# 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:** 5
**Author:** ![BOOM](https://avatars.discourse-cdn.com/v4/letter/b/c4cdca/32.png) [@BOOM](https://boards.straightdope.com/u/BOOM)\ **Post date:** [February 19, 2015, 7:21am UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/81 "2015-02-19T07:21:01Z")
> [@Terr](#): > > I cited the paper. It’s in there. > > For the private market, non-benefit costs are about 11-14 percent of total premiums, while the direct administrative costs reported for Medicare are about 3 percent of Medicare outlays. A reasonable allocation of a share of outlays for general government functions and for the administration of justice increase direct and indirect administrative—that is, non-benefit—outlays as reported in the federal budget to about 6 percent of Medicare outlays. > … > Because the federal tax system is an institution necessary for financing all federal programs, including Medicare, the unmeasured costs borne by the economy as a result of the tax system are a real cost of federal spending, and the lowest plausible assumption about the magnitude of that excess burden has the effect of raising **the non-benefit costs of Medicare to about 24-25 percent of Medicare outlays** , or about double the net cost of private health insurance. A more realistic assumption raises the **true cost of delivering Medicare benefits to about 52 percent of Medicare outlays** , or about four to five times the net cost of private health insurance. > > See bolded. I can’t begin to tell you how much confidence I have in the views of an organisation - sorry ‘Institute’ - fronted by a Hedge Fund manager. He is surely involved for the common good. As are the rest of the lawyer and fund managers on that board. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [February 19, 2015, 7:27am UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/82 "2015-02-19T07:27:33Z")
> [@BOOM](#): > > I can’t begin to tell you how much confidence I have in the views of an organisation - sorry ‘Institute’ - fronted by a Hedge Fund manager. > > He is surely involved for the common good. As are the rest of the lawyer and fund managers on that board. What a stunning refutation! Are there other fallacies you will share with us? ---
**Author:** ![Salvor](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Salvor](https://boards.straightdope.com/u/Salvor)\ **Post date:** [February 19, 2015, 8:41am UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/83 "2015-02-19T08:41:39Z")
> [@Terr](#): > > I didn’t cite the paper for his criticism of price controls. I cited it for his analysis of what the true administrative costs of Medicare are. Hint: they are a lot higher than 2%. Then you are air brushing his own confusion on what really drives total cost of healthcare. [![](http://www-tc.pbs.org/prod-media/newshour/photos/2012/10/02/US_spends_much_more_on_health_than_what_might_be_expected_1_slideshow.jpg) ](http://www-tc.pbs.org/prod-media/newshour/photos/2012/10/02/US_spends_much_more_on_health_than_what_might_be_expected_1_slideshow.jpg) What % of total healthcare expenses are related to administrative costs? Is that really the driver of why our healthcare is so much more expensive? ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [February 19, 2015, 10:57am UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/84 "2015-02-19T10:57:59Z")
> [@Terr](#): > > The Medicare 2% overhead myth is achieved by comparing apples to oranges. Try taking all things into account: > > [http://www.manhattan-institute.org/html/mpr\_05.htm](http://www.manhattan-institute.org/html/mpr_05.htm) > [@](#): > > true cost of delivering Medicare benefits to about 52 percent of Medicare outlays, or about four to five times the net cost of private health insurance. For those wondering how manhattan-institute was able to come up with such a huge estimate of “single-payer overhead”, here’s how they do it. Consider an employee, John Doe, earning $50,000 in the private sector who’s on-track to become a $100,000 manager. Because of single-payer, the Medicare deduction from his payroll check becomes 4% instead of 2%. In other words an extra 2% is going to be withheld; the $50,000 extra he was hoping to earn will only be $49,000 with the new tax policy. With this loss looming, he abandons his career path, content with the lower wage. Who wants a better job, when there’s little extra money to be had? The economy suffers $50,000 in losses – the contributions Mr. Doe now refuses to make because the state is just confiscating his earnings anyway. In the accounting of the linked article, this entire $50,000 loss must be considered part of the health-care administrative burden. Opinions may differ on whether this analysis is valid, but if you, like me, find it specious, here’s a simple pro-tip: Manhattan Institute is a right wing “think” tank. – 'Nuff said. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [February 19, 2015, 11:00am UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/85 "2015-02-19T11:00:10Z")
> [@Velocity](#): > > … single payer … 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. 😕 > [@Velocity](#): > > Also, the premiums could pose a real hardship for the middle class, facing the existing tax burden. 😕 😕 > [@Velocity](#): > > I would favor single payer in America if there were a corresponding cutback in taxes elsewhere to ensure that the overall tax burden remains largely unchanged. 😕 :smack: > [@sweeteviljesus](#): > > What are the conservative arguments against single payer health care? > > Please, no straw men. **Velocity** , are you a conservative? Or are you a centrist just trying to guess what conservative arguments might be, since they’ve been unable to elucidate reasons in this thread? In any case, OP asked for “no straw men.” ---
