Reno Gazette Journal September 24, 2017
Last week, Bernie Sanders proposed a single-payer system which would nationalize healthcare in America. This measure garnered the support of 16 other Democrat Senators and over 100 Democrats in the House. Let us examine the ramifications of this bill’s approach.
Former Supreme Court Justice Louis Brandeis once wrote, “states may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.” In that spirit, some states have attempted a single-payer system. In 2014, Vermont had to abandon the single-payer proposal as it would have cost the tiny state an additional $2.6 Billion a year when the total annual revenue of the state is only $1.7 Billion. In other words, Vermont would have to increase its taxes by a whopping 160% just to implement single-payer. A ballot initiative in Colorado, dubbed ColoradoCare (which would have resulted in a single-payer system), was soundly defeated by a 79-21 margin in 2016. This would have cost the state an additional $25 Billion per year when the total annual state budget is around $27 Billion. Just this year, the California Senate passed a bill that would implement a single-payer system. The price tag, according to the legislative analysis published by the LA Times, is $400 Billion a year. To put things in perspective, California’s total annual spending is $187 Billion. In other words, California needs to more than triple its already high taxes just to implement single-payer.
Once you get past the exorbitant price tag, there are significant issues. Government reimburses providers at a lower rate. As budgets get squeezed, reimbursement rates will continue to drop. This would result in more doctors not accepting single-payer patients. With the current Medicaid reimbursement rates, about one-third of all physicians are no longer accepting new Medicaid patients. As more doctors stop accepting new single-payer patients (or exit the single-payer market altogether), wait times will inevitably increase. For example, in Great Britain which has a single-payer system, recent data indicates a wait time of 18 weeks for a specialist referral, 15 months for a cataract removal surgery, and most British ERs have over a 4-hour wait according to the Harvard Business Review. Quality in the single-payer market will also suffer as better doctors typically end up in the “private” system due to higher and faster payments, creating a two-tier system where the “private” system has lower wait times, better quality and lower mortality rates relative to the single-payer “government” system. This last scenario has been seen repeatedly in Socialist nations and dictatorships alike throughout this past century.
One final point: Obamacare impacted just one in five Americans. If a program that impacted just 20% of Americans wreaked the kind of havoc that Obamacare did, just imagine the mess that Sanders’ complete healthcare overhaul impacting 100% of Americans (and abolish employer sponsored plans) would wreak. As for costs, back in 1977 Bernie Sanders said the following: “If we expanded Medicaid for everybody, we would be spending such an astronomical sum of money, we would bankrupt the nation”. Senator Sanders, you are right.