“If you think health care is expensive now, wait until it’s free!” This line from political writer P.J. O’Rourke is timely advice for Colorado voters, who will have the chance to adopt a “free” government-run, single-payer healthcare system in 2016.
But it’s not just the economic expense of so-called “universal health care” that should concern Coloradans; it’s the limitation on choice and impact on quality of care — especially for those people who need it most. In other words, government-run health care isn’t just costly; it’s not compassionate.
First, voters need to know that this proposal would result in significant costs in dollars for taxpayers. In fact, the state of Vermont just abandoned a similar system, citing economic costs as the main reason. It would be foolish to repeat Vermont’s mistake.
According to the state government, a single-payer healthcare system would cost about $25 billion annually, effectively doubling the state budget, and increasing payroll taxes by 10 percent.
And remember, this is only the cost estimate. Government estimates for healthcare programs, like Medicare, have a record of woefully underestimating costs, mainly because people consume more care when the costs are paid together. (The same concept applies to a group splitting the check for lunch at a restaurant.)
But this proposal won’t just cost dollars: A single-payer health system will cost patients in terms of choice and the quality of health care available to them.
In economics, a system with just one seller is called a “monopoly.” Similarly, one buyer (or one payer) is called a “monopsony.” Americans understand that, because of a lack of competition, monopolies can abuse consumers by charging too-high prices. Conversely, a monopsony can also cause problems, by underpaying for goods or services, causing the quality of those goods or services to deteriorate. The entity that pays is in control.
Coloradans might rightly be frustrated now that big insurance companies have outsized control over healthcare decisions, such as which doctors and hospitals are “in-network” for patients, or what treatments and drugs are covered.
These insurance companies are backed up by crony policies, like ObamaCare, which limit competition and meaningful choice in health insurance by mandating that all plans become standardized in offerings and in pricing.
Yet it would be a mistake to go further down this road of government-controlled health care. Single-payer would only lead to more standardization and the further destruction of competitive forces, leaving consumers with even less power or ability to encourage providers to offer better quality or value.
Changing Colorado from an ObamaCare state to a single-payer state would be the equivalent of moving to Boston, and then from Boston to Eureka, Canada, because the Boston winter was too harsh. It’s a move in the wrong direction.
President Reagan once said, “It’s very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it.” It’s true. Politically, it’s easy to argue for ColoradoCare on the (false) premise that it will help the poor.
But there’s nothing humanitarian about single-payer healthcare systems. In fact, the poorest and most vulnerable people in a society suffer most from underperforming public systems. If the upper-income people of Colorado do not like ColoradoCare, they will find other options. For example, they might contract directly with physicians or healthcare facilities for “concierge care” or other direct-pay options.
But low- and middle-income Coloradans and their families will have no such escape if ColoradoCare follows the trend in other international single-payer programs and begins rationing the healthcare services available to the public. Voters do our impoverished neighbors no favors by supporting the creation of ColoradoCare.
If Coloradans want a better, more efficient, responsive, accessible and compassionate healthcare system, they should say no to ColoradoCare and yes to market-friendly, patient-centered reforms that go in the opposite direction entirely.
Hadley Heath Manning is director of health policy at the Independent Women's Forum. She lives in Denver.