The Morality of a Single Payer Health Care System

[Theo520]

Vonsalza,
In all the major single payer countries, the Govt does end up owning much of the health care infrastructure, hiring staff and making support contracts.

Private hospitals will only set up in the most profitable locations, leaving the rest of the country to be managed by public managers.

The doctor will bill for his time and leave the govt to hire and manage all the nurses, orderlies, etal.

 

[JonNC]

=Vonsalza;14875820]In no way did I suggest it as being the only type, so lets not stretch the goal-post on this. But it is a very pertinent type, as a large portion of hospital admissions come via the emergency room.

Nor did i say you said it was the only type. What I said was it is not my experience, and that you made an argument for catastrophic care. For young, healthy people, that of course should be an option.

To the contrary, I think it’s actually a valid exercise of the commerce clause. One of the few.

It is a perversion of the commerce.

You’ve seem to forgotten than we only levy it in time of need. :whacky:
When our 18 year old men no longer have to register for Selective Service, you’ll have a point. But not until then.

I think that’s a good idea.

Well… He is God, right? Sovereign author, judge and finisher of all creation?

Certainly seems rather authoritarian to me, even as he allows for a free-will component. That just means His autocracy isn’t purely deterministic.

If you want to compare God to human authoritarianism, okay. I won’t join you.

Moreover, all things certainly serve the will of God, ultimately. Including the rise of powers you don’t like.

All things certainly can serve the will of God.

I disagree. It’ll be no more authoritarian than any other construct of our government that is in place because your opinions against it aren’t popular enough.

Even ACA is authoritarian. It has an individual mandate. It seeks to suppress religious free exercise. These are attributes of government power restricting individual rights. That authoritarian. Again, if you want to have this, pass a constitutional amendment.

No need. The constitution as-is provides sufficient room for enactment.

Not in its original intent. What the left is trying to do is expand government power and restrict individual rights.

Again, Jon, Anachronism works both ways. Trying to divine Adams’ or Jefferson’s views on a contemporary issue that they either didn’t face or faced in an entirely different context is another solid example of Anachronism.

The framers provided two ways to respond to the needs of any current era after theirs: both of them are ways of passing a constitutional amendment. Attempts to increase government power beyond the specific and limited enumerated powers is, in my view, subversive.

Oh goodness, you don’t need to look as far as Europe. The plight of the Native Americans under American “Manifest Destiny” serves a nice example.

Indeed. Somehow citing that as a support for government healthcare is counterproductive to your cause.

Again, Jon, everyone believes in “limited government”. Just as long as you don’t limit the parts that they personally benefit from; knowingly or not.

No. Progressives do not believe in limited government, hence the continuous march toward strong central government, and the dwindling of individual rights.

It’s a useless term.

It is only useless to those who wish to eliminate the protections of individual rights found in the constitution.

Neither do single-payer advocates.
The responsibility of care still lies with the doctors. The government is just acting as the insurer. They issue no direct care just like Humana or Blue Cross doesn’t issue direct care.

Oh, yes they do. that is exactly what they do. Giving government power of one’s healthcare, where government determines what is in your plan against your right to choose, determining what is or isn’t covered and for whom, is turning over our responsibility to care for the least of His children to government, and contrary to free will, coercing others to do so.

I agree fully. Let’s support a single-payer option instead.

Single payer IS authoritarian.

 

[Vonsalza]

It is a perversion of the commerce.

As such, we disagree. Thus the primary recourse is an act of democracy. One I’m eventually going to win, may I add.

Even ACA is authoritarian.

I think we have different understandings as to what “authoritarian” means.

A democratic regime can still pass rules that are binding upon the people, but that doesn’t make it an authoritarian regime. We still have the power to “change it back” if it ends up being a bad idea. Authoritarian regimes, generally, do not give this power to the people.

I think a lot of your cries of “Authoritarianism!” are sensational and over-simplified coping mechanisms for living in a democracy where most of the voters are starting to disagree with you on this issue.

