Closing Arguments

We are in a series exploring the idea of a single payer healthcare system.  Click here to find the prior posts.

Don’t you think it is time?

OK, OK, you’ve been patient, so let’s see what we can do to wrap this up. 

If you have been paying attention at all, you have rightly concluded that I am not personally a supporter of the single payer idea, but I want to do my best today to represent the primary arguments of those who are.

For many, if not most, this is not really an economics or policy debate, but a matter of civic morality.  Universal healthcare coverage is, to them, a self-evident, unalienable human right that is part of Life, Liberty and the Pursuit of Happiness, endowed by the Creator, and government has been granted power by the people to  secure such rights.

Now, if we had a bigger budget, the preceding paragraph would have been read by Johnny Cash as a flag, superimposed over faint images of Washington and Jefferson, waved in the background.  Use your imagination.

The corollary to the moral argument is, ‘Every other nation can do this, but we, the most prosperous one, can’t?  What the heck?’

Hacking the Declaration of Independence sounds so much more prestigious than ‘what the heck,’ doesn’t it?

Corollaries to the corollary include points about general fairness, the inherent evil of profiting from healthcare, and the correlation between access to healthcare and things like poverty and oppression.

As we recently reviewed, the economic arguments for a single payer rest on the ability to spread risk broadly and simply drive costs down by dictating lower prices.  In a society where one industry is consuming one of every five dollars and driving ever higher levels of public debt, a little pricing squeeze is needed.

Finally, there is the argument that whatever it is we’ve been doing is not working, so why not give this a try?

I hope my friends who advocate this idea would grant that is close enough.

While we’ve used this long-winded series as an excuse to ignore whatever is happening in Washington, we still have been peeking at the news and noticed the Republican Senate is pushing for a vote on their plan this week.  The majority whip, trying to get those four or five holdouts to come around, said that if they don’t pass something, the Democrats will gain a majority in 2018 and immediately push a single payer system.  The conservative editorial page of The Wall Street Journal, urging the Republicans to pass what they view as a less than perfect bill, made the same argument.  So hopefully this wandering journey has provided a little background when and if we ever tune back into the politicians.

Now what am I going to do? 

It is easier and safer to criticize the dumb ideas of others, but we’re going to put on our big boy pants and see if we can lay out some core ideas that we believe could be part of the solution. 



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Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.

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