weird medical joyrides, just because they can, or simply let themselves go because they’ll have free doctor visits. I hate to ruin this gloating fantasy of lumpenproletariat irresponsibility, but people need take an honest look at the various health crises in the United States compared to other OECD (Organisation for Economic Cooperation and Development) countries. If readily available healthcare turns people hedonistic yahoos, why does Germany have less lethal drug overdoses than the U.S. Why does Canada have less obesity and type II diabetes? Why does the Netherlands have less teen pregnancy and less HIV? The evidence is appallingly clear: Among first-world countries, the U.S. is a public health disaster zone. We have reached the point where the rationalist santería of economistic incentives in our healthcare policies have nothing to do with people as they actually are.
If socialized medicine could be in conformity with conservative principles, what about Republican principles? This may seem a nonstarter given the pious market Calvinism of Paul Ryan and Congressmen like Reps. Scott Perry (R-Pa.) and Mo Brooks (R-Ala.), who seem opposed to the very idea of health insurance of any kind at all. But their fanaticism is surprisingly unpopular in the U.S. According to recent polling, less than 25 percent of Americans approve of the recent GOP healthcare bills. Other polls show even lower numbers. These Republicans are also profoundly out of step with conservative parties in the rest of the world.
Strange as it may seem to American Right, $600 EpiPens are not the sought-after goal of conservatives in other countries. In Canada, the single-payer healthcare system is such a part of national identity that even hard-right insurgents like Stockwell Day have enthusiastically pledged to maintain it. None of these systems are perfect, and all are subject to constant adjustment, but they do offer a better set of problems–the most any mature nation can ask for–than what we have in the U.S.
And virtually no one looks at our expensive American mess as a model.
I recently spoke with one German policy intellectual, Nico Lange, who runs the New York outpost of the German Christian Democrats’ main think tank, the Konrad Adenauer Stiftung, to get his thoughts on both American and German healthcare. Is socialized medicine the entering wedge of fascism and/or Stalinism? Are Germans less free than Americans because they all have healthcare (through a heavily regulated multi-payer system), and pay a hell of a lot less (11.3 percent of GDP) for it?
Mr. Lange paused, and took an audible breath; I felt like I had put him in the awkward spot of inviting him over and asking for his honest opinion of the drapes and upholstery. “Yes,” he said, “we are less free but security versus freedom is a classic balance! National healthcare makes for a more stable society, it’s a basic service that needs to be provided to secure an equal chance for living standards all over the country.” Even as Mr. Lange delineated the conservative pedigree of socialized medicine in Germany–“You can certainly argue that Bismarck was a conservative in founding this system”–I had a hard time imagining many Democrats, let alone any Republican, making such arguments.
Indeed, the official GOP stance is perhaps best described as Shkrelism than conservatism, after the weasel-faced pharma entrepreneur Martin Shkreli, who infamously jacked up the price of one lifesaving drug and is now being prosecuted for fraud. (Though in fairness, this type of bloodsucking awfulness is quite bipartisan: Heather Bresch, CEO of Mylan corporation, which jacked up the price of EpiPens from $100 to $600, is the daughter of Senator Joe Manchin (D-WV), who defended his daughter’s choice.)
But GOP healthcare politics are at the moment spectacularly incoherent. Many GOP voters have told opinion polls that they hate Obamacare, but like the Affordable Care Act. And as the GOP healthcare bill continues to be massively unpopular, Donald Trump has lavished praise on Australia’s healthcare system (socialized, and eating up only 9.4 percent of the GDP there). Even in the GOP, this is where the votes are: Trump’s move to the center on questions of social insurance–Medicare, Medicaid, Social Security–was a big part of his appeal in the primaries. The rising alt-Right, not to hold them up as any moral authority, don’t seem to have any problem with universal Medicare either.
It will fall on “reform conservatives” to convince themselves and others that single-payer or some kind of universal care is perfectly keeping with conservative principles, and, for the reasons outlined above, it’s really not much of a stretch. Lest this sound outlandish, consider how fully liberals have convinced themselves that the Affordable Care Act–a plan hatched at the Heritage Foundation for heaven’s sake, and first implemented by a Republican governor–is the every essence of liberal progressivism.
Trump’s candidly favorable view of Australian-style socialized healthcare is less likely a blip than the future of the GOP. Republican governors who actually have to govern, like Brian Sandoval and John Kasich, and media personalities like Joe Scarborough, and the Rock, will be soon talking up single-payer out of both fiscal probity, communitarian decency, and the in-your-face evidence that, ideology aside, this is what works. Even the Harvard Business Review is now giving single-payer favorable coverage. Sean Hannity and his angry brigade may be foaming at the mouth this week about the GOP failure to disembowel Obamacare, but Sean’s a sufficiently prehensile fellow to grasp at single-payer if it seems opportune–just look at his about-face on WikiLeaks. And though that opportunity has not arisen yet, check again in two years.
The real obstacle may be the Democrats. As Max Fine, last surviving member of John F. Kennedy’s Medicare task force, recently told the Intercept, “Single payer is the only real answer and some day I believe the Republicans will leap ahead of the Democrats and lead in its enactment,” he speculated, “just as did Bismarck in Germany and David Lloyd George and Churchill in the UK.” For now, an invigorating civil war is raging within the Democrats with the National Nurses Union, the savvy practitioner-wonks of the Physicians for a National Health Program, and thousands of everyday Americans shouting at their congressional reps at town hall meetings are clamoring for single-payer against the party’s donor base of horrified Big Pharma executives and affluent doctors. In a few years there might even be a left-right pincers movement against the neolib/neocon middle, whose unlovable professional-class technocrats are the main source of resistance to single payer.