The framers…

Are dead. The US is a democracy of the living. No voting rights or autocratic powers shall be bequeathed to the dead beyond what laws they enacted that still apply.

Attempts to increase government power beyond the specific and limited enumerated powers is, in my view, subversive.

I think the enumerated power most cited in support is the commerce clause. It is up to the SCOTUS to determine if this is a correct application of said clause, but I do like my odds.

No. Progressives do not believe in limited government, hence the continuous march toward strong central government, and the dwindling of individual rights.

You can tell yourself that, but it’s not true. Progressives believe in solving problems with government when the solutions provided by lassez-faire paradigms are unacceptable. No one, again - no one, wants to increase government for the simple sake of increasing government.

Oh, yes they do. that is exactly what they do. Giving government power of one’s healthcare…

sigh

This isn’t what’s being discussed. A single-payer system is what’s being discussed. Just like the rest of the world, no one is pushing for a soviet-style healthcare scheme.

You can argue against that all you wish. But as that’s not what’s being sought, your arguments against it really are perfectly irrelevant.

…turning over our responsibility to care for the least of His children to government…

For the umpteenth time, it is the doctor that provides the care, Jon.

…coercing others to do so.

We’ll be coerced to pay for it through taxes, yes. Just like we’re coerced to pay for roads, schools, F-22s and foodstamps.

But you don’t have to consume it. No one is going to make you do that. You do realize that in all these nightmare countries in the rest of the developed world that get on just fine with a public healthcare option, private care still exists, right?

Now, it’s overwhelmingly for the very wealthy, but “if you’ve got the cash, you get to splash”, so to speak.

Single payer IS authoritarian.

Again, I’m not sure you know exactly what authoritarian is. The UK, Canada, France, Switzerland, Germany and several others are really iron-shod autocracies?!?!?

Someone should tell the UN!

Quite a boogeyman you’ve fabricated for yourself, Jon.

 

[o_mlly]

Again, I’m not sure you know exactly what authoritarian is. The UK, Canada, France, Switzerland, Germany and several others are really iron-shod autocracies?!?!?

At some number of citizens, the single payer system becomes immoral as an impersonal and overly bureaucratic method of delivering health care services and violates the principle of subsidiarity.

I think those who oppose single payer fear that a federal system in the US requiring 320 million citizens sending money to Washington, DC will do just that – become impersonal and unjust. Additionally, Catholics are right to fear that the federal government is presently hostile to some of our values and given the power to pay results in the power to dictate what may or must be paid for (to qualify as a provider) and how much will be paid.

The single payer advocates claim that a one-off reduction in administrative costs justify this radical (and very likely irreversible) change to centralizing the planning and delivery of health care services for the entire country. Such a change in governance is historically a one way street. Once the power is given, that power is never relinquished. The power to dictate what may be paid for and how much will be paid is absolute control – it does not matter who employs the providers or who owns the facilities. The power to pay is the power to dictate.

Centralized planning, a communist principle, has never worked in history. The reason centralized planning has never worked is that no small group of elites is smart enough to understand the needs and wants of the many, i.e., 2000 pages of Obamacare that few if any legislators read. The Europeans know this; very few have single payer systems. How many do?
*There are fewer than many people might think. Most European countries either never had or no longer have single-payer systems.

Germany, for example, has 135 “sickness funds,” which are essentially private, nonprofit insurance plans that negotiate prices with health care providers. “So you have 135 funds to choose from,” said Anderson.

Nearby, Switzerland and the Netherlands require their residents to have private insurance (just like the Affordable Care Act does), with subsidies to help those who cannot otherwise afford coverage. npr.org/sections/health-shots/2016/01/22/463976098/debate-sharpens-over-single-payer-health-care-but-what-is-it-exactly*

 

[Vonsalza]

At some number of citizens, the single payer system becomes immoral as an impersonal and overly bureaucratic method of delivering health care services and violates the principle of subsidiarity.

Respectfully, they’re not delivering services. They’re delivering payment for the services.

We’re not pushing for a British model. We’re pushing for a Canadian model.

They are different. Thus, a critique for one does not automatically apply to the other.