**Author:** ![drewtwo99](https://avatars.discourse-cdn.com/v4/letter/d/d07c76/32.png) [@drewtwo99](https://boards.straightdope.com/u/drewtwo99)\ **Post date:** [February 19, 2015, 12:41pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/86 "2015-02-19T12:41:36Z")
Another one I hear libertarians and conservatives go on about is “rationing” of health care. If we put the government in charge of running who gets health care, then they are going to ration people unfairly. Of course the truth is that with private insurance companies we already get rationing, and it’s really evilly unfair. Government may or may not be worse, but they wouldn’t be creating rationing. It already exists. ---
**Author:** ![amanset](https://avatars.discourse-cdn.com/v4/letter/a/8dc957/32.png) [@amanset](https://boards.straightdope.com/u/amanset)\ **Post date:** [February 19, 2015, 12:44pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/87 "2015-02-19T12:44:02Z")
I’m still trying to work out what “gaming the system” is with regards to Healthcare. Getting unneeded antibiotics? ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [February 19, 2015, 1:19pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/88 "2015-02-19T13:19:48Z")
> [@amanset](#): > > I’m still trying to work out what “gaming the system” is with regards to Healthcare. Getting unneeded antibiotics? Welfare mamas break their own legs deliberately to get free splints? 😃 Eat greeasy food and get artery disease knowing the taxpayer will pay for their heart surgery? But “best of thread” has to be the “think” tank that puts single-payer overhead as 4 to 5 times private overhead because of all the Job Creators who would move their factories to Somalia if, instead of paying for employee health insurance, they had to pay more Taxxes! (As if the “thinkers” wouldn’t just borrow more from China instead of raising taxes. :smack: ) ---
**Author:** ![Red\_Wiggler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/red_wiggler/32/13190_2.png) [@Red\_Wiggler](https://boards.straightdope.com/u/Red_Wiggler)\ **Post date:** [February 19, 2015, 1:51pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/89 "2015-02-19T13:51:41Z")
> [@XT](#): > > Nothing novel about it…nor is it as ridiculous an argument as some of you who are handwaving it away seem to think. It’s a fundamental structural change for us to get from where we are today to some ill defined ‘let’s do it like the Europeans’ goal, and I’ve yet to see a good way to do it except to gradually move people from the current system to Medicare somehow, which means we will have two systems we will be supporting for some ill defined number of years through a transition that will cost some ill defined amount of money and have some ill defined amount of disruption. > > Because other countries have UHC or single payer systems doesn’t mean that the US can just do the same thing because they did. You can’t handwave away all of the political ramifications, nor the entrenched corporate and health care provider issues, no even the issues that Americans know the system we have and would need to be convinced that the pain of moving from where we are to some ill defined final goal will be worth it in the end, especially since no one can really say what we will get to in the end, considering that it will probably be a compromise system and probably won’t end up what it started out as, considering that there will most likely be several administrations and changes in Congressional majorities between the theoretical start and finish. These are issues that other countries didn’t have to deal with in getting from where ever they started to where they are today because no one else is structured like we are politically and socially. > > When one of you becomes god Emperor of the US and can simply do whatever you want by fiat, then come back. Until then handwaving away reality is really just mental masturbation and doesn’t do anything constructive to the real issues. > > It would be like me saying that we should build hundreds of nuclear power plants because that would be the best thing we can do for global warming and that we could do this because France already has over 70% of their power generation via nuclear…why can’t the US do that too if France can?? Well, we can’t because we aren’t France. The point of the debate is to convince people that their concerns are things which can be overcome. It’s essentially the same path we are taking to universal marijuana and same sex marriage legalization. Because the basic objection to single payer is that “we can’t convince enough people to support it” and other issues have shown that that’s simply not true. I want to be like our English friends and never worry about health insurance again. I think my employer would very much like to get out of the game as well. I know exactly what we pay in direct costs and have a pretty good idea about the indirect ones as well. The concept of running this whole thing through a company is really pretty bizarre. American exceptionalism, my ass. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [February 19, 2015, 2:12pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/90 "2015-02-19T14:12:11Z")
> [@amanset](#): > > I’m still trying to work out what “gaming the system” is with regards to Healthcare. Getting unneeded antibiotics? “Gaming the system” has been going on for some time. One aspect of it is unbundling services. The government says it will pay $50 for an office visit. The doctor therefore charges $50 for an office visit - plus $10 for copying the record and $2 for a DRE. I used to work in IT medical records. It made a difference to our Medicare billing status if patients were admitted thru the ER or from the skilled nursing facility next door. (I got a bonus and an award for figuring this out.) Regards, Shodan ---
