It just takes awhile – Single Payer is Doomed Before It Starts
The Law of Subsidy has killed the NHS. It just doesn’t realize that it is dead.
Ya think? According to the article it’s due to common sense laws of economics.
The first is the Law of Rationing. In short, “Everything is rationed, either by price or by rule.” I can’t afford a private jet. Price rationing limits those to people of substantial wealth, and their high price acts as a signal in the market to balance the supply of private jets with the market of willing buyers.
To prevent everyone from having private jets (Boulderites, this is a metaphor), a number of new rules crop up. Pivoting back to healthcare, for example in England’s NHS…
In England, this process is reaching a tipping point. A couple of years ago people were waiting many hours in the Emergency Department just to be seen by a doctor. So the NHS ruled in 2004 that 95% of all patients would be seen within four hours of arrival. In order to avoid breaking the rule, Emergency Departments refused to allow ambulances to unload their patients until the ED could meet the time standard. So patients were stuck in ambulances outside the ED door, and there weren’t enough ambulances left to answer calls. Now the rule has been scrapped. Predictably, the left-wing members of Parliament are calling for more money. And that brings us to the second law.
The Law of Subsidy says that “When you subsidize something, you get more of it and it gets more expensive.” In England, this happened a bit more slowly than in the U.S. It may be that the older generations of Britons were a bit more “proper” than us Yanks, and so tended to rely less on the dole than current generations. This slowed the growth of the NHS but did not change the ultimate outcome.
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The Law of Subsidy has killed the NHS. It just doesn’t realize that it is dead. But thousands of those it was created to care for are dead, because it simply cannot fulfill its promised goals. And the U.S. is headed down the same path. Fortunately for us, voices are starting to point out real fixes.
…. and the US has a not dissimilar problem with health insurance as author Ted Noel explains.
I have repeatedly pointed out that government is bad for your health. Just as with the NHS, the U.S. population has been sold the lie that insurance is necessary for long life. In fact, all insurance does is increase cost, because it’s a subsidy for those who provide health care. (emphasis added) But there has been a conspiracy of silence over this fact. Further, the treatment of health insurance premiums as a non-taxed “fringe benefit” makes it easier to subsidize further. In short, Congress passes a pretty “benefit” that you actually pay for. And it ultimately ratchets costs higher.
…. and he offers some suggestions
President Trump has done a bit to reverse the trend, but private citizens are doing more. Medishare is a private cost sharing program that provides care at a fraction of insurance rates. Outpatient surgery centers such as the Surgery Center of Oklahoma operate at lower costs because they don’t have to wrestle with insurance companies. And many physicians are now providing concierge Direct Primary Care at drastically reduced costs.
What do these have in common? They are completely outside the government and insurance company umbrellas. (emphasis added) Patients see how much their care actually costs. Providers work to be competitive in order to attract patients. And patient satisfaction is much greater.
In closing, Noel takes a shot at the insurance company/Hospital/Medical group administration cabal…
I spent thirty-two years on the medical staff of a major metropolitan medical center. There was no incentive for the administration to ever negotiate with an individual on price. Instead, it was always a deal between the hospital and the insurance company. My medical group did the same thing. We negotiated prices with Blue Cross, Humana, and other insurance companies. They passed on the costs to patients via premiums, all the while lobbying for more and more mandates on coverage.
Could there be a system more devoted to screwing the public? No one is personally intending to cause harm to anyone else. In fact, my group worked hard to provide high-quality care. But the incentives are there for all to see, if they will look. The Laws of Rationing, Subsidy, and the Bureaucrat are laws of nature. Nothing will ever repeal them. Our only hope is to stop going down the roads to which they lead us.
Seems doubtful. That’s why I use a DPC (Direct Primary Care) and am also enrolled in a HCSM (Health Care Sharing Ministry) plan (not Medishare). My wife and daughter are part of the ACA. My wife may leave as we have a good understanding of her medical situation and would easily save money compared to standard insurance. Our daughter has had serious medical issues although she seems past most everything now. That said, I’m not willing to take the baby steps off the ACA with her. Of course, with her lower income and her no longer being a dependent, if she were to get seriously ill we could get her on Medicaid in a flash. Also, someone in our family finally gets a tax credit/subsidy! We get to work the system. Hooray!
Oh and before the ACA we had a plan with a nationwide network that paid out well over $200,000 in medical expenses for our daughter. Plus the plan had an annual max of well over $20 million and guaranteed issuance of a policy to my daughter when she would have to leave our plan. This was a feature that didn’t seem important at the time but would have become important if the ACA hadn’t intervened.
