The Single Payer reality

Loved this post from Greg Sargent about the stupidity of so many attacks against single payer, “but taxes will go up a bunch!”  I face this with my students every year.  Would you rather have $5000 in additional health expenses and no additional taxes or $4000 in additional taxes and $0 in additional health expenses (and, let’s be clear, the evidence is overwhelming that single payer saves money on total health expenditure).  That $4000 in additional taxes looks pretty good then, huh.  But, of course, the opponents of more sane health care (I’m not particularly wedded to single-payer, but it is far better than our current status quo), just ignore this fact and just say, “but look at all the new taxes!”  Anyway, Sargent:

Democratic politicians are rapidly embracing single payer health care, and as they do, they’re being met with an utterly bogus criticism. Unfortunately, it’s coming not only from Republicans but also from misinformed members of the media.

So before this goes any farther, we need to get a few things straight.

To see how this is happening, take a look at a recent exchange between some CNN personalities and Randy Bryce, the mustachioed ironworker challenging Paul Ryan in Wisconsin, as reported by the Post’s David

Weigel. Bryce favors single payer, and has said he supports a plan that Rep. John Conyers has been offering in Congress for years:

This week, Bryce beamed into CNN to keep up the momentum — and ran straight into a question about whether he, like a growing number of Democrats, supports European-style universal health care.

“You want to raise $32 trillion in taxes?” asked CNN’s John Berman.

“There’s a lot of people not paying their fair share in taxes,” Bryce said. “There’s corporations getting away with a lot.”

“That would be quite a tax hike,” said CNN’s Poppy Harlow. “That’s an astonishing number, $32 trillion over a decade.”

Ugh. We saw a similar discussion in 2016 around Bernie Sanders’ single payer plan, and while I had numerous criticisms of that plan, this is the single dumbest response to single payer that you could possibly come up with. We shouldn’t be surprised to hear it from Republicans — if there’s an enormous number they can toss around while screaming “Democrats are gonna raise your taxes by a zillion percent!” they’ll do it. But no self-respecting journalist should fall into the trap of repeating something so inane.

There is simply no critique you can make of single payer health care that is more wrong than “It’ll be too expensive.” That is 180 degrees backwards. Single payer is many things, but above all it is cheap. And what we have now is the most expensive system in the world, by a mile.

If we were to institute some kind of single payer system, what we’d be doing when it comes to money is changing how we pay for health care. But when you say, “Hoo boy, it would mean trillions in new taxes!”, you’re acting as though we’d be paying all those taxes on top of what we’re already paying. But of course we wouldn’t… [bold is mine, italics is Sargent]

It wouldn’t work out that way precisely, of course. But the point is, if we were to shift to a single payer system we’d be changing how we pay for health care, not just paying more. Right now if you’re like most working-age Americans, you pay thousands of dollars every year to insurance companies. If we switch to a primarily government-funded plan, you’d pay for it with taxes, but you’d be relieved of what you now pay to insurers.

But Republicans would like you to believe that any cost of single payer would be on top of what you already pay, which is completely false. Now here’s the truth: Republicans don’t object to single payer because it’s expensive, because compared to what we have now, it isn’t. Their objection is philosophical: they don’t think it’s government’s role or obligation to provide health insurance.

Great points.  It’s bad enough that we can count on Republicans to lie about this reality, we don’t need the media credulously believing their misleading talking points.


About Steve Greene
Professor of Political Science at NC State

7 Responses to The Single Payer reality

  1. rgbact says:

    My theory is single payer is just a bumper sticker slogan for “I have no idea how to lower health costs and my other ideas have all failed”. 2 words is way easier to memorize.

    • Steve Greene says:

      I have an idea that you know surprisingly little about health care policy for somebody who is always so ready to opine upon it. Allow an economist to explain it to you:

      • rgbact says:

        Yes, that sadly is a common response from left wingers in debates…..but I’ve got over 15 years of health care finance experience that proves otherwise.So theres a reason I don’t like bumper sticker solutions to complex problems…although I admit, chanting “single payer” sounds better at a campaign rally than my ideas.

      • Steve Greene says:

        Hmmm, you’ve been hiding your knowledge well, then. Single payer 1) fits on a bumper sticker *and* 2) is proven in delivering quality health care at much lower cost.

      • rgbact says:

        Well, I’m sorry for the mediocre HC posts then. Although I do admit I get some sick amusement out of people telling me I know nothing about the field I work in.

        As for single payer, I assume the Left is now pushing this because ACA costs way too damn much. Else, not sure what the gain is to most people over ACA. So in that case, lefties should start detailing all the people that will get less as single payer saves all that money. So far, that conversation hasn’t gone well in Vermont, Colorado, or California. Its time to push single payer beyond slogan land and lets see some details.

      • Steve Greene says:

        I will say “health care finance experience” is pretty vague. I’ve got 18 years experience as a college professor, but no meaningful expertise on federal and state policy regulating universities.

    • Dunning Kruger says:

      My mom worked as a dishwasher in a hospital for 35 years. I guess that makes her an expert on health care.

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