**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 19, 2015, 2:12pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/91 "2015-02-19T14:12:58Z")
[QUOTE=Red Wiggler] The point of the debate is to convince people that their concerns are things which can be overcome. It’s essentially the same path we are taking to universal marijuana and same sex marriage legalization. Because the basic objection to single payer is that “we can’t convince enough people to support it” and other issues have shown that that’s simply not true. [/QUOTE] Well, except that it’s a handwave. Let me put it this way…why don’t we have a single payer system NOW? I mean, the side of right and light has wanted one. They have been doing their best to convince people it’s the best thing ever. They have pointed out that Europe and many other countries have one, in one form or another. Yet here we are. > [@](#): > > I want to be like our English friends and never worry about health insurance again. I think my employer would very much like to get out of the game as well. I know exactly what we pay in direct costs and have a pretty good idea about the indirect ones as well. The concept of running this whole thing through a company is really pretty bizarre. And I want to see the US build a boat load of nuclear power plants and send manned missions to Mars…and I wouldn’t be opposed to a single payer UHC type system in the US either. I doubt I’ll see any of that in my lifetime, though. > [@](#): > > American exceptionalism, my ass. 'Cause really we are just like everyone else, right? Tell you what…hold your breath until we get either UHC or a single payer system and see how that works out. Everyone else has done it, so the US being just like everyone else, well, we’ll do it too. Any day now. Keep holding that breath and telling yourself that we are just like everyone else and hand wave away the fact that even if no one else opposes it, the Republicans do, and considering that they have at least 30 % of the population who votes for them regularly that this is enough to block it form happening, at least until you manage to convince such a large majority of the American people that it shifts the whole system…something that most other countries didn’t and don’t have to do to get something like this through. Myself, I think I’ll see the last Game of Thrones book published and read long before that happens. This will be just after the US takes a firmer stand on GhG emissions and Global Warming… ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [February 19, 2015, 2:26pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/92 "2015-02-19T14:26:30Z")
> [@XT](#): > > > [@](#): > > > > American exceptionalism, my ass. > > … the Republicans [oppose UHC], and considering that they have at least 30 % of the population who votes for them regularly … So the TL;DR summary of your point is that the U.S. _is_ exceptional because we have the GOP and less exceptional European countries do not. Right? I’m not sure OP is getting answers to his question. So far, discounting a “think” tank analysis, we have one genuine conservative worried that doctors, who at present spend much money interfacing to private insurance bureaucracies, will add $12 to his office visits because … (Because what? Because government auditors are less competent than private auditors?) ---
**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 19, 2015, 2:27pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/93 "2015-02-19T14:27:52Z")
> [@BOOM](#): > > 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? You seem to have mistaken me for someone who doesn’t think the US should adopt a single payer model. Make no mistake, it would be _terrible_ for me personally on a financial level. I’m a lawyer working in a field that will largely cease to exist (or at least the amount of litigation in that field will drop to near zero) if that happens. My wife is a manager for a human resources outsourcing firm, which basically means she’s a third party health insurance administrator. Her field will _entirely_ cease to exist. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [February 19, 2015, 2:41pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/94 "2015-02-19T14:41:13Z")
> [@Really\_Not\_All\_That\_Bright](#): > > You seem to have mistaken me for someone who doesn’t think the US should adopt a single payer model. > > Make no mistake, it would be _terrible_ for me personally on a financial level. I’m a lawyer working in a field that will largely cease to exist (or at least the amount of litigation in that field will drop to near zero) if that happens. My wife is a manager for a human resources outsourcing firm, which basically means she’s a third party health insurance administrator. Her field will _entirely_ cease to exist. So you are an altruist willing to support policies good for society that would be bad for you personally? Thank you much! We were recently assured in a nearby thread that such altruists are rarer than seven-leaf clovers. Now go back to North Korea or France or Canada or whatever communist country brainwashed you so bad! 😃 ---
**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 19, 2015, 2:51pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/95 "2015-02-19T14:51:22Z")
[QUOTE=septimus] So the TL;DR summary of your point is that the U.S. is exceptional because we have the GOP and less exceptional European countries do not. Right? [/QUOTE] You should have taken the time to read it and not try and summarize something you didn’t bother reading. No, my point is that our political system and political/social/corporate climate is different than Europe’s, or Canada’s, or Japan’s or anyone else, so saying that they have done this as an argument that we should ignores all of those differences. But, by all means, just keep saying that the US is just like everyone else and holding your breath for UHC/Single Payer health…and scratching your head in puzzlement when year after year it doesn’t happen. You’d think that people would have learned from the Obamacare/ACA fiasco that even with a large political majority as the Democrats had at the federal level, you STILL can’t push something through and have it working without major political digging in by the opposition unless and until you get BOTH parties (and the voters, and business, etc) on board. Until you guys can wish away the Republican party (or get them on board with this…or, better yet, get THEM to push this, since it would be like Nixon and China if the Republicans pushed UHC or a single payer system) and/or a large majority of voters and businesses it’s not going to happen, despite examples of how it works everywhere else. ---
