Thursday, March 18, 2010

Europeans and Single Payer

Advocates of single payer frequently point out that the people of Europe seem to like their universal coverage systems and ask why it is that we can’t have one as well.

I think I have the answer to that. Europeans think their systems are better than what existed before but insured Americans aren’t convinced that single payer would be better than what they have.

In this country Medicare - a single payer, universal coverage system for seniors -is popular. Despite its taint of “socialism”, it is thought to be an improvement over the situation that existed during the early 1960’s when costs had risen beyond the ability of most seniors to pay out of pocket when they got sick, or to afford expensive health insurance.

However, when Medicare was amended during the Reagan administration to provide for catastrophic coverage, it was not seen as an improvement. There were vigorous objections and the program was repealed before it had a chance to get started.

Thanks in large part to our generous level of spending, most insured Americans are satisfied with what they have. They do not see how a governmental system of health insurance would be better for them and suspect it might be not as good. Furthermore, somebody would have to pay the added cost of a single payer system and the already insured people suspect it could be them.

That leaves the humanitarian argument; i.e., that we ought to be helping the people who can’t get health insurance or can’t afford it. For reasons pointed out in an earlier posting, that argument has so far not proved effective enough to carry the day for single payer or universal coverage – at least not at the national level.

If Americans with health insurance thought that they would be better off with single payer, we’d probably have it by now. But they don’t, and so the European comparison does not apply.

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