Single-Payer Ready for Strike Three and You're Out

Single-payer healthcare remains the holy grail for Democrats seeking the ultimate in command and control government. Wealth redistribution on a previously unimaginable scale. The nanny state government controlling all aspects of everyone’s life, as few human activities don’t influence health in some way.

Congressional Democrats are locked and loaded with federal legislation expanding Medicare to everyone. Specifically, this bill would provide, “all individuals residing in the United States and U.S. territories with free health care.” Interesting wording. “Individuals residing in the U.S.,” not “legal residents in the U.S.,” meaning, free medical care for anyone from anywhere, with any disease or medical condition, if they are physically within the U.S. This would include illegal immigrants.

The bill was introduced by Democratic Rep. John Conyers on Jan. 24, just four days after President Trump was inaugurated. I must hand it to the Democrats. Their pet issue, ready to go, only 30 pages in length, even though it will go nowhere in a Republican-controlled Congress.

Contrast with the Republicans, railing against Obamacare for the past seven years, endless promises of “repeal and replace” if voters give them control of the House. Then the Senate. Finally, the White House. Why not a repeal bill, four days after inauguration, which is all the Democrats needed? Instead several months later, the House passed Obamacare-lite, barely, after initially postponing the vote due to political infighting.

Even now the “non-repeal and replace” bill is in jeopardy based on how the CBO might score the bill. Again, Democrats had legislation introduced immediately. And if they had Congressional majorities and a Madam President, this would have been signed into law before Valentine’s Day.  Rather, four months into the largest majority Republicans have enjoyed in almost a century, they have accomplished nothing on healthcare reform, instead fretting over Trump, James Comey, and mythical Russian collusion.

If Congress can’t even tie their shoes, let the states take a shot at reform. As Mitt Romney said, the states can each be a “laboratory of democracy,” testing novel reform ideas on a smaller scale before thrusting a bad idea, such as Obamacare, on 300 million Americans.

Vermont was the first to try a single-payer plan. The ideal state for single payer. Home to Ben and Jerry’s. Democrats as far as the eye can see, including one of the major single-payer proponents, socialist Sen. Bernie Sanders. How did that turn out in the land of Chunky Monkey?

Not well. Legislation was signed into law. But then reality hit. The price tag was more than the entire state budget, funded by a tax hike above and beyond Bernie’s wildest dreams. The governor wisely pulled the plug, rather than bankrupting his state, sending business east, west and south to more friendly states. Strike one.

Last year Colorado placed a single-payer plan on the ballot, hopefully sweeping victoriously into law by the same landslide that was supposed to elect Hillary Clinton. Despite no evidence of Russian collusion in the Colorado vote, single-payer lost by a 4 to 1 margin. Not just a landslide. But a tsunami and meteor strike as well.

Colorado faced the same problems as Vermont. A price tag as large as the entire state budget. Requiring tax hikes large enough to double state revenue. Enough to give Colorado the highest state tax rates in the nation. Coloradans decided to stick with legal marijuana rather than voting to raise their taxes so high that they could barely afford a pack of cigarettes. Strike two.

Fool me once, shame on you. Fool me twice, shame on me. Fool me a third time, call me California. The state that can’t maintain vital infrastructure such as the Oroville Dam is ready to provide free healthcare to 40 million residents, and another 2 million illegals. Are California’s numbers better than in Colorado or Vermont?

California has a current budget of about $180 billion, including a projected deficit. The cost for a single-payer plan, unlike in Colorado and Vermont where the cost was equal to the budget, is more than twice the California budget with a $400 billion price tag. This new healthcare scheme would in effect triple the state budget. Good luck with that.

California already has the highest state income tax at 13 percent. This is on top of federal income tax, property tax, sales tax, and who knows what other taxes and fees that are squeezed out of Californians. Need to triple state revenue? Guess what happens to state income tax rates?

Employers will be off the hook for health insurance costs, but will these savings be passed on to employees? Employers may not be so quick to share their savings as their personal taxes will be going up, too. And such a pay raise bumps many workers into a higher federal tax bracket. I don’t see any winners here.

If tax revenues are insufficient, just pay doctors less right? Until they leave the state. Can’t you pay hospitals less? Sure, until they close their doors. Then come the wait-lists. Waiting for not enough doctors or hospital beds. Don’t believe me? Just look across the pond at the British National Health Service to see exactly how this plays out under a government-run single-payer system.

The state that wasted $7 billion on a failed attempt to house the homeless is ready to spend more than twice its yearly tax revenue on free healthcare for all. Bernie Sanders wants California to “lead on healthcare.” Lead to where? Bankruptcy? Insolvency? Turning a once-prosperous state into Venezuela? Strike three.

Brian C. Joondeph, MD, MPS, a Denver based physician and writer. Follow him on Facebook,  LinkedIn and Twitter.