The Morality of a Single Payer Health Care System

[Theo520]

The reason why the US healthcare system is expensive is because the government is too involved already, in small part because of terrible tort law backed by trial lawyers unions.

The reason why other countries have cheaper (and often less accessible services) is because the USA covers much of what would be their defense budget.

We also cover all the developmental costs for new drugs and new procedures, which are later adopted by other countries after they are mature and the cost to deliver has dropped.

The below is a bit dated, but it makes the point.

Of almost 3,000 articles published in biomedical research in 2009, 1,169, or 40%, came from the United States. As the line graph below demonstrates (that’s the number of publications on the Y axis, and the year of publication on the X axis), the output of every other single country in the world is dwarfed by what America produces. The closest contender is Great Britain, which comes in at about 300 articles.
blogs-images.forbes.com/matthewherper/files/2011/03/most-innovative-biomedicine1.jpg?
(Please Note: This uploaded content is no longer available.)

 

[Vonsalza]

It doesn’t work well at all, especially outside of primary care.

As literally every other developed country on this planet has a single payer system, I think the law of large numbers might refute you on this.

The reason why a lot of countries have universal health care is because by default the USA pays their defense bill with its nuclear navy and long-range air force.

The US’s absurdly bloated defense budget (alone 25% of global defense spending) is prepared for large, set-piece wars that won’t be fought anymore. As many of the “culturally decadent” countries that practice single-payer healthcare also have their own nuclear arsenal, they don’t particularly need American subs and carriers.

In the post-nuclear age, full-scale invasions are obsolete. A trillion dollar invasion force can get smoked by a half-million dollar bomb just like expensive battleships got smoked by far cheaper aircraft. It’s why we don’t make battleships anymore.

Aside from that, universal health doesn’t work well because it means the national government is delivering a product. Governments do not nor will they ever (barring a completely new evolution of humanity) bring a quality product simply because they have no incentive to do so.

Most national systems work sorta like the Apollo missions that sent us to the moon. The US government paid contractors to provide material for the government mission. Similarly, the hospital is privately owned, the doctor is privately employed. They’re just paid a given rate for a particular operation just like Northrop-Grumman is paid for a particular airframe.

The problem in principle is cost. The governments control cost by rationing care and deciding who gets what.

There is actually far more rationing in the US where folks don’t get care because they’re frightened of the potential cost.

But you’re right on this: a retired MRI machine in Canada actually looks like it was used.

Since it’s not checked by the free market where someone who doesn’t provide a good service would make less money or go out of business, there is no incentive for the government to care----no matter many times the politicians say they do.

False. In most single-payer systems folks are free to choose their doctors, ergo the doctors compete among themselves for the business just like I compete with the others in my industry.

If you’re talking about America, think of it like this: If you like the VA Clinic, you’ll like universal health care.

The VA is government-owned healthcare. Different thing entirely.

The new private hospital built 8 or 9 years ago in my rural community knew they were constructing in an area where 60% or so are on medicaid or medicare. They still built the million-dollar reflection pool on the north side of the hospital for pure aesthetics. They were confident the money was there.

 

[JonNC]

People of wealth will always be able to get the care they want. The “national” part of national healthcare is for the vast majority who cannot pay the huge bills. The top 1% can have their private doctors and clinics. Concierge medicine can alway be a private option.

Unless, of course, government outlaws it, which likely would happen under a government dictated single payer healthcare.

 

[JonNC]

Insurance companies are a huge part of the problem imo.

In the end, they are most concerned with their PROFITS.

In a later post, there is a graph that shows the fruits of those profits: forums.catholic-questions.org/showpost.php?p=14850992&postcount=61

 

[twf]

The UK NHS is the largest employer in all of Europe.
In fact, they are the 5th largest employer in the whole world, with 1.7m employees.

When people talk about single payer, I notice they don’t realize it means making everyone in healthcare a Govt employee.

Not necessarily. In Canada each province administers its own health care system, so I can only speak to here in BC… but many doctors have private practices and simply bill the Province for each patient they see. They’re not government employees.

 

[JonNC]

To oppose nationalized health-care is to hold that human life is secondary to the right to profit. The Church, whatever it may say now or in the past concerning socialism, is never going to say that.

ICXC NIKA

This the kind of claim that needs to be opposed. There is nothing moral about government dictated single payer healthcare. It cancels the right to healthcare and turns it into a government power.

But where I take umbrage is the implication, though knowing you by your posts not intentional, that it is only government that can or will take care of our neighbors. Christ’s call to care for His children does not include using government force to make people care for others. It is the responsibility of the Church, and one can see with the HHS Mandate how the Church will be handled in a single payer system.

 

[twf]

A government has an obligation to recognize that right, but does not the govnerment of the UK, or Cananda recognize a right of that Tanzanian girl to health care. If so, how do they enforce it?

