As the editors of the Wall Street Journal point out with a certain amount of unbecoming glee, when details of just how a single-payer system would work in the United States are fleshed out opposition to the plan mounts, at times from unexpected sectors, in this case public employees’ unions:
“We have been successful at negotiating good quality health care for many of our members and many don’t pay for health care right now,†explained a Civil Service Employees Association organizer. “This plan would impose a cost they are not used to paying.â€
Progressives say the wealthy will bear most of the higher tax burden, but union leaders were skeptical. “What is the cost?†asked the chair of the New York State Public Employee Conference. “I cannot sell an estimate to my members.â€
The New York State United Teachers also worried about retirees who have left the state and continue to receive subsidized union-run health benefits. Unions “don’t want to give up what they fought so hard for and suddenly see their members either lose their coverage, or lose it because their pensions aren’t enough to stay here in this state,†said state Senator Diane Savino, a former labor organizer.
Several thoughts occur to me. The first is that however structured any conceivable single-payer plan will result in those who are presently subsidized paying more than they do now. That includes not just public employees but all workers with company-sponsored health care plans and the companies as well, insurance companies, physicians, hospitals, and other providers. No wonder the safest strategy for enacting health care reform legislation is to enact it before reading it.
The other is that the source of much present distortion is in the tax code which taxes income rather than compensation and picks and chooses which health care plans it will subject to tax.
“single-payer plan will result in those whose are presently subsidized paying more than they do now.”
This post is so riddled with grammatical errors as to make it incoherent in places.
” The first is that however structured any conceivable single-payer plan will result in those who are presently subsidized paying more than they do now.”
Depends. If we adopted Medicare, as it is managed now, total costs spent per person would be much lower. At present most companies require that employees pay a substantial amount towards their health care. If companies decided to remain compensation neutral, they would lower the amount that they require employees to contribute. For the few remaining gold plated plans were employees pay nothing, they might pay more, or just have a salary increase.
Steve
No, it doesn’t depend. Most medium-sized and large companies presently are self-insuring. The reason for that is it’s cheaper. If it were not cheaper, they would not self-insure. They are not paying the insurance company markup to which you attribute (wrongly in my opinion) our high health care costs—just a small administration charge, just as would be the case in M4A.
Your argument is based heavily on average per-person charges. That might be lower although I doubt it. But to claim that more people will be insured and it will be cheaper for everybody is wishful thinking. So, for example, it would more expensive for public employees because they typically pay nothing now. You can’t get lower than nothing.
IMO the reason that our health care costs are so much greater than those in France or Germany is that a) we’re subsidizing health care ferociously and b) nobody is saying “no”. That’s why I think that saying “no” must be the first step in health care reform not the last.
Note: when I say “subsidy” I use the term the way that economists do, i.e. “paid for by the government”. Every government outlay is a subsidy. For that not to be the case you would need to argue that there is a “true price”. There is no such thing as a true price. That’s not just Econ 101. It’s Econ .01.