Arnold Kling argues that the administrative savings from a single-payer system is minimal and superficial:
After [getting rid of private insurance administrators], costs might be less than the existing system. By a small amount. For a short time. But innovation in health care management and administration would slow to a crawl. Health care providers would need permission from Washington to try anything new. In the long run, administrative costs will be higher than they would have been under private health insurance.In the short run, getting rid of competition and installing a monopoly lowers overhead. In the long run, it’s not so brilliant.
Aside from the supposed savings from administrative costs, the main problem with a single-payer system is that there is no recourse for physicians to turn to should things sour. With the recent Medicare debacle, doctors threatened to drop Medicare patients and successfully pressured Congress to reverse a pay cut.
With a single-payer/Medicare-for-all system, physicians no longer have that leverage. Of course, health wonks would love nothing more than powerless physicians.
What puzzles me is why some within the medical profession are willing to give that up.
Related posts:
- Administrative costs and single-payer
- The make-believe savings of single-payer
- "Medicare for all" = lower administrative costs?
- The cost of "free" health care
- Medicare: The big asterisk
- Medicare and single-payer
- Single-payer supporters, be careful what you wish for
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Single payer system works ok in canada and UK…Whether it works or not will depend on how that single payer functions..and I guess not many ppl have any confidence in the US govt to run it smoothly and efficiently. The only thing we do know is that the current system does not work at all.
According to Mark Steyn:
Aneurin Bevan, the socialist who created the National Health Service after World War II, was once asked to explain how he’d talked the country’s doctors into agreeing to become state employees: “I stuffed their mouths with gold,” he crowed. Sixty years later, no amount of gold can persuade Britons to spend their working lives in the country’s dirty, decrepit hospitals (they spend enough of their nonworking lives there, waiting to be seen, waiting for beds, waiting for operations). According to a report in the British Medical Journal, white males comprise 43.5 percent of the population but now account for less than a quarter of students at UK medical schools. In other words, being a doctor is no longer an attractive middle-class career proposition.
“innovation in health care management and administration would slow to a crawl”
Is that a bad thing? Let’s have some innovation in helping patients.
Years ago I watched a socialist debate Bill Buckley. The socialist argued for socializing the US auto industry, for efficiency’s sake. Noting that each town has several competing dealerships, each with an advertising budget, repair budget, etc., the socialist calculated that if the various auto companies merged under government management, we could all drive Cadillacs for the price of VW Beetles.
Years later one may ask,”Did any socialist country ever make a car worth driving?”
You do not get to choose who your patients are in a NHS type of health system. Dropping patients is virtually impossible: actually, even the reciprocal (patients dropping you) is complicated.
Re: “white males comprise 43.5 percent of the population but now account for less than a quarter of students at UK medical schools. In other words, being a doctor is no longer an attractive middle-class career proposition.”
Probably the funniest line of reasoning I ever read on the Internet. “Most Scottish postmen are white males” — make up your conclusion. My med students’ classes are composed mostly of middle/upper-class white females.
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