I remember what Mother Teresa said to one of her sisters, who was concerned about financing a new convent " Don’t worry about money, God has plenty of that"

The question becomes, does a government facilitate that. Governments, by definition are focused on their voters. So how does the government of a country that is rich provide healthcare for citizens of poor countries. If we look at the democratic socialist model, that would be a tax on rich health care systems to support poor, or non existant health care systems.

I really do not see that happening. The UK government would not stand at having a third of the NHS budget diverted to the developing world, nor Canadian OHIP.

So I don’t agree with you, in that governments would seek to enforce the right to health care.

I know this is immaterial to your point, but it’s come up in a couple posts now…so I just want to point out that OHIP is the public health insurance program of the Province of Ontario. It has nothing to do with the rest of Canada. We British Columbians tend to be overly sensitive to the rest of the world equating Canada to Ontario.
In BC we have MSP, and there are a growing number of private treatment options in addition to the public system.

 

[Rau]

…Christ’s call to care for His children does not include using government force to make people care for others. It is the responsibility of the Church…

By “Church” you must surely mean the followers of Christ? There is nothing to oppose us seeing our taxes and the machinery of government as a means of assisting the poor to access healthcare. Such a position is in fact widely held. And of course, this does not need to be the only means.

 

[GEddie]

This the kind of claim that needs to be opposed. There is nothing moral about government dictated single payer healthcare. It cancels the right to healthcare and turns it into a government power.

But where I take umbrage is the implication, though knowing you by your posts not intentional, that it is only government that can or will take care of our neighbors. Christ’s call to care for His children does not include using government force to make people care for others. It is the responsibility of the Church, and one can see with the HHS Mandate how the Church will be handled in a single payer system.

Neurosurgery and cancer treatment cannot be operated like a soup kitchen. Considering how financially pinched my former parish was during the decade I was there, if it was representative, I can’t imagine Church charity outdoing the state in high-cost medicine in this millennium.

ICXC NIKA

 

[JonNC]

Neurosurgery and cancer treatment cannot be operated like a soup kitchen. Considering how financially pinched my former parish was during the decade I was there, if it was representative, I can’t imagine Church charity outdoing the state in high-cost medicine in this millennium.

ICXC NIKA

The federal debt is a $20 trillion budget debt and a unfunded responsibilities over $100 trillion

 

[JonNC]

By “Church” you must surely mean the followers of Christ? There is nothing to oppose us seeing our taxes and the machinery of government as a means of assisting the poor to access healthcare. Such a position is in fact widely held. And of course, this does not need to be the only means.

I have an opposition to forcing with government power others to do this. Absolutely.
And for those who do favor it, just note that it isn’t compassion, as compassion is never the result of compulsion. It isn’t charity because charity comes from a freedom to choose.
What it is is authoritarian

 

[Rau]

I have an opposition to forcing with government power others to do this. Absolutely.
And for those who do favor it, just note that it isn’t compassion, as compassion is never the result of compulsion. It isn’t charity because charity comes from a freedom to choose.
What it is is authoritarian

You miss the point. There is widespread support in democratic countries for progressive taxation and service delivery to persons in need despite their lack of capacity to pay.

 

[Monte_RCMS]

I would like to point out that the USA is about the only civilized country in the entire world that does not have a single-payer health care system, with the exception of countries like Switzerland, where everyone is required to buy basic medical insurance, with subsidies for those who can’t afford it.

If this is a sin, then a huge number of countries are very immoral!

The USA is about the only civilized country in the entire world that did not start out with a king.

If your country is or was a monarchy, then everything in the country was “granted” DOWN to you from the monarch.

In the United States, as a former colony and then as a small at first independent country, our health care system evolved from voluntary associations of private citizens. It is a mix of charitable voluntary donations systems and religious systems and municipal systems and private systems.

Totally different evolution from the monarchial system.

Everything in the United States is an outgrowth of free voluntary associations among the citizens.

Tocqueville’s book: “Democracy in America” is still valid even after all these years!

en.wikipedia.org/wiki/Alexis_de_Tocqueville

Local hospitals originated from individual doctors who established philanthropic clinics that they ran themselves. Private clinics were established by individuals to offer premium care. The Catholic Church in the USA also established prominent hospitals as a philanthropy … part of its call for charity … subsidized by parishioners and the local dioceses. Government run hospitals evolved to care for indigent people. Doctors made house calls and were paid in cash. Pharmacists performed minor surgery *

The Packard automobile was famous where I lived because it was reliable and they were purchased by doctors so they could make house calls in all weathers.

Numerous hospitals such as Shriners and St. Jude’s are famous for not charging.

During World War Two, employers were allowed to “violate” wage freeze laws by issuing medical insurance to employees. Prior to that people paid cash and/or received medical care as charity. But the issuance of employer-paid medical insurance created a number of discussions … who pays. Complicating the discussion are various laws prohibiting individuals from purchasing their own insurance … the major concern was the prohibition of interstate purchase of medical insurance.