I think those who oppose single payer fear that a federal system in the US requiring 320 million citizens sending money to Washington, DC will do just that – become impersonal and unjust.

First, we’re already required to send money to Washington, right?

Secondly, the system would be no more “impersonal” than it is now; as you’ll be going to the exact same doctor. But it would be far more just. Folks won’t be getting denied needed treatment because they lack the money to pay for it. Unless, of course, you consider a system where the poor perish due to their poverty as “just”.

Additionally, Catholics are right to fear that the federal government is presently hostile to some of our values…

Well, in fairness, it isn’t a “Catholic” government any more than it is a Hindu or Buddhist or Muslim or Atheist government.

The single payer advocates claim that a one-off reduction in administrative costs justify this radical (and very likely irreversible) change to centralizing the planning and delivery of health care services for the entire country.

As a long-time singler-payer supporter, this is news to me. Yes, there will be an overall reduction in administration, but it’s nowhere NEAR being a main justification for it.

Care. Getting care to people that otherwise don’t have it or face financial ruin in obtaining it would be the primary motives.

And in a Democracy, nothing is irreversible. See the 18th and 21st amendments to the US Constitution.

Now, something may appear irreversible to those in the minority that don’t support a popular law. But welcome to life in a democracy.

Such a change in governance is historically a one way street.

I don’t see that as being very true.

Again, the 18th and 21st amendments.
Roosevelt began the WPA to employ unskilled men after the depression. It was terminated during WW2.

There are loads of government programs, agencies and initiatives that have been closed or reorganized away…

The power to pay is the power to dictate.

I agree. The American Taxpayer should hold that collective power.

Centralized planning, a communist principle, has never worked in history.

And if we ever stop talking about single-payer healthcare and start talking about centralized planning instead, I’m sure you’d have a lot of points here that would become very valid in that particular discussion.

These are simply not the same thing.

Germany, for example, has 135 “sickness funds,”…
Nearby, Switzerland and the Netherlands require their residents to have private insurance (just like the Affordable Care Act does)…

Right on. Lots of ways to solve the problem.

 

[Viki63]

R

. . . the system would be no more “impersonal” than it is now; as you’ll be going to the exact same doctor. But it would be far more just. Folks won’t be getting denied needed treatment because they lack the money to pay for it. Unless, of course, you consider a system where the poor perish due to their poverty as “just”.

Refreshing to read your posts, since you get it.
I got so tired of talking to patients who couldn’t afford their medications or couldn’t make an appointment with their doctors until they paid off their bill.

Medical bankruptcy is huge in this country.

.

 

[JonNC]

Refreshing to read your posts, since you get it.
I got so tired of talking to patients who couldn’t afford their medications or couldn’t make an appointment with their doctors until they paid off their bill.

Medical bankruptcy is huge in this country.

.

No one should suffer that way. No one should be coerced to help them, either

 

[JonNC]

=Vonsalza;14877237]As such, we disagree. Thus the primary recourse is an act of democracy. One I’m eventually going to win, may I add.

“Democracy is the right of the people to choose their own tyrants.” -Madison

Not in a constitutional republic. That’s not how the republic under the constitution is supposed to operate. That’s why I say that government healthcare is a perversion of the commerce clause, and subversion of the intent of the document.
Instead, pass a constitutional amendment. That’s the process in place to change the powers the federal government has. If the people want it, it will pass.

I think we have different understandings as to what “authoritarian” means.

We have a different understanding of what a constitutional republic is.

A democratic regime can still pass rules that are binding upon the people, but that doesn’t make it an authoritarian regime. We still have the power to “change it back” if it ends up being a bad idea. Authoritarian regimes, generally, do not give this power to the people.

See the above.

I think a lot of your cries of “Authoritarianism!” are sensational and over-simplified coping mechanisms for living in a democracy where most of the voters are starting to disagree with you on this issue.

Peace in our time. I get it. We’ve become so misinformed about what individual rights are and what limited government is, and how without the latter we lose the former.
Please find the term democracy in the constitution.

