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November 24th, 2017

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13 Reasons Why ... Single-Payer Would Be a Disaster

Laura Hollis

By Laura Hollis

Published Sept. 14, 2017

13 Reasons Why ... Single-Payer Would Be a Disaster

If the title of this piece sounds familiar, perhaps it's because you've heard something about the adolescent angsty suicide drama, "13 Reasons Why."

Adolescents are notoriously difficult to reason with. They tend to live in the present. They believe pie-in-the-sky promises. They want what they want. When they are warned about the possible consequences of their impending decisions, they frequently disregard the wisdom and experience in any such advice. And when the consequences of their poor decisions come to bear, adolescents feign ignorance: "I didn't think this would happen!" they wail.

Democrats' love affair with single-payer health care is a textbook example of adolescent thinking. So here are 13 reasons why we must be grown-ups about ridiculous proposals like the one being floated by former presidential candidate Bernie Sanders:

1. Single-payer has problems nearly everywhere it has been implemented. Canada ranks dead last in wait times for care, as compared to 10 other wealthy western nations (including the United States). The United Kingdom's National Health Service is contending with long wait times, funding deficits and deteriorating patient care.

2. Countries held up as exemplars of single-payer are a fraction of the size of the United States. Canada has 36 million people. England has 53 million. Australia has 24 million. Finland has 5.5 million — that's half the size of Los Angeles County. The U.S. has more than 326 million people.

3. Single-payer hasn't worked here, either. The news has been filled for years with horror stories about wait times and poor care (or no care) within Veterans' Affairs (despite its $200 billion budget) and the Indian Health Service. If the government cannot provide care for 9 million veterans (those actually enrolled in the VA health care system) or 5.2 million Native Americans, what makes anyone think they can provide it for 330 million Americans?

4. Sanders claims his plan will "save money." Bunk. Politicians' cost projections are always wrong. In 1965, Medicare was projected to cost $9 billion by 1990. The actual cost was $67 billion. Ditto for Medicaid, which was projected in 1967 to cost $12 billion by 1990 and actually cost $98 billion. Current projections put the costs of Sanders' proposal at $32 trillion dollars. If he's wrong (and I guarantee you, he is), then we're bankrupt.

5. You cannot have socialized medicine and open borders. Democrats don't want a border wall or deportations. They want lax border enforcement, "sanctuary cities," chain migration and single-payer health care. In practical terms, this will means tens of millions more people streaming into the country demanding "free" health care. Unsustainable.

6. When the funding deficits hit — as they always do — then the public discovers the first hard truth: Single-payer isn't a health care provision system; it is a health care rationing system.

7. Under rationed health care, innovation dries up and care declines.

8. There are always unanticipated problems, and government is too big to respond nimbly or change quickly, even when the need is great. A system set up by Congress and run by federal agencies will not be able to be changed except by congressional election, subcommittee hearings, changes to federal regulations or litigation in the federal courts. Who among us can accomplish or afford any of that?

9. In other words, it will be everything you hate about big insurance companies, on steroids and without options, because ...

10. Sanders proposes making other private insurance illegal. This is Marxism at its purest, and the mark of a system whose designers know it will fail. (After all, if a product is great, you don't have to force people to buy it, and you don't need to ban the competition.)

11. It will be used as a tool against political opponents. The IRS discriminated against conservative not-for-profit applications. A recent Brookings Institution poll showed that 20 percent of college students think violence is an acceptable reaction to opinions they find offensive. The poll's author warns, "Today's college students are tomorrow's attorneys, teachers, professors, policymakers, legislators, and judges." Do you want people like this deciding when you get the appointment with the specialist, or whether the government will pay for your lifesaving surgery?

12. Politicians are utterly unqualified to control our lives to this extent. Consider the staggeringly stupid things that come out of their mouths daily. Most have never owned a business or made a payroll. And yet we are going to sit back and let these numbskulls tell us what health care we can and cannot have, who can and cannot provide it, what insurance we can and cannot pay for? We are a free people, and this is an abuse of the limited powers of government enshrined in the Constitution.

13. I'm sure I've missed something. Insert your own reason here.

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Laura Hirschfeld Hollis is on the faculty at the University of Notre Dame, where she teaches courses in business law and entrepreneurship. She has received numerous awards for her teaching, research, community service and contributions to entrepreneurship education.

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