Wednesday, August 29, 2007

Single Payer Insanity

The August 26, 2007 Colorado Springs Gazette has taken a strong position against "single-payer" health care:
Single-payer insanity
Using chemotherapy to treat the common cold

We'll have time in the months ahead to more carefully dissect the options and recommendations put forward by the Blue Ribbon Commission for Health Care Reform, in response to the fact that many Coloradans lack health care coverage. But our initial response to one of the proposals, with a price tag of $26.6 billion a year, is that somebody hasn't been taking their meds.

Give these people something to clear their heads, stat! Give it to them whether or not they have health insurance!

And get this. Proponents of this single-payer plan, which would be funded with a new payroll tax, along with higher income, alcohol and tobacco taxes, say it will actually "save" us all $4 billion a year, based on the fact that Coloradans now pay an estimated $30 billion a year on medical care.

Sounds like a bargain. Where do we sign up?

That's sarcasm, in case you didn't catch it. The $26.6 billion guesstimate is $8 billion more than the entire state budget, just to put things in context. And like all such guesstimates, it’s likely to be laughably low when all is said and done.

The relevant number isn't the $30 billion Coloradans spend annually on health care. What matters, for the purpose of this debate, is how much is spent on caring for the indigent, and how much more the taxpayers and the insured spend to cover them. But proponents of a government-centered solution seek to fuzz distinctions by using irrelevant comparisons — and by treating the "uninsured" (whose numbers keep growing, every time we read a news story on the subject) in monolithic terms, in order to generate a sense of crisis.

We'll reserve judgements on the other proposals until we've studied them further. But the single-payer solution amounts to using a howitzer to kill a hummingbird, since just 9 percent of Coloradans are chronically or temporarily uninsured. Another 8 percent counted among the uninsured are 1) illegal immigrants (who qualify for Medicaid in emergencies): 2) individuals who could get coverage through their employers, but don't; 3) people who are eligible for Medicaid but aren't enrolled; 4) people who can probably afford insurance but don't have it.

Once we begin to look at the uninsured more closely, not only does the sense of "crisis" evaporate but one can see that a series of narrowly targeted responses is what’s needed, not a massive overhaul of the system.

At least one commission member also is shaking her head at the notion that we can "save" money with a single-payer system. "They just said we could save money if we go to a singlepayer plan that has a bigger plan of benefits than anything that exists?" asks Linda Gorman, the health care policy analyst at the Independence Institute. "Does that make sense to anybody?"

It apparently makes sense to somebody, or it wouldn't have made the list of options. But this proposal won't be acceptable to most Coloradans. We suspect it was placed on the list as a ploy -- in order to make the other options appear reasonable.

Yes, this plan covers "everyone." But not everyone needs coverage. A minority of Coloradans are contributing to the problem; asking the majority to embrace a socialized health care system in response isn't just unreasonable, it's insane.

If you have a common cold, do you treat it with chemotherapy? Of course not. And if a physician ordered such a treatment, you'd walk out of his office and report him to a medical licensing board. Colorado's uninsured situation is more analogous to a case of sniffles than to terminal cancer, so any treatment we apply should be calibrated accordingly. This proposal constitutes a case of overkill, to say the least.