Are dead. The US is a democracy of the living. No voting rights or autocratic powers shall be bequeathed to the dead beyond what laws they enacted that still apply.

“Democracy is indispensable to socialism.” - Lenin
Please find the term democracy in any state constitution.

I think the enumerated power most cited in support is the commerce clause. It is up to the SCOTUS to determine if this is a correct application of said clause, but I do like my odds.

I’m hopeful for another Neal Gorsuch. I think it is the key to saving the republic.

You can tell yourself that, but it’s not true. Progressives believe in solving problems with government when the solutions provided by lassez-faire paradigms are unacceptable. No one, again - no one, wants to increase government for the simple sake of increasing government.

That’s naive. Power, indeed corrupts. Increase in power is always the goal of government. It is too bad that the founders didn’t listen more closely to the warnings of the anti-federalists.

This isn’t what’s being discussed. A single-payer system is what’s being discussed. Just like the rest of the world, no one is pushing for a soviet-style healthcare scheme.

Incrementalism. It is always denied, and always comes true.

You can argue against that all you wish. But as that’s not what’s being sought, your arguments against it really are perfectly irrelevant.

We’ll just have to disagree.

For the umpteenth time, it is the doctor that provides the care, Jon

.

And if the doctor becomes a servant of the state, it is the state thatmight provide the care you need.

We’ll be coerced to pay for it through taxes, yes. Just like we’re coerced to pay for roads, schools, F-22s and foodstamps.

Exactly. Lest’s include abortions and euthanasia in your list.

Jon

 

[Vonsalza]

No one should suffer that way. No one should be coerced to help them, either

Total nonsense, Jon. No one is coercing you to help them any more than you’re being coerced to build interstates or fund any other federal program you may or may not like.

When Cain asked God “Am I my brother’s keeper?”, the answer is obviously “yes”. We’re all our brother’s keepers.

Instead, pass a constitutional amendment.

Why? The constitution gives room for it as-is. No need to bother.

Now you may not like it, but the document is interpreted by the SCOTUS. I doubt SCOTUS will have any problem with it.

We’ve become so misinformed about what individual rights are and what limited government is, and how without the latter we lose the former.

I see that this is how you cope with the eventuality of change, and that’s fine.

We’ve already established that solving 21st century problems with an 18th century paradigm is perfect anachronism.

I’m hopeful for another Neal Gorsuch. I think it is the key to saving the republic.

You might be disappointed. The Scalia court legalized homosexual union, for good or bad.

That’s naive. Power, indeed corrupts. Increase in power is always the goal of government. It is too bad that the founders didn’t listen more closely to the warnings of the anti-federalists.

I would argue they initially did. The failure of the Articles of Confederation is part of their legacy.

Incrementalism. It is always denied, and always comes true.

Cliche. “Equilibrium” is what occurs. The more people you have living together in a fixed space, the more rules you must have to govern conduct. Government grows with population density, as it must. I know you don’t like that, but alas

And if the doctor becomes a servant of the state…

Non-argument, Jon. The doctor serves the patient. According to your view, doctors today really serve Aetna and other large insurance companies? Because that’s all that’s changing.

 

[Vonsalza]

Refreshing to read your posts, since you get it.
I got so tired of talking to patients who couldn’t afford their medications or couldn’t make an appointment with their doctors until they paid off their bill.

Medical bankruptcy is huge in this country.

.

Thanks for your kind words.

I think a lot of folks believe that the creation of a single-payer system is a lot more involved and complex than it really is.

Essentially, everyone gets put on medicare. That’s pretty much it.

No “death panels”, absolute statism, folks being denied their chemo and a myriad of other boogeymen promoted by insurers and doctors that don’t want to see either a decrease in income or an increase in workload.
With 1-in-5 Americans on Medicaid and 1-in-6 Americans on Medicare, a single-payer system is already the reality for a third of this country. Easily the most expensive third, btw.

We want a system where the other two-thirds can also go get their intermittent chest-pain checked-out without worrying about how much its going to cost them. The gall we have!

