A Single-Payer Healthcare System Would Have Made the Pandemic Worse


The intended-to-scare-readers headline said “California hospitals discuss rationing care as virus surges.” And it should frighten anyone who saw it. Though not necessarily for the reason the headline writer had in mind.

The alarmist string of words topped a Dec. 21 Associated Press story, which warned that “overwhelmed hospitals” in California “are setting up makeshift extra beds for coronavirus patients.”

Much as they did in 2018, when the seasonal influenza created “a ‘war zone’ of flu patients” across California, according to the Los Angeles Times.

“Hospitals across the state are sending away ambulances, flying in nurses from out of state and not letting children visit their loved ones for fear they’ll spread the flu,” the Times continued. “Others are canceling surgeries and erecting tents in their parking lots so they can triage the hordes of flu patients.”

Not to minimize the gravity of the coronavirus pandemic, but what should alarm Californians is the certainty that rationing will be normalized should the state adopt a single-payer healthcare system.

Policymakers have been threatening — yes, that’s the appropriate word — for years to force a single-payer healthcare system on the state.

In June 2017, the state Senate passed the Healthy California Act, which, says Pacific Reserach Institute President and CEO Sally Pipes, “would have basically outlawed private insurance and made care free at the point of service” while forcing virtually everyone into a government-administered system. Californians were temporarily spared, though, because Speaker Anthony Rendon refused to bring it to a vote in the Democrat-controlled Assembly, in part because of its enormous cost – $400 billion a year, double the state’s annual budget.

Had it become law, imagine how the elites who ordered us to stay home during the pandemic as they openly violated their own rules would cheat a single-payer system. The masses would be dumped into a centrally administered program, as policymakers, their families and political cronies received special treatment. Few dare call it socialism, but as Harvard economics professor Edward L. Glaeser wrote in the autumn issue of City Journal, collectivism “is a machine for empowering insiders.”

“Few insiders have ever been rewarded more assiduously than the nomenklatura of the Soviet Union,” Glaeser continued. “A vast expansion of the American government, as imagined by today’s Democratic Socialists, would create its own privileged elite.”

While insiders thrive, the rest suffer in a single-payer arrangement. The quality of care declines sharply as costs break us. Even if half the funding were dollars redirected from existing programs, as some have suggested, the remaining balance would require an increase in revenue, likely from a 15% hike in the state payroll tax. So in addition to a future of poorer medical care — declining innovation, physician and nurse shortages, deteriorating facilities, the inevitable political interference — a single-payer system would choke the state economy, as well as the personal and family finances of millions.

Even with its steep cost, access to care is not guaranteed. A system overwhelmed as Californians, and the state’s many “visitors,” demand “free” services rather than self-regulate consumption will have no choice but to ration services.

This is not a gray area. The world’s most famous universal care system, Great Britain’s “sacred” National Health Service, which covers 90% of the population, is in a chronic access crisis. Not quite two years ago, before the pandemic arrived, the Royal College of Surgeons reported that British hospitals were struggling “to reduce long waiting lists,” as more than 220,000 patients were “waiting more than six months for treatment.” The care for nearly 37,000 was held up more than nine months.

Patients in Canada, where the government operates a true single-payer system, also suffer from extended delays. The Fraser Institute reports the median waiting time in 2020, from seeing a primary care doctor to receiving treatment from a specialist, was the longest since it began measuring them – 22.6 weeks, more than double the 9.3 weeks of 1993.

While public health officials continue to fail Californians during the pandemic, a panel commissioned by single-payer advocate Gov. Gavin Newsom is drawing up a plan to provide “coverage and access through” unified financing. It apparently isn’t “what single-payer advocates would want it to be” as much as “it is a forum to bring over the skeptical middle, to bring over some key players” whose support is needed to install a government-run system.

Either way, its recommendations won’t generate terrifying headlines in the legacy media, though they should. The more government is involved in healthcare, the more government rations services.

Kerry Jackson is a fellow with the Center for California Reform at the Pacific Research Institute in San Francisco.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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