States are striking out on single payer | opinion

By Sally C Pipes

The progressive crusade for single-payer health care brings to mind the classic definition of insanity—doing the same thing over and over again and expecting a different result.

On the last day of January, a high-profile attempt to make California the first state with a single-payer healthcare system fizzled when supporters realized they were short of the votes needed to advance the bill by its legislative deadline. Rather than see the proposal go down to defeat, Democratic Assemblyman Ash Kalra, the bill’s lead sponsor, shelved it at the last minute.

Not that Kalra was chastened. He has vowed to fight on. Progressives won’t abandon their dream of socialized medicine even in the face of repeated defeat.

At the national level, single payer has been moribund since Joe Biden defeated the pied piper of single payer, Sen. Bernie Sanders, in the 2020 Democratic presidential primary. Progressives briefly hoped the pandemic would force Biden’s hand, but he has refused to budget.

With no path forward for single payer nationally, progressives have suddenly fallen in love with federalism. If they can’t impose government-run health care from Washington, why not draft a blue state to demonstrate the supposed blessings of socialized medicine? Lawmakers in New York, Massachusetts, and more than a dozen other states are answering the call with proposals to establish single-payer systems within their borders.

Advocates like to point to opinion polls showing public support for single-payer health care is growing. What they don’t mention is that support cools considerably once the public learns someone has to foot the astronomical bill — namely, taxpayers. California has rejected single-payer health care multiple times before this year – in a referendum 1994 and again in the legislature in 2017. The price tag has long been the sticking point.

Assemblyman Kalra’s proposal this year would have required the largest tax increase in California’s history — $12,250 per household annually — to meet its potential $391 billion annual cost. No wonder one survey found 64% of voters opposed the idea. Prior efforts elsewhere have met a similar reception. Progressives were fired up when Colorado put a single-payer system to voters on a ballot initiative in 2016. Then voters learned that to pay for the program, Coloradans would face a new tax of 10% on all wage and non-wage income, including Social security benefits.

Nearly 80% of Coloradoans voted no. In Massachusetts, single-payer has languished since a bill was introduced back in 1986. It’s never even made it out of committee. Why are Beacon Hill Democrats so timid? Perhaps it’s the fact that the bill would nearly double the size of the state’s budget and require correspondingly huge tax hikes. Then there’s Bernie Sanders’s home state, Vermont. In 2011, then-Gov. Peter Shumlin signed a single-payer bill into law. Three years later, the state abandoned the plan.

True to Democrats’ penchant for passing a bill to find out what’s in it, Vermont lawmakers were shocked to discover that the program they green-lit would require $2.5 billion in additional revenue in its first year. Since Vermont collected just $2.7 billion in taxes annually, even progressives had to admit the math didn’t work.But exorbitant price tags are far from the worst thing about government-run health care. Single payer exacts a huge human toll. Rationing, long wait times, and physician shortages are all hallmarks of single-payer systems around the world. Progressive love to hold up my native Canada as a model, yet a recent survey found that nearly two-thirds of Canadians want access to private health services if it means they can get faster care and better access to the latest treatments and diagnostic tools.

Last year, the median wait for care from a specialist following referral from a general practitioner was over 25 weeks.States are the laboratories of democracy — and democracy keeps voting single payer down. Voters and their representatives in state capitals must ensure that the recurring progressive push for government-run health care meets the same end as previous efforts.

Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on Twitter @sallypipes.

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