 

[JonNC]

=Vonsalza;14879574]Total nonsense, Jon. No one is coercing you to help them any more than you’re being coerced to build interstates or fund any other federal program you may or may not like.

Yes, you are. the constitution provides no enumerated power in healthcare.

When Cain asked God “Am I my brother’s keeper?”, the answer is obviously “yes”. We’re all our brother’s keepers.

Indeed we are. But it is not my place to force others to be their brothers’ keeper.

Why? The constitution gives room for it as-is. No need to bother.

Nope

Now you may not like it, but the document is interpreted by the SCOTUS. I doubt SCOTUS will have any problem with it.

Like I said, I hope for jurists who will maintain original intent.

I see that this is how you cope with the eventuality of change, and that’s fine.

We’ve already established that solving 21st century problems with an 18th century paradigm is perfect anachronism.

It is remarkable how individual rights are now an “18th century paradigm”.

You might be disappointed. The Scalia court legalized homosexual union, for good or bad.

Disappointed, because they should have eliminated any government say in the sacrament/rite of marriage.

I would argue they initially did. The failure of the Articles of Confederation is part of their legacy.

And, apparently, the growing loss of that 18th century paradigm known as individual rights is the failure of the federalists.

Cliche. “Equilibrium” is what occurs. The more people you have living together in a fixed space, the more rules you must have to govern conduct. Government grows with population density, as it must. I know you don’t like that, but alas

Excuse for growing tyranny.

Non-argument, Jon. The doctor serves the patient. According to your view, doctors today really serve Aetna and other large insurance companies? Because that’s all that’s changing.

Aetna cannot control my actions at the point of a gun. Government can.

 

[JonNC]

Essentially, everyone gets put on medicare. That’s pretty much it.

No “death panels”, absolute statism, folks being denied their chemo and a myriad of other boogeymen promoted by insurers and doctors that don’t want to see either a decrease in income or an increase in workload.
:

Not to start with.

 

[Rau]

Yes, you are. the constitution provides no enumerated power in healthcare.

Is lack of constitutional coverage key to the coercion concern? Were an amendment to be passed, would that eliminate the claim of coercion?

 

[JonNC]

Is lack of constitutional coverage key to the coercion concern? Were an amendment to be passed, would that eliminate the claim of coercion?

I think it would be huge mistake, but yes. I think it a fair distinction that when the people through the states determine to grant a certain power to the general government via a constitutional amendment that this would eliminate the claim

 

[Vonsalza]

I think it would be huge mistake, but yes. I think it a fair distinction that when the people through the states determine to grant a certain power to the general government via a constitutional amendment that this would eliminate the claim

As respectfully as I can, I’m going to have to call “balderdash”.

Coercion doesn’t somehow cease to be coercion just because a law got passed at some arbitrarily selected level. Whether via constitutional amendment or additional entry into the US code, law is law and one must abide by it or face due process and penalty. Which is coercion. It’s the coercion necessary to make government function.

“People through the states” is no more or less valid than “people through their representatives”. The distinction on your part is purely arbitrary as both bodies are acting under the Will of the People.

Preempting your reply of the 10th amendment, we’ve already discussed the commerce clause and how SCOTUS (the only relevant opinion in the room) seems to be just fine with it, as Medicaid and Medicare already exist.

---

To Rau as well: The fact of the matter is that some people create irrational boogeymen and straw-men for things they don’t like. Even if you manage to defeat their arguments, you still can’t convince them because their dislike is emotionally predicated. They usually don’t have an intellectual problem with the given proposition; it’s an emotional problem masquerading as an intellectual problem in an effort to hide its irrationality.

Rhetoric just can’t defeat that by itself because they’ll just jump to another defense or deny that you’ve flattened their argument. I “keep it up” only for the sake of the rational readers that are on the fence about the issue and may yet be convinced by a good argument…

 

[o_mlly]

Rhetoric just can’t defeat that by itself because they’ll just jump to another defense or deny that you’ve flattened their argument. I “keep it up” only for the sake of the rational readers that are on the fence about the issue and may yet be convinced by a good argument…

Friend, you have not as far as I can tell argued the morality of a single payer system. Only that it is your personal preference.