**Author:** ![Claverhouse](https://avatars.discourse-cdn.com/v4/letter/c/13edae/32.png) [@Claverhouse](https://boards.straightdope.com/u/Claverhouse)\ **Post date:** [February 19, 2015, 3:03pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/96 "2015-02-19T15:03:10Z")
> [@ElvisL1ves](#): > > Reagan eased his way into politics by way of [shilling for the AMA](http://en.wikipedia.org/wiki/Ronald_Reagan_Speaks_Out_Against_Socialized_Medicine), which opposed Medicare > … > > > [@](#): > > > > “When I opposed Medicare, there was another piece of legislation meeting the same problem before Congress. I happened to favor the other piece of legislation and thought it would be better for the senior citizens. … I was not opposing the principle of providing care for them…” Carter’s campaign accused Reagan of “rewriting history”, saying that there was no such alternative legislation. > > Oh, and, showing that some things never change:There wasn’t, of course. There isn’t now and never will be, either. To be fair the old boy was pretty out of it much of the time. I truly believe he wasn’t lying when he remembered personally liberating Nazi Death Camps. That was his true recollection. For a brief shining moment during the '80s the leaders of three of the most powerful countries on earth were led by leaders _non compos mentis_. Fortunately Ronnie Alzheimer’s and Maggie Dementia were balanced by Leonid Needs-Two-People-To-Hold-Him-Up if the Russian Bear got up to his old tricks. ---
**Author:** ![Squirrel\_Whisperer](https://avatars.discourse-cdn.com/v4/letter/s/ac8455/32.png) [@Squirrel\_Whisperer](https://boards.straightdope.com/u/Squirrel_Whisperer)\ **Post date:** [February 19, 2015, 3:08pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/97 "2015-02-19T15:08:01Z")
Hi. I’m new here. There is an argument I hear from conservatives that I don’t think has been mentioned: The United States basically “carries” the rest of the world when it comes to medical technology innovation. So if we went to a more cost-controlled healthcare system, it would stifle this innovation. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [February 19, 2015, 3:09pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/98 "2015-02-19T15:09:52Z")
> [@XT](#): > > You should have taken the time to read it… 😕 I did read it, and read your latest as well. My summary still stands. > [@XT](#): > > …and scratching your head in puzzlement when year after year it doesn’t happen… Who’s puzzled? 😕 I’m reminded of Johnny Cash who, when the Folsom Prison warden asked him not to remind prisoners they were in prison, replied “Do you think they’ve forgotten?” **XT** , do you think those complaining about U.S. rejecting UHC are unaware of the GOP’s opposition? 😕 ---
**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 19, 2015, 3:13pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/99 "2015-02-19T15:13:17Z")
> [@XT](#): > > You should have taken the time to read it and not try and summarize something you didn’t bother reading. No, my point is that our political system and political/social/corporate climate is different than Europe’s, or Canada’s, or Japan’s or anyone else, so saying that they have done this as an argument that we should ignores all of those differences. > > But, by all means, just keep saying that the US is just like everyone else and holding your breath for UHC/Single Payer health…and scratching your head in puzzlement when year after year it doesn’t happen. You’d think that people would have learned from the Obamacare/ACA fiasco that even with a large political majority as the Democrats had at the federal level, you STILL can’t push something through and have it working without major political digging in by the opposition unless and until you get BOTH parties (and the voters, and business, etc) on board. > > Until you guys can wish away the Republican party (or get them on board with this…or, better yet, get THEM to push this, since it would be like Nixon and China if the Republicans pushed UHC or a single payer system) and/or a large majority of voters and businesses it’s not going to happen, despite examples of how it works everywhere else. So you’re saying we should give up pushing for it just because we haven’t succeeded so far and it’s hard. Thanks for the input. ---
**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 19, 2015, 3:16pm UTC](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974/100 "2015-02-19T15:16:39Z")
> [@davidm](#): > > So you’re saying we should give up pushing for it just because we haven’t succeeded so far and it’s hard. Thanks for the input. :smack: Good grief. No, I’m not saying that at all. Obviously though what I am saying is going in one ear and out the other with most of you, so I think I’ll leave you guys to the circle jerk and just laugh when this comes up over and over again at all the puzzled faces wondering why everyone else can do this but the US can’t, since are really no differences between the US and everyone else. Have fun storming the castle… [Previous page](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974.md?page=4) [Next page](https://boards.straightdope.com/t/what-are-the-conservative-arguments-against-single-payer-health-care/712974.md?page=6)