Single payer: No choice, no competition, no freedom

Tuesday, January 9, 2018
Chris Woodward (

waiting roomSenator Bernie Sanders (I-Vermont) and Democrats continue to push universal healthcare, but critics say it's a prescription for bad medicine.

"'Single payer' is basically a government monopoly, so if you're opposed to ObamaCare because it's government control over the healthcare markets or the health insurance markets in particular, and you don't think that's working out very well, you certainly do not want a single-payer system," says Robert Moffit, Ph.D. of The Heritage Foundation. "It's basically giving the government a monopoly over the delivery of healthcare – and that is a real problem because basically it is no choice, no competition, and ... really no freedom."

To date, there are several plans from liberal lawmakers when it comes to universal or single-payer healthcare. Perhaps the best-known plan is the "Medicare for All Plan" from Senator Sanders. He believes healthcare is a right and everyone should be on equal footing, regardless of income.


"First of all, it's not exactly Medicare," counters Moffit. "If you actually read the bill, it makes some rather radical changes in Medicare."

How so?

"It creates a standardized benefits package, and it says in effect that you will take the standardized benefits package, but if you want something else you really can't have it," he says. "It forbids people to have private insurance for standard medical coverage." (More details)

Meanwhile, Senator Tim Kaine (D-Virginia) is offering Medicare-X. It's described as a public insurance plan to be initially deployed in communities that lack private insurer competition. Moffit sees this as a money pit for taxpayers.

"The purpose of this is not to enhance competition, it's to destroy competition," he adds. "They artificially price the government plan below that of the private plans, or pay rates at an artificially low level, and again the taxpayer ends up paying the cost."

Sen. Brian Schatz (D-Hawaii) and Rep. Ben Ray Lujan (D-New Mexico) have also introduced legislation that would allow states to open their Medicaid programs up to people willing to pay premiums. At the same time, Yale University political scientist Jacob Hacker is working with Democrats in Congress on a new public health insurance plan. Based on Medicare, the plan aims to benefit certain people who don't have access to job-based coverage. According to The Associated Press, Hacker's plan would be financed partly with taxes on companies that don't provide insurance. Consumers would pay income-based premiums, and hospitals and doctors would be reimbursed based on Medicare rates.

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