We all agree on the goal – health care for all. We do not agree on the method, i.e., that the single payer is a moral method. BXVI’s encyclical Deus Caritas and the Kansas bishops’ letter cite specific moral questions that have not yet been answered. Do you have any authoritative documents from Catholic bishops or the ordinary Magisterium that support your opinion that only a single payer system is morally good? I think one has to argue that solidarity clearly outweighs susidiarity.

We may and I think will disagree on the prudence of the single payer system but that is not the question.

 

[Vonsalza]

Friend, you have not as far as I can tell argued the morality of a single payer system. Only that it is your personal preference.

I was just replying to Jon’s interesting view that amendments to the constitution don’t involve coercion, somehow.

But challenge accepted! Here’s just a few.

- First and most importantly, single-payer systems are more moral because they result in more people getting care.
Under our private system before the dreaded Obamacare, roughly 20% of Americans didn’t have health insurance. These were generally “the working poor”. Post-ACA, this has fallen to 10%.
But under a single-payer system, 0% of Americans will go without health insurance.

- Second, single-payer systems save millions of people from bankruptcy (and this saves marriages!).
60% of all personal bankruptcy filings involve unaffordable medical debt. 20% of all US households still carry medical debt from last year.
Compile this with “financial issues” being the #1 cause of divorce in the US and it isn’t hard to see that a single-payer system is also good for families.

- Third, single-payer systems provide better stewardship of the money spent.
Under our private system before Obamacare trimmed the limit to 15%, roughly 20% of insurance expenses went to “operating costs” like paying Norman Payson of Oxford Health Plans $70 million a year to run the company.
Single-payer systems don’t get close to that level of exorbitance. The admins of Medicare were paid far, far less and overhead expenses run roughly 3% of expenditures.

- Fourth, single-payer systems get life-saving drugs to people for fairer prices.
In single-payer countries, most medications cost half of what they do in the US. Why? Individuals have no negotiating leverage with big-pharma. None. A single-payer healthcare system, on the other hand, negotiates price for that entire market. For the pharmaceutical company, it’s either “agree on a price” or “lose access to that market”. They don’t want to lose access to the market.

I’ve only covered the four mentioned briefly and there are many others (like lower infant mortality and private insurers being incentivized to deny care), but I’ll stop here for now.

 

[JonNC]

=Vonsalza;14881774]As respectfully as I can, I’m going to have to call “balderdash”.

Coercion doesn’t somehow cease to be coercion just because a law got passed at some arbitrarily selected level. Whether via constitutional amendment or additional entry into the US code, law is law and one must abide by it or face due process and penalty. Which is coercion. It’s the coercion necessary to make government function.

Yes, it does. When the proper level of governance (in this case the amendment process) , as designated by the governing document (it is ludicrous to call it arbitrary), properly provides additional power to the general government, it is by the choice of the governed, and it is not coercion. If, on the other hand, subversion of that process is used, then it is coercion.

“People through the states” is no more or less valid than “people through their representatives”. The distinction on your part is purely arbitrary as both bodies are acting under the Will of the People.

The will of the people, when it comes to adding powers not already enumerated to the general government, is only legitimate and valid through the amendment process.
But then, we already know your opinion of individual rights as being an 18th century paradigm.

Preempting your reply of the 10th amendment, we’ve already discussed the commerce clause and how SCOTUS (the only relevant opinion in the room) seems to be just fine with it, as Medicaid and Medicare already exist.

True. And if the SCOTUS determines that any form of single payer is constitutional, then that will be the law of the land, and it will be no more moral than Roe V Wade.​

To Rau as well: The fact of the matter is that some people create irrational boogeymen and straw-men for things they don’t like. Even if you manage to defeat their arguments, you still can’t convince them because their dislike is emotionally predicated. They usually don’t have an intellectual problem with the given proposition; it’s an emotional problem masquerading as an intellectual problem in an effort to hide its irrationality.

Yes, we’ve heard your “peace in our time” approach before.

