A Single-Payer System Won't Make Health Care Cheap

[Torie]

This article is well worth reading I think.  Too bad the matter of forcing drug companies to charge US consumers the same as consumers in other rich nations, is not broached. But then, one does not need a single payor system for that. And yeah, hospitals and the way they are structured, are a headache. The author also does not get into whether the service system being basically of the HMO variety (so there is no incentive to over-treat), would help matters (the US is slowly moving to that system anyway is my impression).

[Chief Justice Keef]

Oh god, Megan McArdle? UGGGGH.

[Devout Centrist]

I don't think it is possible to achieve huge cost savings in healthcare (unless you want to be a psychopath and let thousands of people die). The best option is to aim for reducing healthcare inflation as best as possible by getting as much extra utility as possible out of each physician, nurse, hospital, etc.

But here's my point: single payer may not significantly reduce costs, but it is a far more humane way to organize healthcare coverage. McArdle focuses on how other nations with single payer have been unable to reduce costs, but I think she's missing the point. The whole reason we should implement a single payer system is to increase preventative medicine and make the population healthier. Any cost savings are incidental.

You could argue that there are better ways to achieve universal coverage a la a private/public mix as seen in the Netherlands or Japan. But regardless, this article misses the whole argument for single payer coverage and obsesses over costs. The United States missed the opportunity to have lower healthcare expenditures today back in the 1970's.

But more importantly, McArdle argues it's impossible because of the current political reality. Which is true, Medicare-for-All is not going to be achieved today. What it requires is a major realignment. When and if that will happen is a matter of debate.

[Absentee Voting Ghost of Ruin]

This article is well worth reading I think.  Too bad the matter of forcing drug companies to charge US consumers the same as consumers in other rich nations, is not broached. But then, one does not need a single payor system for that. And yeah, hospitals and the way they are structured, are a headache. The author also does not get into whether the service system being basically of the HMO variety (so there is no incentive to over-treat), would help matters (the US is slowly moving to that system anyway is my impression).

From Bloomberg, four years ago:

The Reason Health Care Is So Expensive: Insurance Companies
https://www.bloomberg.com/news/articles/2013-04-10/the-reason-health-care-is-so-expensive-insurance-companies

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An issue Megan McArdle doesn't even mention.  She also doesn't mention her own publicly stated opposition to single-payer health care or her reasoning behind it: that  a government-run single-payer system would stifle innovation, and be controlling and invasive. (Documented, by her, here: https://www.theatlantic.com/business/archive/2009/07/a-long-long-post-about-my-reasons-for-opposing-national-health-care/22299/ )

This isn't reporting, it's propaganda by a manipulative and deceitful hack.

She's also lying. The financing could be accomplished, even at current US spending levels - it would just require taxing the very wealthiest Americans at rates comparable to those they were paying in the 50s and 60s.

[True Federalist (진정한 연방 주의자)]

There's also one minor distortion in her argument. She fails to note that a lot of the public money already spent on healthcare goes towards the sickest part of the population. Hence, the cost per person covered would go down if we did expand coverage, not remain the same as she tries to insinuate.

[publicunofficial]

Torie, linking to Megan McArdle should be grounds to strip you of your mod powers, if not a complete ban from the site.

Or did you miss her most recent article: "Perhaps safety rules could have saved some residents. But at what cost to others' lives? There's always a trade-off.". She's the WORST kind of libertarian, the kind that sees no value in other people's lives and hates the idea of her money being used to help anyone that isn't her.

[Antonio the Sixth]

I agree to some extent: while it reduces some of the inefficiencies in the system, single-payer retains health companies' incentive to rack up huge profits by charging as much as they get away with. That's why fully socialized medicine is the real way to go.

[🦀🎂🦀🎂]

McArdle is the sort of cold hearted utilitarian that would thrive as a bureaucrat in a totalitarian government.

[Hermit For Peace]

I don't think it is possible to achieve huge cost savings in healthcare (unless you want to be a psychopath and let thousands of people die). The best option is to aim for reducing healthcare inflation as best as possible by getting as much extra utility as possible out of each physician, nurse, hospital, etc.

But here's my point: single payer may not significantly reduce costs, but it is a far more humane way to organize healthcare coverage. McArdle focuses on how other nations with single payer have been unable to reduce costs, but I think she's missing the point. The whole reason we should implement a single payer system is to increase preventative medicine and make the population healthier. Any cost savings are incidental.

You could argue that there are better ways to achieve universal coverage a la a private/public mix as seen in the Netherlands or Japan. But regardless, this article misses the whole argument for single payer coverage and obsesses over costs. The United States missed the opportunity to have lower healthcare expenditures today back in the 1970's.

But more importantly, McArdle argues it's impossible because of the current political reality. Which is true, Medicare-for-All is not going to be achieved today. What it requires is a major realignment. When and if that will happen is a matter of debate.

This is exactly right on. Anyone who feels differently has no heart, and lacks foresight.