As Americans turn their eyes to Uncle Sam for guidance about the COVID-19 pandemic, it’s a certainty that Leftists will be mindful of Rahm Emanuel’s mantra “never let a crisis go to waste.” Every misstep and deficiency will be touted as an example of why there should be a single, government-run healthcare system in our country.
Fortunately, we have a counterexample: China.
I was witnessing the kind of maximum, almost brutal efficiency a society must develop when the state is the master and the individual is merely a subject. Why would a Communist country not have an effective FDA? Because who are you going to complain to if you get tainted food? The government? They don’t answer to you. The press? They are owned by the government. And again, they don’t answer to you.
So what if you don’t like the conditions in the hospital? Where else are you going to go? This hospital is the last (and only) stop. You can’t opt for another place and then just pay out of your own pocket. The government has capped financial upward mobility. There is now “income equality.” And that means nobody has the means to buy their way into a different (or better) situation. And even if you could, one doesn’t exist. The state provides it all. You’re stuck.
Single payer also means single buyer. That means the dynamics of the market get eliminated. One of the natural checks-and-balances of finding a hot-shot surgeon willing to do the risky procedure or even just seek a second opinion, get chopped away little by little. Because now we’re answering to the government. It isn’t answering to us. After all, where are we gonna go? They’ve got us. And our cancer treatment or skin graft surgery or kidney stone blast is up to their red tape. Sure, we can get in the door for free. But we might die in there, waiting on someone with no incentive and who faces no recourse, to change our plasma bag.
That’s a good summary of two basic problems with government-run anything: a lack of competitive incentives to improve and reduce costs, and no recourse when the product/service isn’t what is needed. Left unmentioned in the linked article is an additional problem: when government is a provider, it also decides who gets the provisions. They can decide you don’t merit the product/service because you’re too old, or a troublesome dissident, or a newborn who would be ‘too expensive’ to save.
There are legitimate criticisms of how healthcare is provided today in the United States. Costs consistently rise faster than general inflation, making much of it unaffordable for those without access to group insurance plans or government programs. It can be argued, though, that this is the case precisely because the government is already heavily involved. The idea of free markets is that the cost of goods and services will reach an equilibrium based on what the market (consumers) will bear. But the presence of a purchaser/guarantor (Uncle Sam) who believes he can throw as much money as he wants at a problem, eliminates any market incentives to become more innovative and efficient. In fact, Sam’s presence as a customer is usually accompanied by extra overhead and red tape that make the product/service less efficient. This same dynamic is at work in higher education, where the rising costs of tuition parallel the rise of government aid and the availability of student loans. If County General Hospital and the University of Hereville could only charge what the average American family could afford, their operations would, of necessity, become leaner and more efficient (sorry, diversity bureaucrats!).
This is not to say government doesn’t have a role. But instead of being a consumer, it’s supposed to be a referee — the one to whom people have recourse when an industry is being abusive or careless. The recent requirement for hospitals to post prices for most common procedures is a tiny step in the right direction. The requirement needs to be clarified that hospitals provide the lay reader with context by linking associated costs and giving a reasonable range of the average total price for a given procedure. Such information is necessary for customers to know their options and take advantage of competition (which currently is next to nonexistent).
The same is true for pharmaceuticals. Patients in the U.S. can pay anywhere from two to six times more than in other countries for the same brand-name prescription drugs. In this paragraph’s linked article, the argument is made that’s because buying is more fragmented than in a country like the United Kingdom, whose National Health Service is a large, single buyer with associated market clout. CNN is, of course, in favor of nationalizing U.S. health care, so it makes sense that would be their take on it. But as they admit in their own article, Medicare is legally forbidden from negotiating drug prices (wonder who lobbied for that rule). It isn’t that the market is ‘fragmented,’ it’s that there are only a few big players, including Uncle Sam. When a prescription drug becomes available in an over-the-counter strength, pricing shifts to a broader market: the individual consumer, who will compare prices and look to save money. There’s no reason this wouldn’t work in the prescription category:
[Dr. Peter] Bach, of Memorial Sloan Kettering, said that when buyers can say no, for whatever reason, they can control prices better. In fact, Bach’s hospital refused the colon cancer drug Zaltrap in 2012 because it cost double that of a reasonably good alternative, Avastin. The company that manufactures Zaltrap, Sanofi, worried that other cancer hospitals and doctors would follow suit, so it halved the price of the drug.
And they would do the same if it was millions of Americans individually making the same cost comparisons in their purchase decisions. Granted, for some medications there are no approved substitutes, so such competition wouldn’t apply. But those situations occur in part because drug manufacturers can patent their new products for as much as 20 years. I sympathize with the argument that development can be expensive and it’s right to expect a return on investment. But given how many drug-related trinkets I see in doctor’s offices and patient discharge bags, I’m not sure it takes two decades to recoup costs on an effective new medication. I’m wary of any scheme wherein government determines prices, so the preferred solution would be to reexamine what a reasonable patent period should be before generic equivalents are allowed on the market. After that point, let market forces work.
As repeated examples have shown in history, the equality Marxism achieves is an equality of misery for the masses, with exceptions and privileges for those running the Leviathan of government. That’s not the right prescription for whatever ails us.