# What are the conservative arguments against single payer health care? **URL:** \ **Category:** Great Debates\ **Created:** [February 18, 2015, 3:59am UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974 "2015-02-18T03:59:49Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 18, 2015, 5:57pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/41 "2015-02-18T17:57:32Z")
> [@bump](#): > > I think there are really 3 main reasons: > > 1. It’s essentially wealth redistribution, like **DrCube** points out, and the basic concept is that you should be able to spend YOUR own money on YOUR own health. And they should have the right to go bankrupt because of medical expenses also, right? Or to forgo them when the money is not there? > [@](#): > > 1. Distrust of government and a belief that anything the government does is de-facto more shoddy and less efficient than the private sector can. Which is why Tea Party idiots yell that the government should keep its hands off their Medicare. > [@](#): > > 1. There’s a big belief that it’ll reduce choice and prevent people from making their own decisions about their own health care. This isn’t so important among the younger set, but the old-timers take this very seriously. Which is why old-timers hate Medicare so much. > [@](#): > > 1. A fear that their treatment will be driven by financial bottom-lines and/or political agendas, and not by sound medicine, and that they won’t get much say in it as a result. This is similar to, but not quite the same as #3. Now this is a good one. Since conservatives want to decrease government spending on non-military applications no matter what, and since conservatives in Congress are not so good on the facts or evidence, and since conservatives are likely to have significant power for some time, a good argument is that if we have a single payer plan conservatives will tend to make the recipients of the plan and the medical community suffer through under-funding. ---
**Author:** ![XT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xt/32/456_2.png) [@XT](https://boards.straightdope.com/u/XT)\ **Post date:** [February 18, 2015, 6:03pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/42 "2015-02-18T18:03:25Z")
> [@ElvisL1ves](#): > > I’m sure you know that term is often used as an exhortation, meaning “shouldn’t”. I agree that there are a lot of things we shouldn’t do, but the realty is that we do them all the time. If Bob meant ‘shouldn’t’ instead of ‘can’t’ then I’ll just drop it, with the caveat that if wishes were fishes we’d all cast nets. ---
**Author:** ![davidm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/davidm/32/225_2.png) [@davidm](https://boards.straightdope.com/u/davidm)\ **Post date:** [February 18, 2015, 6:03pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/43 "2015-02-18T18:03:35Z")
> [@Voyager](#): > > A… > Now this is a good one. Since conservatives want to decrease government spending on non-military applications no matter what, and since conservatives in Congress are not so good on the facts or evidence, and since conservatives are likely to have significant power for some time, a good argument is that if we have a single payer plan conservatives will tend to make the recipients of the plan and the medical community suffer through under-funding. And this is the result of voting people who hate government into government. Their predictions of inefficiency and incompetence become self-fulfilling. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [February 18, 2015, 6:05pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/44 "2015-02-18T18:05:30Z")
I lived for quite a few years in a country with single payer. It encourages people to game the system, which can ruin it. In that country, it wasn’t that much of an issue, but in America, I think there would be much more of a tendency to game the system. So while it worked there, I don’t think it would work here in the USA. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [February 18, 2015, 6:06pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/45 "2015-02-18T18:06:48Z")
Also, the premiums could pose a real hardship for the middle class, facing the existing tax burden. ---
**Author:** ![BobLibDem](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/boblibdem/32/3149_2.png) [@BobLibDem](https://boards.straightdope.com/u/BobLibDem)\ **Post date:** [February 18, 2015, 6:07pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/46 "2015-02-18T18:07:05Z")
> [@XT](#): > > I agree that there are a lot of things we shouldn’t do, but the realty is that we do them all the time. If Bob meant ‘shouldn’t’ instead of ‘can’t’ then I’ll just drop it, with the caveat that if wishes were fishes we’d all cast nets. Yeah, that’s what I meant. Shouldn’t would have been a better word. We’re letting morons dictate policy, which we can’t do, meaning we really really shouldn’t. ---
