Don Wooten and I have at least one thing in common: We both like ancient Greek tragedy.
Every time I hear Sen. Bernie Sanders glibly proclaim that if we only trash the present American health-care system, and adopt a single-payer system, the American health-care system will be vastly improved, my thoughts recur to Euripides, The Bacchae: "A man whose glibness flows from his own conceit, is a worthless and stupid citizen."
On June 18, our Rock Island County Board voted to put Hope Creek Care Center up for sale. The county care facility is $7.5 million in debt. Running the facility at a profit has never been the goal. Sadly, the county has been unable to break even. (If the county imposed a one-time $53 tax on every resident of the county, that would cure the $7.5 million deficit, and give Hope Creek a fresh start.)
So why is there any reason to believe that the U.S. government can run a nationwide health-care system, caring for 330 million people from Maine to Hawaii and from Florida to Alaska from headquarters in Washington D.C., when Rock Island County can't manage its small care facility in East Moline? Have we forgotten the problems of the VA?
If Hope Creek is sold, about 220 employees could lose their jobs and some employment benefits. At present, it is estimated that there are 500,000 workers employed by the health insurance companies, such as Aetna and Blue Cross.
Issue No. 1: What happens to those 500,000 health-care employees if the U.S. adopts a single-payer system? Is there even one single-payer advocate addressing this issue?
If we go to single-payer, do the 500,000 lose their jobs? Benefits? If they are transferred to the federal payroll, will the cost to the taxpayers be less than the cost to their former private employers? If so, how does that save any money? Will those who aren't transferred be replaced by new federal workers? If those who aren't transferred are re-trained for new jobs in other industries, what will that cost?
Will the cost of new federal employees, plus the cost of employees transferred from the private sector, plus the cost of re-training those not transferred, exceed what the private sector was paying its 500,000 employees?
And what about workers in related industries? Under single-payer, will the number of employees in hospitals, care centers, and doctors' offices remain the same? And if the numbers decrease, what happens to those workers? Do they go on unemployment or into job re-training?
Issue No. 2: Are American's better off destroying the present systems of coverage and going to single-payer? Total U.S. population (2016): 325,000,000. Covered by Medicare: 53,000,000. Employer plans: 155,000,000. Non-employer private plans: 90,000,000. Veteran's Administration: 15,000,000 Uninsured: 27,000,000.
In 2016, 91.2% of Americans had health insurance coverage and 8.8% didn't. That 8.8% will certainly be better off if we go to a single-payer system, but what percentage of Americans will receive less desirable coverage or substantially inferior coverage?
Would we be better off bringing the 8.8% into the present system? How many of the 8.8% already are on Medicaid?
Issue No. 3: Canada has a single-payer system. The Fraser Institute evaluates the Canadian experience from year to year. Have things gotten better or worse in Canada over the years? They advise that a key indicator is wait time: the time between referral by a general practitioner to a specialist and receipt of treatment. Fraser's answer: substantially worse.
The average Canadian wait time in 2018 was 19.8 weeks; up from 9.3 weeks in 1993. The wait consists of two components: an average 8.7 weeks wait to see the specialist; and an additional 11 weeks to obtain the treatment. In 2018, Canadians could expect to wait an average of 4.3 weeks for a CT scan, 10.6 weeks for an MRI, and 3.9 weeks for an ultrasound.
When the patient is suffering pain, a wait time is not his friend. Wait times can result in poorer medical outcomes. They can transform potentially reversible illnesses/ injuries into chronic, or irreversible conditions, or even permanent disabilities.
When I hurt my knee golfing, it didn't take me 19.8 weeks with my present insurance to see a specialist and get my MRI. What have your wait times been with your private plan or Medicare? Should 91.2% of Americans plunge into the unknown to provide insurance for 8.8%? Or is there a better alternative?
Simply put: Are you willing to buy the Sander's snake-oil elixir?