The other really important issue is the absence of competition in a single payer health care system … lack of choice.

Complicating the discussion is the exemption of Congress, their employees, union members, and “certain” members of “certain” religious groups.

Recently, I became aware that Solidarity Healthshare has been formed to overcome the concerns of Catholics.*

 

[Monte_RCMS]

I got timed out … but I was adding this:

Complicating the discussion is the exemption of Congress, their employees, union members, and “certain” members of “certain” religious groups from the Affordable Care Act … “Obamacare”.

And then over time, the government got more and more involved AND thanks to Senator Teddy Kennedy D-Mass … RIP … who wanted to impose a system of socialism, more and more restrictions were placed on voluntary associations. So you can buy car and house insurance across state lines, but NOT medical cost insurance.

If Obamacare was made optional, so that people could freely purchase their own insurance then the overall system would be much more equitable.

One of the issues is how to indigent people or people with chronic illnesses get and or pay for medical care. The answer is the use of the 1040MED tax form. We already have a reverse income tax for really poor people. So, if your income is below the poverty level, the IRS will compensate hospitals and medical providers. There already is HCFA that establishes government approved medical charges. So, the hospital or provider can fill out the 1040MED and send it in to the IRS and the IRS will mail them a check.

 

[Vonsalza]

One of the issues is how to indigent people or people with chronic illnesses get and or pay for medical care. The answer is the use of the 1040MED tax form.

For those who already have the income to treat a chronic illness, this works great.

This does not apply to the overwhelming majority of Americans.

 

[o_mlly]

Have any Popes (including Pope Francis) ever said anything? Has the Vatican or the Magisterium in general ever said anything on the subject?

28 b) The State which would provide everything, absorbing everything into itself, would ultimately become a mere bureaucracy incapable of guaranteeing the very thing which the suffering person—every person—needs: namely, loving personal concern. We do not need a State which regulates and controls everything, but a State which, in accordance with the principle of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need (Deus Caritas, Benedict XVI).*
In the realm of economics, monopsony power always distorts free market prices by exploiting suppliers. The result is less quantity-supplied at lower prices. Under-paid doctors and hospitals simply leave the market. Add to this economic problem, the political problem of funneling trillions of dollars through a few politicians, lobbyists and bureaucrats in Washington, D.C. and the recipe for graft and corruption on a massive scale is set.

 

[Vonsalza]

28 b) The State which would provide everything, absorbing everything into itself, would ultimately become a mere bureaucracy incapable of guaranteeing the very thing which the suffering person—every person—needs: namely, loving personal concern. We do not need a State which regulates and controls everything, but a State which, in accordance with the principle of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need (Deus Caritas, Benedict XVI).*
In the realm of economics, monopsony power always distorts free market prices by exploiting suppliers. The result is less quantity-supplied at lower prices. Under-paid doctors and hospitals simply leave the market. Add to this economic problem, the political problem of funneling trillions of dollars through a few politicians, lobbyists and bureaucrats in Washington, D.C. and the recipe for graft and corruption on a massive scale is set.

Good thing we’re asking for a single-payer system rather than a state owned system. Like how it already works for the 35% of Americans on Medicaid and Medicare that get their treatment at private facilities.

 

[twf]

I have an opposition to forcing with government power others to do this. Absolutely.
And for those who do favor it, just note that it isn’t compassion, as compassion is never the result of compulsion. It isn’t charity because charity comes from a freedom to choose.
What it is is authoritarian

Why then are other government services OK? Why is it moral for the state to raise taxes to go to war? Why should you be compelled to pay for the defence of your neighbour? It’s the same principle. Your argument logically leads to the dissolution of all states.
Democracy and modern states are novel concepts in Church history. In Christian medieval Europe, When a local Lady decided, out of Christian charity, to care for the sick among her husband’s people, she could do so because her husband the lord raised revenue from his subjects. How is this any different?
The Church used to impose a mandatory tithe. That’s no longer true in most places (Germany is an exception). Without that, there’s no way we can depend on voluntary charity to care for all the health needs of the poor.

 

[Monte_RCMS]

For those who already have the income to treat a chronic illness, this works great.

This does not apply to the overwhelming majority of Americans.

Not at all.

Someone with chronic illness or an indigent person, would merely sign the 1040MED which the hospital or other provider fills out. No money changes hands.

The hospital or other provider would send the form to the IRS and be paid by the IRS in accordance with the usual procedure for handling the Earned Income Credit and HCFA rules.

 

[Vonsalza]

The hospital or other provider would send the form to the IRS and be paid by the IRS in accordance with the usual procedure for handling the Earned Income Credit and HCFA rules.

And there’s my point.

That don’t cover the cost of chemo, my friend.