Would we be better off without UPS and FedEx? What problem would we solve if we eliminated all other carriers except the US Postal Service for delivering packages and letters? Such a thing would create rather than solve problems. In fact government has always opposed monopolies, except for those of its own making. Yet there is this incessant chatter about how we should adopt a single payer plan for US health care, as if it would solve some problem. Consider this from John H. Cochrane:
The U.S. health-care market is dysfunctional. Obscure prices and $500 Band-Aids are legendary. The reason is simple: Health care and health insurance are strongly protected from competition. There are explicit barriers to entry, for example the laws in many states that require a "certificate of need" before one can build a new hospital. Regulatory compliance costs, approvals, nonprofit status, restrictions on foreign doctors and nurses, limits on medical residencies, and many more barriers keep prices up and competitors out. Hospitals whose main clients are uncompetitive insurers and the government cannot innovate and provide efficient cash service.
I always used to think that regulation of medicine and medical services was foremost for the benefit of providers, particularly the doctors. Years ago the American Medical Association explained how it imposed limits on the number of medical school slots through its acreditation authority and why they did it. It was to ensure the highest quality education for physicians, but it was also intended to keep physician compensation high.
A single payer system won't alleviate our shortage of doctors, and instead adds even more restrictions on medical care to the ones mentioned above by Mr. Cochrane. But the limitations imposed by a single payer plan won't have the effect of pushing up doctors' incomes. This is pretty obvious when you look at the way doctors are reimbursed for Medicare and Medicaid services. They're getting stiffed. That's why more and more are refusing to take on new Medicare and Medicaid patients, and why there is "Doc Fix" just about every time congress passes a budget.
Think of the Affordable Care Act as the first step towards a single payer plan, which itself is a hostile takeover of an industry by the party of government. Its purpose and the purpose of a single payer plan is to siphon off some of the billions spent on medical care and divert it into political party coffers and wallets. Democrats are the party of government, and they want their piece of the action.
Comments