**Author:** ![BobLibDem](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/boblibdem/32/3149_2.png) [@BobLibDem](https://boards.straightdope.com/u/BobLibDem)\ **Post date:** [February 18, 2015, 6:29pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/47 "2015-02-18T18:29:16Z")
> [@davidm](#): > > And this is the result of voting people who hate government into government. Their predictions of inefficiency and incompetence become self-fulfilling. Absolutely. For example, anti-government types wants the USPS to fail, so they saddled it with preposterous requirements to pre-fund pensions and benefits far beyond what any business requires. Their mantra is “government sucks, it always has sucked, it always will suck. Vote for me and I’ll make it work.” ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [February 18, 2015, 6:31pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/48 "2015-02-18T18:31:36Z")
> [@Velocity](#): > > I lived for quite a few years in a country with single payer. It encourages people to game the system, which can ruin it. In that country, it wasn’t that much of an issue, but in America, I think there would be much more of a tendency to game the system. So while it worked there, I don’t think it would work here in the USA. Do you think gaming the system hasn’t been happening all along in the USA anyway? The insurance companies and the big for-profit hospital chains are the biggest system-gamers of them all, and that’s the biggest single reason for our extraordinary cost and minimal coverage. It’s hard to see how single-payer, or any other system that takes at least some of the rent-seeking out of the system, wouldn’t be more cost-efficient ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [February 18, 2015, 6:34pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/49 "2015-02-18T18:34:13Z")
> [@Velocity](#): > > I lived for quite a few years in a country with single payer. It encourages people to game the system, which can ruin it. In that country, it wasn’t that much of an issue, but in America, I think there would be much more of a tendency to game the system. So while it worked there, I don’t think it would work here in the USA. Why would there be more of a tendency for people to game the system in America? Are we innately sneakier than the people of wherever you lived before? ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [February 18, 2015, 6:38pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/50 "2015-02-18T18:38:10Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Why would there be more of a tendency for people to game the system in America? Are we innately sneakier than the people of wherever you lived before? Different places have different cultures, but that’s a separate topic. There is one way in which single payer would not be gamed, though, and that’s with regards to severe injuries or illnesses. Nobody goes to a hospital to treat a broken leg unless they have a broken leg. Nobody goes to get chemotherapy unless they need chemotherapy. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [February 18, 2015, 6:42pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/51 "2015-02-18T18:42:32Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Why would there be more of a tendency for people to game the system in America? Are we innately sneakier than the people of wherever you lived before? Our current system encourages, and to an extent even requires, gaming. In the same way, many countries’ other systems require low-grade bribery in almost any dealing with low-grade bureaucrats. But the resulting behaviors are learned, \*not \*innate, and can be unlearned. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [February 18, 2015, 6:46pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/52 "2015-02-18T18:46:31Z")
So, let’s say single payer happened here in the US. How big of a premium are we looking at? 5-7% of annual income for a middle class family? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [February 18, 2015, 6:59pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/53 "2015-02-18T18:59:00Z")
The simplest, easiest, most practical, and best-proven method would be to gradually expand Medicare eligibility to cover anyone, with its tax system graduated and expanded to include unearned income, although private insurance could still try to compete (and why couldn’t it, if the private sector is always more efficient than the government, as we are so often told?). For a number, you could start by cutting the 30 percent or so overhead that the private system charges to Medicare’s 2 percent. Do you think Medicare gets gamed by patients nearly as much as private insurance gets gamed by the non-value-adders running it? If so, it’s by far less than 2 percent. ---
