> It thus makes no sense to reject single-payer on the grounds that it would require higher tax revenues. That’s true, of course, but it’s an irrelevant objection.
> The most important source of cost savings under single-payer is that large government entities are able to negotiate much more favorable terms with service providers.
I agree these objections are not relevant for the overall system. But certain individuals and groups within the current system will get screwed.
The wealthy and upper middle-class will oppose any tax increases, as it will decrease their take-home income. Plus the resentment of having to pay for someone else (the moochers).
Providers will oppose any haircut that comes with single-payer rates and price controls. No more millionaire doctors, specialists, or dentists.
And of course the overhead of health insurance middle-men and the huge administrative bureaucracy costs.
This is the crux of the problem. We could have a reasonably good system for everyone. But it requires a lot of people with heavily vested interests into a less ideal situation.
Yeah, and we ban people from public roads for bad behavior. Will we ban people from public healthcare for bad health choices? Do we really want to give the government that kind of exclusive control over a service while giving up control of our bodies?
Smokers typically exhibit compressed mortality. Yes, they die younger than non-smokers, and yes, they have health issues. But the health issues are typically of the sort that get deadly in short order and so actually save money.
> The most important source of cost savings under single-payer is that large government entities are able to negotiate much more favorable terms with service providers.
I agree these objections are not relevant for the overall system. But certain individuals and groups within the current system will get screwed.
The wealthy and upper middle-class will oppose any tax increases, as it will decrease their take-home income. Plus the resentment of having to pay for someone else (the moochers).
Providers will oppose any haircut that comes with single-payer rates and price controls. No more millionaire doctors, specialists, or dentists.
And of course the overhead of health insurance middle-men and the huge administrative bureaucracy costs.
This is the crux of the problem. We could have a reasonably good system for everyone. But it requires a lot of people with heavily vested interests into a less ideal situation.