I don’t want to oversell the friction-free smoothness of the GOP’s conversion to socialized healthcare. Our funny country will always have a cohort of InfoWars ooga-boogas, embittered anesthesiologists and Hayekian fundies for whom universal healthcare is a totalitarian jackboot. (But, and not to be a jerk, it’s worth remembering that Hayek himself supported the socialized healthcare of Western Europe in one of his most reasonable passages from the Road to Serfdom.)
So even if there is some banshee GOP resistance at first, universal Medicare will swiftly become about as controversial as our government-run fire departments. Such, after all, was the trajectory of Medicare half a century ago. You read it here first, people: Within five years, the American Right will happily embrace socialized medicine.
Chase Madar is an attorney in New York and the author of The Passion of Bradley Manning: The Story Behind the Wikileaks Whistleblower.
Yes.
There were rumblings of this among corporations during the election. They want to dump the semi socialized system we have now from the businesses to the tax payers.
Then a lot of new FReepers started making the case for socialized medicine a few months ago. And Trump used to be an open advocate for single payer.
Of course, limiting competition always works so well, right?
Just like basic income, we have a lot of people who should know better advocating for the dumping of basic economics.
The U.S. based doctor who'd developed the treatment said in January of this year that it would've given Charlie a good chance at recovering. Charlie and his parents were DENIED that treatment by the NHS (Government) and they were prohibited by the Hospital and the Government from taking him out of the country for treatment.
Who in the HELL gave any Government the power over two parents to deny them seeking the best medical care possible for their child?
It's an outrage. Charlie's death is on the Judges, NHS' and Government of the UK's hands. It's an outrage you'd defend the position you are. You're arguing against natural parental rights.
And the Doctor will tell you, "Come back in about nine months, and I might be able to fit you in."
There is no CONSERVATIVE case for Single Payer, but there is a REPUBLICAN one.
Many of the crony-capitalist donors who fund that party would like nothing better than to shove their employee health care costs onto somebody else’s books.
It’s not “single-payor”.
It’s “government-payor” which means the Feds determine how much doctors and providers are paid, and what services are available to patients. It would turn into the largest crony capitalism scheme in the history of mankind - then bankrupt our children and grandchildren.
Most people my age are on single payer. I’m on two single payer systems plus my retirement insurance. The one I like best is the VA. Any serious problems I go to the VA. No deductibles for anything except an $8 co-pay for prescription drugs.
I rarely use my United Health Care / Blue cross.
And they let this person on a site called “The American Conservative” to post a “conservative case” for one of the most un-conservative causes out there.
It’s interesting that the Amish never have to discuss this sort of thing.
True ... the wording from your post is correct ... kudos
The phrase “single payer” does imply an absolute monarchy, does it now.
Innovations have stopped now. R&D costs a lot of money, and the finance teams that run publicly traded companies view it was an unnecessary expense.
They keep some around for “Show me”, but not much.
The U.S. based doctor who'd developed the treatment admitted that he never examined the patient. I've even read reports that the NHS in Great Britain asked him to come over and examine Charlie back around January, but he never did.
By any objective measure this guy is a quack, and there's a move afoot in New York or Mass. (I forget which state holds his license) to initiate a formal complaint against him through his medical licensing board.
Rather than regulate to an efficient healthcare, compete to one. Let the government provide healthcare, but also allow without hindrance private enterprise to compete.
The “treatment” is not “developed”. It is pre-phase one experimental therapy.
This is what Dr. Hirano said after (finally) examining the patient: “I became involved in Charlie’s case when I was contacted by his parents, and I subsequently agreed to speak with his doctors to discuss whether an experimental therapy being developed in my lab could provide meaningful clinical improvement in Charlie’s condition.
Unfortunately, a MRI scan of Charlie’s muscle tissue conducted in the past week has revealed that it is very unlikely that he would benefit from this treatment.”
“Meaningful clinical improvement”, for a researcher, does not mean the same thing it means to laypeople. And, it is clear from the above that your charge that Charlie Gard was “denied lifesaving therapy” is false.
Flame away!
I am a straight down the line conservative that agrees strongly with this article. You can reply that I am not conservative because of this stance, but you would be wrong. You can cite, as has already been done, the 5 or 6 standard canards that are always used when health care comes up, but are they really correct?
Simply put, our health system is not “the best in the world.” What it is is the leading cause of bankruptcy in America (even for the insured) and it does not provide outcomes that compare favorably to many of the single payer systems. Those systems work better for their people at a much lower cost per person or % of GDP than our system works for us.
Whether we have single payer (government) or multi-payer (insurance) we still place ourselves under an “access master.” Insurance companies deny treatments as uncovered every day. Insurance companies ration every one of us with a lifetime maximum benefit at which point we no longer have access to care except that which we can pay out-of-pocket. Being more comfortable with an insurance company as our gatekeeper than the government is understandable, but in the end it is not significantly different.
My family has faced the ‘uninsurable’ label in the individual market because of a very minor and fully healed per-existing condition. I have paid off enormous medical bills that were over and above great corporate insurance coverage because of an operating room mistake by a doctor. Both scenarios make me very personally aware that our market based, insurance managed system is critically broken.
Disagree if you want, but that is my experience and view.
Precisely! Under which article of the Constitution does federal control of health care fall? I seem to have forgotten...
Under single payer the insurance premiums that you now pay would translate/transform into additional medicare taxes. Maybe a little lees.
I don’t believe we need any national health care program as long as we continue Medicare, making sure at least most of the employee contributions go to that fund and not the general fund. Then provide a reasonable safety net for the poor, including the low wage working segment, a fund for catastrophic cases, and the freedom for any insurance company to service across any state line.
Get rid of Obamacare and set us free.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.