**Author:** ![BOOM](https://avatars.discourse-cdn.com/v4/letter/b/c4cdca/32.png) [@BOOM](https://boards.straightdope.com/u/BOOM)\ **Post date:** [February 18, 2015, 7:09pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/54 "2015-02-18T19:09:45Z")
> [@puddleglum](#): > > Exactly, if the US could implement the same cost control structure as Canada, why has it not done so? . If you really are that naive lets start with ‘socialized medicine’ and ‘Unamerican’ and ‘Death Panals’, etc. You know, 50 years of the biggest most successful con lobbyists and special interests have achieved. Buying politicians, wrapping their con in the national flag and tying it to patriotism: a beautiful case study. > [@Really\_Not\_All\_That\_Bright](#): > > Why would there be more of a tendency for people to game the system in America? Are we innately sneakier than the people of wherever you lived before? Dude, you’ve been gamed for 50 years already. Does 19% GDP ring a bell? How about 19% to cover only 2/3 of the population, plus some feudal tie-in to your employer? ---
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [February 18, 2015, 7:39pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/55 "2015-02-18T19:39:39Z")
> [@BOOM](#): > > If you really are that naive lets start with ‘socialized medicine’ and ‘Unamerican’ and ‘Death Panals’, etc. You know, 50 years of the biggest most successful con lobbyists and special interests have achieved. Buying politicians, wrapping their con in the national flag and tying it to patriotism: a beautiful case study. After single payer is passed, then all the lobbyists will decamp Washington and head back to their hometowns for productive jobs? Of course not, they grow as the money grows. If lobbyists and political pressure make it impossible currently to restrain spending, then that would be doubly so when the new army of lobbyists descends upon congress demanding that everything from acupuncture to cupping be covered and no medical profession ever have to take a pay cut. Look at the Medicaid Doc Fix to see a microcosm of what would happen. There is no plausible scenario where Congress stands up to voters and tells them enough is enough on healthcare spending. Believing single payer would lower health care costs takes a faith in the courage and thriftiness of politicians which is totally unsupported by history. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [February 18, 2015, 7:44pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/56 "2015-02-18T19:44:59Z")
While today, and for the last few years while ACA was in Congress, there were no lobbyists from Big Pharma anywhere to be seen in DC. 😉 Comparing a proposed real system to an ideal is non-productive, and just what those profiting from the status quo want you to do since that’s what it leads you to support. You need to compare the proposed real system to the \*existing \*real system, and to other proposed real systems. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 18, 2015, 7:54pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/57 "2015-02-18T19:54:47Z")
> [@Velocity](#): > > I lived for quite a few years in a country with single payer. It encourages people to game the system, which can ruin it. In that country, it wasn’t that much of an issue, but in America, I think there would be much more of a tendency to game the system. So while it worked there, I don’t think it would work here in the USA. Can you give some examples of people gaming a single payer system? I don’t doubt that they do, wherever there is a system someone will game it, but I can’t think of anything right now. Here doctors game it a good way by writing diagnoses that the insurance company will cover. Hospitals game it a bad way by encouraging the use of MRI machines to help pay for the machines they feel they need to stay competitive. (This will only go away in single payer systems with monitoring.) ---
**Author:** ![BOOM](https://avatars.discourse-cdn.com/v4/letter/b/c4cdca/32.png) [@BOOM](https://boards.straightdope.com/u/BOOM)\ **Post date:** [February 18, 2015, 8:04pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/58 "2015-02-18T20:04:17Z")
Fwiw, I just put into Google ‘cheating the nhs’ and you get a few dentists from 8 years ago and some pharm company got caught … a midwife cheated on timesheets 😃 At 9% GDP you’re probably not getting too much to worry about … ---
**Author:** ![BobLibDem](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/boblibdem/32/3149_2.png) [@BobLibDem](https://boards.straightdope.com/u/BobLibDem)\ **Post date:** [February 18, 2015, 8:20pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/59 "2015-02-18T20:20:15Z")
> [@Velocity](#): > > I lived for quite a few years in a country with single payer. It encourages people to game the system, which can ruin it. In that country, it wasn’t that much of an issue, but in America, I think there would be much more of a tendency to game the system. So while it worked there, I don’t think it would work here in the USA. Is that a dog whistle I hear? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [February 18, 2015, 8:30pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/60 "2015-02-18T20:30:34Z")
More like a sigh of despair. He’s telling us it works well everywhere else he knows about, but for some reason Americans aren’t moral enough for it. Give him points for an original argument there; usually exceptionalism takes a different form. [Previous page](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974.md?page=2) [Next page](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974.md?page=4)