There is no question that the President wants a “single payer,” where hospitals and physicians are all paid from a single source, a single government-run program funded by general taxation. The fact that this leads to shortages, waiting lines, and rationing does not seem to concern those who have this single-minded goal.
Before he became President, Senator Barack Obama addressed members of the AFL-CIO. He stated:
“I happen to be a proponent of a single-payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its gross national product on health care, cannot provide basic health insurance to everybody. Everybody in, nobody out– a single-payer health care plan, a universal health care plan. That’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we’ve got to take back the White House, we’ve got to take back the Senate, and we’ve got to take back the House.”
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The messy business of passing health care reform began in earnest as soon as President Obama took office. His party did have control of the House and Senate, but loud opposition began and the Patient Protection and Affordable Care Act (PPACA) was passed by the slimmest of margins in early 2010. In order to keep the semblance of continuity, the new law was built on the current system of employer-based health insurance. Americans have an independent streak and would not accept a government single-payer system in one fell swoop.
Employer-based health insurance has proven inadequate. It developed in a time when people were less mobile and the norm was to find a job and stay with it until it was time for the retirement dinner and gold watch. Now that people tend to regularly change jobs, getting into and out of health insurance policies leads to disruption of care as different doctors are in different plans.
Despite its drawbacks, 170 million Americans depend on employer-based coverage. What will happen if they lose it in the next two years, thanks to PPACA? The law was actually designed to discourage employers from covering their workers, as the penalty for not meeting the employer mandate is quite small, while the “minimum essential coverage” will be very expensive. The House Ways and Means Committee found that 71 of the Fortune 100 companies could save $422 billion from 2014-2023 by dropping insurance and paying the fine.
In addition, price limits on premiums with increasing mandated benefits will serve to drive the insurance companies out of business.
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If PPACA is not overturned or repealed, President Obama will probably get his wish.
And would Americans get “fair” and “equal” care? On George Orwell’s Animal Farm “all animals are equal, but some are more equal than others.” Under socialism, the ruling elite never seem to have to abide by the rules that they so methodically craft for the rest of us. President Obama knows that his wife and daughters will be immune to the downside of single payer, while the rank and file will suffer greatly. The people will beg for relief from excessive taxation and access to better medical care, but will they be able to find it?
Rather than moving toward single payer, it would be better to eliminate any middleman in most encounters between patient and physician. Allow the patients to pay for routine care and purchase their own health insurance plans with the least government meddling. Big government stifles initiative and punishes achievement.
Our Constitution envisioned citizen legislators who would create laws that are so fair they are happy to live by them. It is what Americans really need. Let’s hope the Supreme Court completely voids PPACA and we can have a system based on liberty, personal initiative, and freedom to access the best care at the lowest cost. Only when the government gets out of medicine will we ever achieve that goal.
