September 18, 2017
This week, 2016 presidential candidate Sen. Bernie Sanders (I-VT) proposed a bill for a single-payer health care system in the United States. Distressingly, a large fraction of potential Democratic presidential candidates — from Sen. Cory Booker (D-NJ) to Sen. Kamala Harris (D-CA) — announced their support for this bill, making its inclusion in the party’s 2020 platform likely. The bill they support is not a piece of serious policy but a cynical political device, and it would be a catastrophe if the country were ever foolish enough to implement it.
Though it is possible to design a semi-functional single-payer system, Sanders’ bill is deeply flawed and would collapse quickly upon implementation. There is not infinite health care to go around, so if prices are taken out of the system, the government must implement a system of rationing. For example, the British National Health System is planning to take the somewhat-Darwinistic step of restricting obese people’s access to “nonessential” surgeries to close a budget shortfall. The U.S.’ current system does that now, as Medicare and especially Medicaid have been shown to provide significantly inferior health care than private insurers.
Furthermore, the bill would probably skyrocket the U.S.’ medical costs due to the broken incentives it provides in an attempt to be populist. Sanders’ bill would completely eliminate co-pays and deductibles, which would make all health care truly free from an individual perspective. If health care is completely free, people have every incentive to use it as much as they can, which would cause a massive shortage of personnel.
However, criticizing Sanders’ bill on policy grounds almost misses the point, as it is simply not meant to be a serious policy proposal. This is because the bill does not specify any way to pay for his single-payer system. According to the center-left Urban Institute, Sanders’ plan would cost approximately an additional $32 trillion over roughly a decade. While Sanders promised a few options to pay for it in a coming paper, they are not included in the current bill. His system would likely spike the deficit and lead to a painful collapse.
This bill is an over-simplified policy that allows an opposition party to signal ideals to their extremists that a governing party would never actually consider. In other words, Democrats are proposing the exact equivalent of the 50-something bills to repeal Obamacare proposed by Republicans during the Obama presidency.
When the 2020 Democratic candidate must justify supporting a bill that would make current health care plans illegal, they will have a lot of explaining to do to the 65 percent of Americans that are satisfied with their current plan, according to a 2016 poll. There is a reason Obama lied, as verified by Politifact, that people could keep their health care plans when he passed Obamacare, and that the lie haunted the Democrats for half a decade. Telling them straight that they will certainly lose their current plan will probably go about as well.
Surveys show that 53 percent of the American public supports single-payer health care. The same surveys also show that the support falls to a mere 20 percent when Americans are asked to consider even basic trade-offs, like higher taxes and government control. I wonder what the support will be when the full costs of $32 trillion dollars of taxes — close to doubling the federal budget — are made clear to them.
As Democratic presidential wannabes look at this proposal, I hope they consider this: Single-payer health care may be popular among the socialists that vote in Democratic caucus states. It may also be enough to single-handedly win Trump a second term.
Jose Trejos is a Weinberg junior. He can be contacted at [email protected]. If you would like to respond publicly to this column, send a Letter to the Editor to [email protected]. The views expressed in this piece do not necessarily reflect the views of all staff members of The Daily Northwestern.