“Single-Payer” Healthcare? You Mean Like the VA?


On May 24th The Signal published a column by Steve Lunetta entitled “Health care free market an abject failure” (Link), and I have to take great issue with much of what Steve wrote.

He claims that “All attempts to create a ‘free market’ in health care have failed here in the United States.”

What “attempts”? How can they have “failed” when there haven’t been any to begin with? Oh, there used to be a free market in health care, but it was so long ago that at 68 years of age I can barely remember it. The only thing that’s been “attempted” in the last five decades or so has been to exert ever more government control and regulation of that market segment.

In all the anecdotal “evidence” Steve presents in the column, one glaring element simply leaps out at me: he had an HMO, which he described as a “blessing”, and HE made the decision  to switch to a PPO, from which all his described problems arise.

If his organization is like the ones I worked for, as an employee I had a choice between either a PPO or an HMO. Didn’t he? Even if he didn’t, he certainly wasn’t forced by his employer to participate in their PPO program. So it seems to me that his problems with his health insurance provider are actually due to his own lack of due diligence, and his own decision to participate in a PPO that doesn’t meet his perceived needs.

His lack of due diligence is also illustrated by his example of allowing visits by a doctor without asking first what his own charges would be for that doctor’s services. Why would anyone do that? That’s a question I ALWAYS ask when a medical service or procedure is being contemplated.

The next problem here is that the insurance companies aren’t “making a mountain of money” as he claims. In fact, under the current structure, many are facing serious financial problems, and are withdrawing from many markets. Further in many jurisdictions, this state being one of them, insurance profits are limited by law.

Then the ultimate sin: proposing “single-payer”, which means government-run health care. You want to see how well that will work out? Take a look at the VA system for your answer. Now imagine that being the national norm.

How about we actually try some REAL free-market health care for a change? For years I’ve promoted three steps to reforming the system:

1.  Eliminate the artificial Barriers to interstate competition for health care and insurance products. Let real competition begin.

2.  Streamline the FDA approval process, which will significantly lower the cost of bringing new meds and procedures to market.

3.  Reform the medical tort system, which will lessen the costs involved in, and perceived need for, practicing “defensive medicine”.

Let’s do those three things, see how well they work, and only then see what else might be done to improve things.

Lastly, we as a society have to get away from the idea that there’s some magic bullet that will indemnify us from the vicissitudes of life. Some people are healthy until the day they drop dead; some are chronically ill for decades. That’s just the way things are. It’s no different from anything else. Some people have investments that make them rich; some people go bankrupt. Life isn’t “fair”.

But no one ever said it would be.


©Brian Baker 2017


(Published 1 June at my blog and in The Signal)



12 comments on ““Single-Payer” Healthcare? You Mean Like the VA?

  1. Nee says:

    It’s amazing how little people really know. I have been called a liar because people don’t want to know the truth. They want to believe that the government does know better. We Crispians understand that when you give it all up to government, failure ensues because the bigger picture is ignored. When Martin lost his job the first time and they offered COBRA? Most people take it out of the sense of disparity of the job loss and trying to protect their own…however, I was smarter. The money went twice as far when I found individual plans that were more affordable. Even though I will pay the penalty (unless Martin’s death is an “exception” ha!) it was still affordable for me to pay cash for any necessary visits to doctors. What is worse is that even the doctor’s don’t have a clue what a self- pay should pay when it comes to the specialists. I believe I am now eligible for the VA insurance by default. I am going to get it, if so. It is no worse than having none.

    And, BTW, we agree on all three points. My healthcare column from TH is one I saved! 🙂

    • BrianR says:

      Thanks, Nee.

      Exactly, and one thing that most people aren’t even aware of is that if you’re paying a provider CASH, most of them will negotiate their fees down for you. After all, they don’t have to do any insurance paperwork, nor use their “insurance” billing rates, which are naturally higher because they have to “discount” them to some preset fraction in order to comply with their agreements with the insurance providers, be it private or government.

      • Nee says:

        My Youngest has a cardio issue. With insurance, my out of pocket cost was still $726.00. When Martin lost his job in 2016, I asked what the bill would be for the 6 month follow-up self- pay. $315.00. It took them two weeks before I got an answer. Something is really wrong with this scenario.

      • BrianR says:

        Which, if I’m correctly understanding what you described, clearly illustrates the point that once the government’s out of the equation (self-pay) costs to the actual user go down.

  2. captbogus2 says:

    My first health care plan was 61 years ago. It was a Hospitalization Policy. It didn’t cover visits to the doctor. It didn’t cover prescription costs. It did cover hospitalization. My father told me if I insisted on ‘driving’ a motorcycle I was going to get hospitalization coverage or else. I got hospitalization coverage. Like I said it didn’t cover anything but hospitalization. Best I remember it was a BC/BS policy. It cost me $5.00 a month.

    • BrianR says:

      Yeah, actual INSURANCE, protecting you against something that MIGHT happen, but probably won’t.

  3. captbogus2 says:

    As long as the government insists on pre-existing condition coverage your insurance rates will be sky high.
    It’s like having a wreck in your new car and then looking for an auto insurance policy that covers pre-existing conditions….

    • BrianR says:

      Yeah, exactly, Buck.

      IMO, the current version of health “insurance” isn’t really insurance at all. Using the car analogy, it’s more like a maintenance policy than an insurance policy.

  4. slowcowboy says:

    Well, this issue is so jacked up its not really funny. At issue, the way I see it, is that health costs need to be addressed so that insurance is not the problem. People need to be able to pay for basic services without the confusion that insurance creates. Everyone complains about the cost of insurance but no one really knows the costs of their visit to the doctor. So insurance just gets in the way, I think.

    But I doubt it will change. If we could be more educated about the costs of everything directly, that would help a lot. Perhaps I am alone in identifying that issue, but I still think the insurance is really a bit of a distraction.

    • BrianR says:

      I agree. It is a distraction, caused by the idea that everyone is “entitled” to everything medically available regardless of the cost or their actual ability to pay.

      It’s like saying that everyone is entitled to a car, and they’ll all get Porsches regardless of whether or not they can actually afford one.

  5. captbogus2 says:

    Speaking of the VA. I tried them for a few years but first of all I am retired with a great insurance plan; second there are lots of veterans who are not so fortunate and need the VA and last I really didn’t care about waiting 3-6 months for an appointment to see a doctor whose name I could not pronounce and whose English I could not understand.

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