Single Payer Health Care and Pareto Efficiency

[Bono]

There are many claims that some form of government provided or sponsored health care is needed to address efficiency problems in the health care market. While I think many of these issues have been overplayed, that is not what I'm making this thread about.

Many people in the American left push for a single payer system--even Obama has said that it would be his favored system if it were starting from the ground. It's pretty ironic, given claims that the political center is farther to the right in the US, that so many take the position of outlawing health insurance which would be seen as very radical in Europe. But I digress.

If you have a single payer system and you change it to allow people to purchase private health insurance, while not allowing them to opt-out of paying taxes to provide for the single payer system, you are creating a Pareto Improvement in that the people purchasing private insurance are made better off without making anyone worse off. Given this, single payer should be off the table in any serious discussion of health care reform. Why is it not?

[Earth]

Given this, single payer should be off the table in any serious discussion of health care reform. Why is it not?

Many see it as a cave in to the health care industry; and voice their objection to what might amount to steep costs for the individual.

[Associate Justice PiT]

Given this, single payer should be off the table in any serious discussion of health care reform. Why is it not?

Many see it as a cave in to the health care industry; and voice their objection to what might amount to steep costs for the individual.

     If they just want to do it to hurt the healthcare industry, then that is the exact sort of pettiness that needs to be avoided. Any system of health care would do best to incorporate a system of private insurance, to force competition if nothing else.

[Ban my account ffs!]

Given this, single payer should be off the table in any serious discussion of health care reform. Why is it not?

Many see it as a cave in to the health care industry; and voice their objection to what might amount to steep costs for the individual.

     If they just want to do it to hurt the healthcare industry, then that is the exact sort of pettiness that needs to be avoided. Any system of health care would do best to incorporate a system of private insurance, to force competition if nothing else.

That's great.  As liberal, that is not my concern.  My concern is for the people that can't afford private insurance or suffer under the bureaucratic bullsh**t that private insurers throw at you when you need them most.

The system here in Minnesota is incomplete (and becoming moreso as Pawlenty dictates his cuts into an epiphany)

But we have a Medical Assistance program for the disabled and very poor.  This program pretty much pays for all medical costs without incurring any out of pocket expenses.  It is the program for the truly disadvantaged.

Then there is MinnesotaCare, which is a cheap alternative to private insurance for the working poor that either can't afford or don't have access to health insurance through work.  You must meet the eligibility requirements, and then you pay a reduced premium and co-pays for similar coverage as to what you'd get under a typical private plan.

When Republican governor Arne Carlson pushed the program, his goal was universal coverage.. but there wasn't enough money for it.. and the REpublicans have since been chopping away at it at any chance they get.

It says a lot about Minnesota Republicans.. that they'd rather you go without coverage and get sick and be totally unproductive than to support a relatively cheap program that keeps people healthy from the start while keeping people at work and insured at an affordable rate.

It doesn't compete with private insurance, because no private insurer would insure these people at the rate they can afford... it's just mean spiritedness from the Republicans and protecting their rich donors' interests.

[Nym90]

Well said Snowguy. The costs of not having insurance are far higher overall than the costs of having it.

[Torie]

I doubt anyone wants to ban private insurance. That would be analogous to banning private schools. The debate revolves around private insurance becoming fairly rare, because the pressure will be out there for a government system to charge below cost rates, or hand it out for "free" with public dollars.

[Ronnie]

I doubt anyone wants to ban private insurance.

Jan Schakowsky does.

http://www.youtube.com/watch?v=rveFv6A-xpU

[Linus Van Pelt]

If you have a single payer system and you change it to allow people to purchase private health insurance, while not allowing them to opt-out of paying taxes to provide for the single payer system, you are creating a Pareto Improvement in that the people purchasing private insurance are made better off without making anyone worse off.

This isn't right, because the supply and cost of medical services available to the public system doesn't stay constant just because the money available to the public system does. If private insurance plans pay doctors higher than the government does, then depending on whether the government tries to match them, either the cost to the treasury of subsidizing insurance will increase or the supply of doctors working in the public system will decrease, thus causing increased waiting times, etc.

Also, there is a political argument that the public is more likely to insist on the quality of the public health care system if it isn't just the poor who are in it.

But as Torie says, this is very unlikely.