The Morality of a Single Payer Health Care System

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JonNC said:
Yeah, lots of people are happy with the choice of one company, one plan, where premiums, co-pays,etc. are skyrocketed, and people who had plans they liked lost them after the lie that they could keep them.
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Eh, like I said, some of us are happy because now we have a plan even if we can’t find full-time work. I guarantee no private insurance would willingly take me, and voluntary associations lower costs by excluding people like me.

As far as medicaid goes, it actually seems to vary by the state. When I lived in upstate NY I never had cause to complain. It was the same thing with the high-risk pools, actually - it can work, but it really depends on someone being willing to properly fund the thing.
 
Asking, “Is the single payer health system immoral?” is akin to asking, “Is killing immoral?” It depends.

The significant difference between private and public health insurance is the freedom to associate. Unlike private insurance in which companies solicit participation, the government, through its monopoly on the use of force, mandates participation. Legislation that proposes single payer must also address limiting that awesome power of the government to impose itself on the citizenry.
There are at least three ways in which the single payer system as presently proposed is immoral – with respect to providers, to the proximate payers and ultimate payers.
  • To providers: All providers must be guaranteed the freedom of conscience that any procedures they deem now or in the future as immoral are never mandated.
  • To taxpayers: All procedures deemed immoral now or in the future by any legitimate group of citizens are never covered expenses.
  • To ultimate payers: That the funding necessary for whatever single plan payer system is proposed is completely funded via revisions in the current tax code.
 
o_mlly said:
Asking, “Is the single payer health system immoral?” is akin to asking, “Is killing immoral?” It depends.

The significant difference between private and public health insurance is the freedom to associate. Unlike private insurance in which companies solicit participation, the government, through its monopoly on the use of force, mandates participation. Legislation that proposes single payer must also address limiting that awesome power of the government to impose itself on the citizenry.
There are at least three ways in which the single payer system as presently proposed is immoral – with respect to providers, to the proximate payers and ultimate payers.
  • To providers: All providers must be guaranteed the freedom of conscience that any procedures they deem now or in the future as immoral are never mandated.
  • To taxpayers: All procedures deemed immoral now or in the future by any legitimate group of citizens are never covered expenses.
  • To ultimate payers: That the funding necessary for whatever single plan payer system is proposed is completely funded via revisions in the current tax code.
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As we can see with current events, two of these three are likely not to happen. If the rights of a baker can be deemed subservient to the rights of a same gender couple, then it seems the religious rights of a Christian doctor or hospital hardly stand a chance regarding something like abortion or gender “reassignment”. And if the plan is single payer, the government will decide what gets paid for or not. One can hardly imagine these immoral procedures not being covered.

As for the third, what type of revisions do you mean?
 
o_mlly said:
To taxpayers: All procedures deemed immoral now or in the future by any legitimate group of citizens are never covered expenses.
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This one’s going to be hard, because there are legitimate groups of citizens that consider a lot of procedures immoral.

There are people who consider blood transfusions immoral. There are people who consider any medicine made from pigs immoral. There are people who consider any medicine tested on animals immoral. There are people who consider lifesaving treatments on disabled fetuses immoral. And all these people are going to not want their tax money to go to something they consider immoral. There’s just no way to manage things where someone isn’t forced to support something they consider immoral.

I’d say that problem already exists both with medicaid and with employer healthcare. How many of us who work for secular employers have any choice about what healthcare we pay for? And anyone on medicaid would be provided with what the government decides.

I’m not sure it’s practical to have a voluntary association that’s big enough to make a difference (economy of scale is a major issue here) and still covers everyone needing it for everyone who finds some medical treatment immoral.
 
If ONE voluntary association is not able to handle the payments, then can we have several different voluntary associations?
 
Healthcare works on economies of scale. You need a fairly large association (of whatever sort) to really work, in order to be able to share costs out without the risk of a few people causing major financial issues, and to be able to negotiate effectively.
They also need to be not spread too thin geographically. So you’d need a situation where you’d have to have voluntary associations large enough, and concentrated enough for any given area, to be effective. But you’d also need enough of them to cover all the myriad things people would object to.

That’s a really tough balance, and I’m not sure it can be done.
 
I’ve always thought of the Catholic Church as being in favor of socialism, such as Social Security, Medicare, gov help for the poor, etc.

My mother (a Protestant & a Republican) used to complain that Catholics were communists. She also hated FDR and his social programs…but by retirement time in the 1980s she had had a change of heart and had come to embrace such socialist programs.

And what is communism and socialism but caring and sharing. It’s what has been practiced for over 99% of human history in most band and tribal societies before states evolved, and it is practiced in monasteries. Just because some in recent history have corrupted it or failed to bring about better societies does not detract from its good intentions, though to some extent misguided.

Just heard on TV that Castro lamented some decades after the communist takeover of Cuba that he had want to create a utopia, but had failed.

