At the Wall Street Journal Chris Jacobs of Juniper Research has an op-ed in which he notes that Democrats are moving towards endorsing a single payer healthcare system:
Conventional wisdom in Washington holds that so-called moderate Democrats who haven’t endorsed Sen. Bernie Sanders’s single-payer healthcare plan support many coverage options.
But a white paper on healthcare reform from Oregon’s Ron Wyden, ranking Democrat on the Senate Finance Committee, shows that this is false. The report, released July 30, mentions the word “profit” or derivations thereof 185 times in an 86-page document, echoing New York Mayor Zohran Mamdani’s rhetoric demonizing wealth. The outlined policies also resemble those of Mr. Mamdani and Mr. Sanders—proposals that Democrats previously rejected as too costly and disruptive, and that would move the country toward a fully government-run system.
The Wyden document begins with a discussion of “consumer-friendly enrollment.” It proposes “a more standardized or centralized platform that creates a consistent enrollment experience across coverage programs,” suggests that “existing enrollment processes in the employer market can be burdensome for workers,” and raises the idea of including employer coverage in this “more standardized employer platform.” The apparent attempt to integrate businesses and employer coverage into a government-run enrollment architecture resembles the purchasing alliances that defined Hillary Clinton’s failed healthcare proposal in the 1990s.
That raises a more fundamental question: what mechanism prevents the amount being paid from continuing to grow faster than the resources available to pay it? I don’t object to a single-payer healthcare system with one proviso: healthcare costs must be controlled.
Some do it better than others but there are no single-payer systems that do not at least attempt to constrain costs. The biggest problem with single-payer in the United States is that the Congress has abandoned attempting to control healthcare spending on the programs it subsidizes.
Our problem is that the incentives of patients, healthcare providers, and those who pay for healthcare are not properly aligned. My own preference would be for a system that resembles Italy’s, a capitation system in which primary care physicians are compensated based on the number and demographics of their patient base. I would go farther, however, and have specialists compensated through primary care physicians. That would align the incentives of patients, primary care physicians, specialists, and those who pay for care.
A system in which the government merely foots more of the bill without increasing taxation to pay for it may be appealing but is impractical.
For the last several years, we’ve had a single provider system here in Knox Co., Ohio. The local county hospital has purchased all the private practices in the County, and all MD’s are hospital employees. (I believe the few medical marijuana clinics are private.)
Moreover, the local system has just been purchased by Kettering.
My sisters (both RN’s) tell me the same consolidation is happeniNG in NH.
Because of medical misconduct, we lost our family practice physician of some 30 years, and it took the local Hospital more than a year to get us another regular doctor. In the meantime, we made do with a “traveling doctor (??)”\,” who was uninterested in our concerns.
So, what would a single payer vs. single provider look like. The universally despised, and highly politicized British NHS?