Last week, the GOP, realizing it didn’t have enough votes locked up, chose not to bring its health care bill (The American Health Care Act, or AHCA) up for a vote in the House. Facing monolithic opposition from the Democrats, the bill needed most of the House Republicans to vote for it, and fell short because the conservatives and the Freedom Caucus declared against it.

Democrats and the Left are chortling with glee, snidely observing that President “Art of the Deal” Trump couldn’t close his first big piece of legislation. Conservatives are angry that the GOP attempted to pass what many dub “Obamacare Lite,” in what they consider the breaking of a campaign promise to fully repeal Obamacare. Small government types are happy that the Freedom Caucus stood its ground against a bill that they saw as still much too big-government. Moderates and many Trumpkins are upset that the “traitors” to the party didn’t get behind AHCA and hand Trump a victory.

Trump is spinning this as best he can, suggesting that it’ll be better for him if he simply lets Obamacare complete its implosion while simultaneously warning the GOPers who didn’t back his play that, in essence, he’ll “remember” who they are going forward.

All of this is short-term political posturing, and doesn’t address the issue itself. While the GOP does have other options (it can back Rand Paul’s much better bill), it’s likely (and has been stated) that the party will move on to tax reform before it revisits health care. Meanwhile, people on the Left (at least those who aren’t deluding themselves that it’s wonderful) want Obamacare fixed by moving towards socialized medicine, or “single-payer,” as it has been rebranded.

The default arguments that single-payer advocates put forth are typically of two sorts:

1 – They declare health care a “right,” ignoring the fact that no right can exist that requires forcibly taking from or infringing the right of others. This is their “moral” argument, and a false one. Taking that which belongs to A merely to give it to give to B is not moral, and no amount of sophistry can change that fact. But, those who make this argument dismiss the points about morality, so lets move on.

2 – They argue that every other first-world country provides “free” health care, and that they’re better off for it. This is today’s topic.

First off, lets make something clear. “Free” health care isn’t free. It’s paid for via taxation. Doctors, nurses, technicians, administrators, receptionists, assistants, custodians, clerks, accountants, attorneys, bookkeepers, and all the other people involved in providing health care need to get paid. Hospitals, offices, laboratories, research facilities, and other structures need to be paid for and maintained. X-ray, CT, MRI, and other diagnostic equipment must be purchased and maintained. Medicines must be developed, put through regulatory approval, manufactured and distributed. Research into new drugs, new techniques and the like needs funding. All this requires money, and the money has to come from somewhere.

People, even the advocates for single-payer, know this. What they actually mean when they say “free” is “free to me.” In believing this while pointing at the rest of the First World as proof that “free to me” can happen is the flip side of that “free” health care that the rest of the First World provides: much heavier taxation.

Liberals and redistributionists widely lament that America’s wealthy aren’t taxed heavily enough. They translate that belief into the conclusion that “free” health care can be paid for simply by taxing the rich a bit harder and by eliminating the profits made by private-sector insurers (apparently, everyone gets to make money in health care (see the previous paragraph) EXCEPT the people who put up the risk capital that underlies all of the above). They ignore the reality that all those other nations actually tax the working and middle classes more heavily than America does. In fact, America’s taxes are among the most progressive in the world i.e. America taxes her rich far harder, comparatively, than her working classes.

This is the unpleasant (and thus ignored or dismissed) flip side of the calls for America to emulate the rest of the world and provide single-payer health care. The advocates for single-payer don’t like to acknowledge that those other single-payer systems are funded by taxing the lower economic classes much more heavily than they are taxed in America, and that for a single-payer system to work here, everyone’s going to have to pay a lot more in taxes.

Pie-in-the-sky idealists (i.e. the economically illiterate) and snake oil salesmen (i.e. politicians) like to tell us that single-payer can be paid for merely by a small tax on Wall Street, or by making the rich pay “their fair share” (what, exactly, is “fair” about making those who already pay the most pay even more?), or by the efficiencies that government management will offer (BAAAHAHAHAAAHA!!! Please….), or by repurposing the “obscene” profits the insurers make (3-4%, industry wide…. quite obscene, sure). If that’s the case, why, then, does the rest of the world impose such heavy taxes on the working classes?

As Robert Heinlein observed, there ain’t no such thing as a free lunch. So, with that in mind, I ask you, the advocate for socialized medicine: How much more are YOU willing to pay for “free” health care?

Beyond that, there is the other reality of single-payer in other countries: waiting times. In Canada, wait times for specialist treatment average nearly a third of a year. In England, the numbers are as bad or worse, despite formalized rules that cap waiting times. Many other first-world nations have waiting time problems. Their solution? Legislation. They write laws declaring maximum wait times – as if market forces can simply be legislated away.

This is, to anyone who’s studied economics, an obvious outcome. Any scarce resource will be managed by some mechanism. In a free market, that mechanism is price. But, when something is “free,” other mechanisms must and will arise to match supply and demand. In socialized medicine, waiting time is one of those other mechanisms.

Then there’s the bureaucracy. Without competition, without market forces, without the free interaction of providers and consumers generating the information as to what’s wanted, what works, what can be provided and what it should cost, government pencil pushers have to make all sorts of decisions. And, since there is no “market,” there’s no alternate path should you not agree with or be satisfied with the care you receive. Their decisions apply to everyone.

Higher taxes on everyone, longer waits, one-size-fits-all treatments, denial of some treatments, fewer or no options. All these are the actual costs of a single-payer system. If you support single-payer, are you willing to pay all of these? Or do you think that your free health care can simply be miracled into existence, at no cost to you?

Peter Venetoklis

About Peter Venetoklis

I am twice-retired, a former rocket engineer and a former small business owner. At the very least, it makes for interesting party conversation. I'm also a life-long libertarian, I engage in an expanse of entertainments, and I squabble for sport.

Nowadays, I spend a good bit of my time arguing politics and editing this website.

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