Cut-throat capitalism that would throw workers whose arms were severed at work out into the streets to die also has its problems. And what about our 40 hour workweek - another socialist program that people had died for.

I think it is not the economics of socialism (say, as practiced in Europe & in some programs in the US, and in Bernie’s proposed single-payer health care system) so much as politics (totalitarianism) that the Church is against.

The trick is to maintain human freedoms as much as possible, while providing safety nets out of our Christian compassion for others. To avoid encouraging “ne’er-do-well” dependency on the one hand, and kicking the dying in the guts on the other or fleecing the sheep down to the bone. It can be done if we put our minds and hearts into bringing about the kingdom of God and its righteousness.
 
i suppose the morality of it could be discussed forever and much would depend upon its design.

i would say however that it is only one option among many, very many viable, efficient and effective options.

personally, i find very little that is done by the government to be efficient and effective.

all other aspects being equal, efficiency and effectiveness should prevail when creating a system.

in general, i prefer government actions to enhance individual freedoms in so far as possible. the good of the community is the only legitimate reason for limiting individual freedoms.

the good of the community would not justify (so far as i have been able to determine) the limitations on individual freedoms needed to create single payer health care. i say that because of the multitude of other reasonable and viable options that are available.
 
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Yes, but are those other options creating profit for anyone? We need a not-for-profit system, that allows reasonable wages for healthcare workers but doesn’t put our hard-earned money into CEO’s pockets or give physicians fits when they try to prescribe treatments for their patients.
 
Certainly, public systems can provide a profit motive, and they do. Here is an example from a Medicaid recipient. It’s an excerpt from the linked article:

“A Medicaid dentist told me I had 14 cavities, a year after I had gotten a clean bill of health from another dentist, for whom I had paid out of pocket. When this dentist left the room, I asked his assistant how it was possible that 14 cavities developed in one year without me experiencing any pain.

His assistant’s response was: “This place is a factory, and you have Medicaid. That’s a dollar sign on your forehead.” This assistant had looked at my x-rays and done my cleaning minutes before, and assured me I didn’t appear to have a single cavity.”

Source: I was on Medicaid for years. It’s horrible and should be cut, not expanded.
 
Viki63 said:
Yes, but are those other options creating profit for anyone? We need a not-for-profit system, that allows reasonable wages for healthcare workers but doesn’t put our hard-earned money into CEO’s pockets or give physicians fits when they try to prescribe treatments for their patients.
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why do you imagine non-profits suddenly won’t pay their execs big salaries?
 
JimG said:
Source: I was on Medicaid for years. It’s horrible and should be cut, not expanded.
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Having read the article, I’m somewhat wondering about the conclusion. He states the problems with medicaid and why, but not how to fix them. If medicaid goes, what do you do for people who just don’t have the money for their own healthcare? Remember, as of right now, anyone who’s disabled and under medicare age goes on medicaid.
 
Yes, there are a huge number of people on Medicaid. I don’t know whether either Medicaid or Medicare are financially stable. I don’t know how to fix them, but they do need to be fixed.

Both programs are in effect guaranteed income for physicians who want volume of patients. The temptation is to overtreat and overbill or to fudge the billing codes. It would almost be preferable to pay the monthly fee for patients to go to a DPC physician.
 
My husband is on Medicaid, he had 3 hospitalizations last year and this year an operation that cost $49K. We pay several thousand every year but without Medicaid he’d be dead.
 
The salaries of healthcare workers – Mds, nurses, etc – would be paid from taxes , just as Medicare is paid now, but at a more fair rate. Where would these non-profits get the big salaries to pay their execs?
 
Viki63 said:
The salaries of healthcare workers – Mds, nurses, etc – would be paid from taxes , just as Medicare is paid now, but at a more fair rate. Where would these non-profits get the big salaries to pay their execs?
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why are you comparing the bottom rung workers to the top level execs? Have you every looked at what the execs in Planned Parenthood make, while their nurses are making normal wages.
 
Theo520 said:
why are you comparing the bottom rung workers to the top level execs? Have you every looked at what the execs in Planned Parenthood make, while their nurses are making normal wages.
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I feel like there should be a Catholic version of Godwin’s law for when planned parenthood comes up.
 
DarkLight said:
I feel like there should be a Catholic version of Godwin’s law for when planned parenthood comes up.
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What I said applies to virtually any Non Profit, but the Red Cross doesn’t already hire nurses and doctors, so PP was an appropriate example of the issue.
 
There’s just no way to manage things where someone isn’t forced to support something they consider immoral.

I agree. Therefore single-payer without guarantees that tax money will not be used to murder is an immoral system. We are obligated to avoid evil.

Could it happen? It already is. Now is the time for Catholics to resist cooperating with evil. To advocate a single payer system without guarantees is to advocate the evil of abortion.

“Illinois Republican Governor Bruce Rauner signed a controversial bill into law on Thursday to expand state-funded coverage of abortions for low-income residents on Medicaid and state employees.”
 
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