As Republicans continue to stumble and bumble in what is likely a doomed attempt to repeal and replace ObamaCare, there has been an increasingly desperate search for a bipartisan alternative. But that Kumbaya moment isn’t going to happen any time soon.
After all, health‐care reform is a matter of deep ideological conviction for both parties. Most Republicans understand that the desire for universal health insurance cannot repeal the basic laws of economics. They might be too timid to unwind ObamaCare, but most understand that government and health care are a poor mix. And Democrats? If anything, Democrats want to double down on their call for government control of the health‐care system.
Democrats, in fact, have moved far to the left on health care. In the 2016 presidential primaries, Bernie Sanders proposed “Medicare for All.” Most Democrats, including Hillary Clinton, distanced themselves from the idea. Today, the idea of “single‐payer” health care is rapidly becoming part of Democratic orthodoxy.
Just last weekend, New York Sen. Kirsten Gillibrand told The Wall Street Journal that she now supports a single‐payer system. And her colleague, Senate Minority Leader Chuck Schumer, declared “single‐payer is on the table” for Democrats. Sanders may have lost the battle for his party’s nomination, but he is clearly winning the war over its future direction.
How the public will react to the Democrats’ desire for government‐run health care remains to be seen. According to a recent Pew poll, only a third of Americans support a single‐payer system (although that number rises to 52 percent among Democrats and 64 percent among liberals). Americans clearly want everyone to have access to health care — we are a compassionate people — but they’re not rushing to put the government in charge.
After all, Americans can just look to Bernie’s model, Medicare, with its $50 trillion in unfunded future liabilities, and recognize that a single‐payer system would be prohibitively expensive. Recall that Bernie’s campaign proposal would’ve cost more than $30 trillion over its first 10 years.
Earlier this summer, California legislators abandoned an effort to establish a statewide single‐payer system, after the legislature’s own estimates said it would cost some $400 billion per year — more than the state’s entire budget. In New York, a proposal for a state single‐payer system was estimated to cost $226 billion per year.
Of course, in the face of this unaffordable tide of red ink, Democrats will point out that other countries with single‐payer systems spend less on health care than the United States. But that comes with a price of its own: limits on the availability of care. Some developed countries ration care directly. Some spend less on facilities, technology or physician incomes, leading to long waits for care.
Such tradeoffs aren’t inherently bad, and not all health care is of equal value. Plus, the United States imposes its own form of rationing by price. No health‐care system anywhere in the world provides everyone with unlimited care. However, Americans have always believed that such determinations are most appropriately made by patients rather than the government.
The recent tragedy of young Charlie Gard in the United Kingdom may have had as much to do with the British legal treatment of parental rights as it did with rationing by the National Health Service, but is emblematic of the type of government interference with health decisions that Americans are unlikely to tolerate.
Moreover, the US investment in health care helps drive medical innovation and technology around the world. There’s a reason why more than half of all new drugs are patented in the United States, and why 80 percent of non‐pharmaceutical medical breakthroughs, from transplants to MRIs, were introduced first here. Just imagine what would’ve happened if the government had imposed single‐payer‐style price controls on health care a hundred years ago. How many life‐saving drugs or vital medical technologies would not exist today?
The ongoing health‐care circus in Washington may seem to be full of sound and fury, signifying nothing. But it’s really about who should control some of the most personal and important decisions in a person’s life — millions of individual consumers or the government bureaucracy. The Democrats have chosen their side in this debate. Now, let’s see what the Republicans think.