A recent Wall Street Journal article by Daniel P. Kessler opined that we would see a single-payer system in the United States (i.e. government run health care) within the next 6 to 7 years.  While I agree with Mr. Kessler that implementation of a single-payer system has been the dream of Progressives since Harry Truman first tried to implement it in 1948, there are three huge obstacles facing Progressives and Liberal Democrats which I believe will prevent its implementation:

  1. The United States is broke.  We have a $16.8 trillion dollar national debt that is projected to increase to $17.9 trillion dollars next year with little sign that this president will do anything in the way of entitlement reform to reduce it.
  2. The opposition.  If you think there was a great wailing and gnashing of teeth over the passage of ObamaCare and its implementation, imagine what will happen when America is advised that the federal government is taking over the health care system.  The fight would be long and bloody and, without a Democrat majority in the House and Senate as well as a Democrat in the White House, it simply cannot happen.  ObamaCare passed because of the perfect storm.  It will be a long time before there is another one.
  3. The nation’s health care providers.  The last and, perhaps, the largest reason I believe there will not be a single-payer system is this nation’s health care providers.  Health care in this country represents $2.8 trillion dollars that we spend with medical providers–that’s 27 percent more or $750 billion dollars greater than other developed countries with the same per capita high income as the U.S.  If you wonder how that number translates to preventing the implementation of a single-payer system, consider this:  at New York City’s Memorial Sloan-Kettering Cancer Center, 14 administrators are paid over $500,000 dollars a year while 6 administrators make over $1 million dollars a year.  MD Anderson, the country’s leading cancer treatment center, employees 19,000 people while Exxon Mobile in Houston, Texas, employees 14,000.00.  In addition, hospital profits, especially in not-for-profit hospitals, are huge with hospitals charging insurance carriers 30 to 50 percent more than they charge Medicare.  So if you think the health care industry will go quietly into the night and allow the government to impose a federal health care system, consider this:  the Center for Responsive Politics reports pharmaceutical health care product industries combined with organizations representing doctors, hospitals, health services and HMO’s have spent $5.63 billion dollars since 1998 in lobbying Washington while lobbyists for defense and aerospace industries spent $1.53 billion dollars and big oil and gas lobbyists spent $1.3 billion dollars.

While there is no doubt a twinkle in the eye of the Progressives wanting a single-payer system, a reality check shows this would be a long and difficult struggle with little chance of coming to profusion.

Cary Hall

America’s Healthcare Advocate