Is ObamaCare Paving the Way for a Single-Payer System?

NCPA August 14, 2013

Suffering from illness or injury? Good thing you're not British. U.K. police recently investigated the deaths of 300 patients at one hospital. The suspected cause is? Neglect. That could never happen in America, right? On the contrary. ObamaCare's new insurance exchanges and expansion of Medicaid represent the building blocks of a British-style, government-run health care system in this country, says Sally C. Pipes, president, CEO and Taube Fellow in Health Care Studies at the Pacific Research Institute.

If that system metastasizes, rationed care and subpar health outcomes will follow.

• Less than four in 10 Americans say they support "single-payer" health care.
• But the idea remains a hobbyhorse for many Democrats. A single-payer bill has been introduced in Congress every year since 2003.
• Vermont Gov. Peter Shumlin (D) recently signed a single-payer bill into law. And former Congressman Anthony Weiner (D) is pushing for a citywide single-payer system as part of his campaign for New York City mayor.

Initiatives like these could lead to a piecemeal government takeover of the health care system. Consider ObamaCare's health insurance exchanges, which are scheduled to open for enrollment on October 1. Each was intended to be a state-run marketplace offering affordable coverage options. The exchanges haven't unfolded as planned.

• Just 17 states are operating their own exchanges.
• Seven states asked for federal help running their exchanges, and 27 left the task to the feds altogether.
• So the federal government will soon effectively control the individual and small-group insurance markets in more than half the states.

Those markets won't function properly if people don't enroll. That outcome is looking increasingly likely. The exchanges are designed to take premiums from the young and healthy, who typically consume less care, to subsidize coverage for the aged. The individual mandate was designed to force these young folks to participate. But if they ignore the mandate, the exchanges will crumble.

Without young people's premiums to cover costs for older people, the insurance prices will skyrocket. The federal government may feel compelled to reduce premiums, or simply insure everyone directly.

Add the 13 million new Medicaid enrollees to the nearly 63 million people already enrolled and the 50 million people on Medicare, and more than 40 percent of the country will be on publicly financed insurance.

Source: Sally C. Pipes, "Is ObamaCare Paving the Way for Single-Payer System?" San Diego Union Tribune, August 1, 2013.