Re­ject myths and lies fa­vor­ing govern­ment con­trol of health

Orlando Sentinel - - OPINION - By Sal Nuzzo | Guest columnist

The sin­gle-payer path in­evitably leads to ra­tioning.

A few weeks ago, so­cial­ist Sen. Bernie San­ders in­tro­duced leg­is­la­tion that would, over five years, out­law pri­vate in­sur­ance and es­tab­lish a sin­gle-payer U.S. health-care sys­tem. He did so at a press con­fer­ence that in­cluded 15 co-spon­sors, in­clud­ing sev­eral pos­si­ble 2020 pres­i­den­tial as­pi­rants.

And while not sur­pris­ing to see the pitch in light of his pro­nounce­ments on the cam­paign trail, it is no less ironic given the fol­low­ing quote from an old in­ter­view by none other than San­ders: “[I]f you were to ex­pand Med­i­caid to ev­ery­one, if you were to give ev­ery­one a Med­i­caid card, we would be spend­ing such an as­tro­nom­i­cal sum of money that we would bank­rupt the na­tion.”

That was a younger Bernie San­ders. One might say a more log­i­cal Bernie San­ders. It’s dif­fi­cult on most good days to cut through all the ob­fus­ca­tion mas­querad­ing as pol­icy. With that in mind, let’s dis­pel with some of the most heav­ily traf­ficked myths, mis­lead­ing con­clu­sions and out­right lies be­ing per­pe­trated in pro­mo­tion of to­tal govern­ment con­trol of our en­tire health-care sys­tem.

Myth 1: Health care is a right that govern­ment must up­hold. Pro­vid­ing health care is a process in­volv­ing per­son­nel and fa­cil­i­ties (schools, doc­tors, nurses, hospi­tals, equip­ment). By this very fact, health care is the an­tithe­sis of a right. Blindly ad­her­ing to this talk­ing point makes “to­tal cov­er­age” the bench­mark of suc­cess. When the govern­ment is the provider, it has the power to with­hold. That is the ugly re­al­ity. Are you ready to have your child’s lung trans­plant de­nied by a govern­ment bu­reau­crat be­cause of a di­ver­sity goal? That’s the path we’re on.

Myth 2: Ev­ery other in­dus­tri­al­ized na­tion en­sures health care for its ci­ti­zens. Pro­vid­ing a govern­ment bu­reau­cracy by no means en­sures re­ceiv­ing health care. The United King­dom pos­sesses a sin­gle-payer sys­tem. The head­line of an ar­ti­cle in the Aug. 11 is­sue of the Lon­don Times tells all we need to know about how that sys­tem func­tions: “Four Mil­lion Wait for Surgery as NHS Warns of Win­ter Cri­sis.” The sin­gle-payer path in­evitably leads to ra­tioning — just ask the 9 mil­lion U.S. vet­er­ans strug­gling with the VA sys­tem their opin­ion of so­cial­ized health care. Are we re­ally ready to ac­cept the con­se­quences of that sys­tem for 325 mil­lion pa­tients?

Myth 3: The free mar­ket doesn’t work in health care. This is a com­plete false­hood. There ex­ist pock­ets of more mar­ket-based health care — cos­metic and den­tal care, for ex­am­ple. Both have far more mar­ket-based pric­ing and pay­ment sys­tems than tra­di­tional lines of ser­vice, and both have been suc­cess­ful in their ap­proaches.

Myth 4: We can pay for it. San­ders didn’t of­fer a fund­ing mech­a­nism for his pro­posal, and with good rea­son. As he clearly stated 30 years ago, it would bank­rupt the na­tion. Cal­i­for­nia re­cently priced a statewide sin­gle-payer sys­tem – and the tab came in at $400 bil­lion per year. To put that in con­text, the en­tire 2016 bud­get for the state of Cal­i­for­nia was $266 bil­lion. That’s right, sin­gle payer would come close to dou­bling the en­tire state bud­get — and there­fore the bur­den on tax­pay­ers.

Myth 5: We can trust the govern­ment with our health care. Re­ally? Please re­call the hor­ror and dis­gust we right­fully felt at the treat­ment our vet­er­ans were re­ceiv­ing from the VA in 2014, when our bravest were be­ing left to die not at the hands of the en­emy, but at the hands of a govern­ment health-care bu­reau­cracy.

The United States pos­sesses the hu­man cap­i­tal — in ex­per­tise, in­no­va­tion and in­vest­ment — to move in a mar­ket-ori­ented di­rec­tion that can of­fer ex­cep­tional health care to our ci­ti­zens. That path re­quires dif­fi­cult dis­cus­sions about the role of reg­u­la­tions, tax treat­ment, and crony­ism in our health-care sys­tem. Re­gard­less of one’s po­lit­i­cal per­sua­sion, we should all come to­gether to force­fully re­ject the no­tion that Wash­ing­ton, D.C., is the best place to en­trust some­thing as im­por­tant as our health-care de­ci­sions.

Sal Nuzzo serves as The James Madi­son In­sti­tute’s vice pres­i­dent of pol­icy.

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