The Fallacy of Single-Payer Health Care
Chris Pope joins John Stossel to talk about the debate over single-payer health care—a system in which the federal government would assume all health-care costs currently borne by private insurers, employers, and individuals.
Momentum for single-payer is growing among Democratic politicians. Senator Bernie Sanders’s “Medicare for All” proposal would impose $32 trillion in new costs over ten years and a likely annual tax increase of $26,000 per American household. It’s hard to imagine that Congress would adopt massive federal tax increases and rationing of health-care services, but incremental proposals, such as Medicaid buy-in and strict price controls, could be on the horizon if Democrats capture the White House in 2020 and do well in the congressional elections.
Advocates for single-payer health care point to European countries with generous social-welfare systems as evidence of its success. They don’t acknowledge the fact that Germany and France, like the United States, have private and employer-funded health insurance, in addition to government programs for the poor. In the meantime, U.S. lawmakers continue to ignore reforms—like eliminating barriers to hospital competition—that would probably be more effective in improving America’s health-care system.
John Stossel discusses this issue further in an op-ed for Town Hall.
This video is part of a special collaboration with John Stossel and City Journal contributors.
John Stossel: In America today we're told people have a right to health care.
Senator Kirsten Gillibrand (D-NY): Health care should be a right.
Senator Cory Booker (D-NJ): Your right to all
Senator Kamala Harris (D-CA): It's pretty basic, it's just the right thing to do.
John Stossel: Health care should be a right.
Chris Pope: The real question is who pays for it? And that's really not a rights question
John Stossel: Chris Pope of the Manhattan Institute City Journal studies health care around the world. Some countries have single-payer systems meaning government pays for everything. That's what progressives want for America.
Senator Elizabeth Warren (D-MA): Never again in America does anyone go bankrupt just because they got sick. Never.
Chris Pope: What single-payer would do is it would make the government responsible for everybody. Instead of the government being able to focus its resources on the gaps in coverage on the people who can't provide for themselves the government would actually end up spending most of the money on people who are perfectly able to purchase their own insurance.
John Stossel: In England, France, Germany, they have single-payer and they're happy.
Chris Pope: Well that's really not the case in Germany employers provide most of the health care and fund most of the health care, just as they do in the United States.
John Stossel: In France too.
Chris Pope: There are private insurance companies employers fund health care, people pay out of pocket the same way that they do in the United States.
John Stossel: So who does have single-payer?
Chris Pope: Canada, Norway, England.
John Stossel: They have good outcomes in Norway, England, and Canada.
Chris Pope: In England there is rarely a week that goes by without a crisis or another in the health care system being part of the news. This year there was a crisis in emergency room care people left in the hallways for hours and hours.
British TV: Admitted in terrible pain having broken her back, she spent six days and six nights on a bed in a corridor.
Chris Pope: Doctors on strike, nurses on strike.
John Stossel: In Canada too.
Canadian TV: The average length of stay in an emergency room is four hours. One in ten people have to wait more than eight hours.
Chris Pope: What happens when you start thinking of a single-payer system is you start allocating healthcare resources like a politician you start thinking, well what's serious enough to care about and what's kind of not such a big deal.
John Stossel: With public money, you should.
Chris Pope: But it turns out that the government will try and deny care or impose really long waiting lists in the hope that people won't seek treatment. Do they need knee replacement? From a politician's point of view it's not going to kill them and you could save a lot of money by not providing it to them.
John Stossel: In Britain, people buy private insurance to cover that.
Chris Pope: About 15% of the population purchases private insurance.
John Stossel: But private insurance is what single-payer advocates want to get rid of.
Senator Bernie Sanders (I-VT): The private insurance companies don't like this idea. We're going to put them out of business.
John Stossel: Put 'em out of business.
Chris Pope: Well it makes you wonder whether this is more about spite than it is about improving people's health.
Senator Sanders: The drug companies that are ripping off the American people and charging us the highest prices in the world don't like the idea, tough luck.
Chris Pope: The cost of drugs is really quite cheap compared to even a night in a hospital.
John Stossel: In England people don't get billed for such expensive drugs but often that also means…
Chris Pope: whenever a new drug comes on the market that can save lives, the government just doesn't have the funds to pay for it.
John Stossel: The sick person may never know about the better treatment.
Chris Pope: Services that you would have access to in the United States you're just entirely unaware of them.
John Stossel: But what about poor people who can't afford these services?
Chris Pope: The United States certainly does more than other countries.
John Stossel: I hear we do less.
Chris Pope: Over a trillion dollars a year in public spending really, to provide health care to people who don't afford it.
John Stossel: American emergency rooms treat anyone who comes in, and Medicaid pays for health care for poor people. In addition…
Chris Pope: we have the Medicare program which provides care to another 50 million.
John Stossel: So just leave it the way it is?
Chris Pope: There's certainly a couple of areas that we can really improve things on. More competition between hospitals.
John Stossel: We have competition between hospitals.
Chris Pope: We don't really. It's very hard to set up a new hospital.
John Stossel: Many states forbid it unless a board of so-called experts determines that there's a need.
Chris Pope: The people who will be on these boards will be the hospital's that are already in the state, and so the hospital industry is a bit of a cartel.
John Stossel: His main suggestion? Allow more people to choose their own healthcare plans.
Chris Pope: We currently have a system based on employers picking which healthcare plan is good for employees. If we move towards a healthcare system where individuals were more responsible for shopping around, people would choose a better system.
John Stossel: Consumers hear that and say, I can't keep up with this stuff. I'm not smart enough to make the decisions about where I should spend the money. I want experts to do this for me.
Chris Pope: Everyone knows what a good hospital is in the area. If you're an individual shopping for health care, you're looking after your own interests.
John Stossel: Under our current system, government and insurance companies spend seven out of eight healthcare dollars for us.
Chris Pope: The question is do we improve on the health care system by empowering consumers, or do we basically just say this is the government plan, deal with it.
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