Rhetoric just can’t defeat that by itself because they’ll just jump to another defense or deny that you’ve flattened their argument. I “keep it up” only for the sake of the rational readers that are on the fence about the issue and may yet be convinced by a good argument…

That’s funny. I was convinced we were discussing this from a position of mutual respect. To imply that I am irrational is the type of ad hominem we often hear of late from the progressive movement.
To the point, I do not consider your argument irrational. I consider it incorrect, and in many ways, representative of dangerous philosophy that only government can solve problems. It is not, however, irrational, as I understand the belief system surrounding it.
Rational is not equivalent to best.

Jon

 

[JonNC]

=Vonsalza;14882522]

- First and most importantly, single-payer systems are more moral because they result in more people getting care.
Under our private system before the dreaded Obamacare, roughly 20% of Americans didn’t have health insurance. These were generally “the working poor”. Post-ACA, this has fallen to 10%.
But under a single-payer system, 0% of Americans will go without health insurance.

And as you have said, insurance does not provide care.
Post ACA, the cost of co-pays, premiums and deductibles has made actual care as unaffordable as ever.

- Second, single-payer systems save millions of people from bankruptcy (and this saves marriages!).
60% of all personal bankruptcy filings involve unaffordable medical debt. 20% of all US households still carry medical debt from last year.
Compile this with “financial issues” being the #1 cause of divorce in the US and it isn’t hard to see that a single-payer system is also good for families.

As California recently discovered, single payer will place the entire country at risk of bankruptcy, considering the fact that our effective debt is north of $120 trillion already.

- Third, single-payer systems provide better stewardship of the money spent.
Under our private system before Obamacare trimmed the limit to 15%, roughly 20% of insurance expenses went to “operating costs” like paying Norman Payson of Oxford Health Plans $70 million a year to run the company.
Single-payer systems don’t get close to that level of exorbitance. The admins of Medicare were paid far, far less and overhead expenses run roughly 3% of expenditures.

Okay, if we are going to look at the federal government as a model of stewardship, the last 8 years and a doubling of just the budget debt needs to be ignored.

- Fourth, single-payer systems get life-saving drugs to people for fairer prices.
In single-payer countries, most medications cost half of what they do in the US. Why? Individuals have no negotiating leverage with big-pharma. None. A single-payer healthcare system, on the other hand, negotiates price for that entire market. For the pharmaceutical company, it’s either “agree on a price” or “lose access to that market”. They don’t want to lose access to the market.

This is a case of the government placing a limit on the market place, then blaming the market place for the very flaws put in place. Government has limited the right of people to form associations in order to negotiate for large groups. Government places restrictions on the option to shop across state lines. Government places mandates on what may and may not, and must be included, even if the costumer doesn’t want the coverage. The government places a limit on the number of medi-share groups that can exist.

I’ve only covered the four mentioned briefly and there are many others (like lower infant mortality and private insurers being incentivized to deny care), but I’ll stop here for now.

The single greatest incentive to deny care is held by government, particularly the general government. They also are responsible for the payout of Social Securoty payments. Now, considering the fact that there is no existing Social Security trust fund with anything but IOU’s, the incentive is clear: limit care to those who cost government the most. I’m eligible for that category now.

paul.senate.gov/imo/media/doc/ObamacareReplacementActSections.pdf

 

[Rau]

Yes, it does. When the proper level of governance (in this case the amendment process) , as designated by the governing document (it is ludicrous to call it arbitrary), properly provides additional power to the general government, it is by the choice of the governed, and it is not coercion. If, on the other hand, subversion of that process is used, then it is coercion.

1. It’s a problem when the appointed authority to decide on the power of the Government (Supreme Court) is believed to be the one doing the subverting. What should be done about that? If its actions find disfavour with 2/3 of the people/States/legislature (whatever the precise rule is) - we should be bowled over by the objections! If 2/3 are favourably disposed, we have a procedural issue, but one easily corrected by amendment.
2. Even if an amendment is passed, might not the 1/3 that disagreed feel coerced?