Single Payer Healthcare - Nice Christmas present, but Senator Warren’s proposal is absolutely NOT doable, until….
Senator Warren unveiled her “Healthcare For All” proposal to Americans this week (https://www.msn.com/en-us/news/politics/elizabeth-warren-proposes-new-taxes-to-fund-medicare-for-all-but-says-middle-class-would-be-spared/ar-AAJGwIW?ocid=spartanntp). But, it should not be embraced as doable until the Federal government proves they can handle all the other programs that are currently mismanaged.
Senator Warren’s head and heart are totally in the right place. A world where America can have Healthcare as a human right and accessible to all is something we all dream of and want. And, solutions to get there certainly need attention and Senator Warren and Senator Sanders, and many others, have wrestled with getting their heads into the matter for years. Senator Warren, Bernie Sanders, and others, have come up with a proposed plan that costs trillions of dollars more than America is already paying despite the fact that other developed countries already pay less than America and have longer life expectancy. Hello, am I the only one that sees a problem here?
But more fundamental to the criticisms of their proposals is the fact that the Federal government cannot run the much MUCH smaller programs that it already has. How can we put such a huge part of our national income, and you and your family’s health, entirely into the hands of the federal government, the so called “Single Payer System”, and expect them to run such a massive undertaking when they can’t even manage much smaller enterprises?
A centralized “Single Payer” system (ie: government controlled healthcare) would be administrated like the day your young daughter is ready to take off her training wheels and ride a two-wheeler (I know, we are all smiling about visions of that happy day – right!). But you are there with her knowing she will inevitably fall, so you will make sure she’s by the grass so that if you fail to catch her, the grass will soften her fall. But instead of taking the training wheels off and letting her ride the two-wheeler, ready to be caught by you, or the grass, you are going to throw her on top of a Harley Davidson (Motorcycle – yeah, I know…) and let her have at it.
What?!?!?
An extreme analogy, I know. But you get where I am going… Folks, the Federal Government cannot run AMTRAK profitably, and never has. Since its inception in the 1970’s, it loses money EVERY year (Fact)! In 2018, AMTRAK lost approximately $200,000,000.00, and we have the crappiest commuter rail system network of any developed country (https://www.cato.org/blog/will-congress-let-amtrak-stem-losses, https://www.businessinsider.com/amtrak-why-so-expensive-america-train-system-2019-3). Also, the Federal Government cannot run the postal service profitably, or even at break-even, it loses billions of dollars every year (Fact)! In 2018, the United State Postal Service lost almost $4,000,000,000.00 (https://www.govexec.com/management/2018/11/postal-service-loses-39-billion-fiscal-2018/152826/). You get it, right? And, I don’t even have to crack the door on the annual trillion dollar deficits our nation presently runs, the massive national debt load we carry without a coherent plan to work it down (I know, I know… nations are not people – they don’t retire, and they never die, so you can accumulate debt to infinity – especially when you’re the globe’s reserve currency and you can print as much as you want – right? WRONG!), shortfalls in Social Security and Medicare funding to cover medical care, or even the highly efficient and effective Veteran’s Administration Hospital system (NOT!) that’s sadly all too often embroiled in controversy for lack of medical services or response time to veterans.
But, I have faith and hope in the idea that healthcare for all American’s is possible. And, I think the money is there already. And, even if we can’t agree that the money is already there, and Senator’s Warren and Sanders are right on their cost projections to support all Americans with their healthcare needs, as a minimum we should look to other mechanisms to administrate the “Healthcare For All” program – and not federal government centralization.
Federal centralization of the healthcare into a “Single Payer” system will be a huge undertaking that will be very difficult to turn back from once the monstrous bureaucracies that are created to manage it are put in place. Folks, the ultimate goal of healthcare for all Americans is noble, and, I believe, doable, and we must INSIST on it! But a single payer federal government run bureaucracy that manages it for you is NOT the best way forward when the track record for government run enterprises does not offer any sense of responsible management. UNTIL the government has a track record of managing what they already have - all track records of failure incidentally under Senator’s Warren and Sander’s watch - taking the training wheels off and handing the management of your health care needs to government workers and politicians is probably, well, not healthy.
On the basis of this alone, Senator’s Warren and Sanders, are not healthy for America, and should not be supported for President.
That all said, and recognizing you are saying to yourself “okay, smart guy, then what should we do?” Fair question. I admit, I am still listening to the proposals and I don’t have a complete answer on the best solution to get to the ultimate desired end state – healthcare for all Americans. But I think it is doable. I think the money is already there. And, if it is not there, we will have to – yes – tax the shortfall in funding it. I also do not think the American middle class can absorb more taxation – I know I can’t. So, if the Federal Government is not going to centralize your healthcare, with all the mismanagement and increased massive bureaucratic costs associated - I think building on exiting Medicaid programs and empowering the States, Counties, and Communities to have skin in the game to shoulder the burden is in the right direction ( I know – whatever “skin-in-the-game” means). And, I think legislation that incentivizes private innovation that reduces costs and increases patient quality of care and outcomes is necessary – including caps on administrative costs, executive pay, and corporate profit that also takes into account overall performance – ie: reward patient quality of care and outcomes, penalize and weed out under-performers. I lean a bit towards the notion that healthcare, like the military, should be administered a little differently than normal private enterprise (please don’t say I have socialist tendencies, because I don’t). I know, a mouthful. And I know, the challenges with putting in place such mechanisms is complex for many reasons. But favoring getting States, Counties, and Communities skin in the game, vs removing them from the problem, leaving them only to criticize and complain about the central government’s faults in managing the monster, is in the direction of right and better.
Finding our way to healthcare for all Americans is the end state, and we need to make it happen – period! I don’t want to be the person who says when your loved one is sick, “sorry, I must leave you behind.” We need to stop dillydallying and make this happen – now!