The Washington Post Is Selling Snake Oil

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Above Photo: Max Borge / Flickr

Our friends at the Washington Post are waging a brave campaign against Medicare for All.

Over the weekend, the Washington Post editorial board took a bold stance: they argued that universal health care with single-payer financing is simply beyond reach.

That the Post felt the need to issue the editorial at this particular moment is a testament to single payer’s rising fortunes. From coast to coast, activists are on the march: against the widely loathed, upward-wealth-redistributing, health-care-stripping abomination known as Trumpcare, for sure — but also for real universal health care.

Yet the Post’s frail arguments should be confronted, because they repeat a number of common talking points that rest on flawed assumptions and that could do real harm.

The Post editorial board begins by briefly conceding that single payer does have “some strong advantages.” It notes that single payer would be less of a hassle for many people (a good point), that it would get employers out of the messy role of providing health-care benefits (reasonable), and finally that it would facilitate cost-effectiveness research by government investigators (fine I suppose, although this is unlikely to galvanize the average person).

At the same time, however, the Post entirely neglects any of single payer’s actual “strong advantages”: the elimination of uninsurance (28.6 million uninsured in 2016), the ending of underinsurance (most single-payer proposals and bills say that care will be free at point-of-use), or the expansion of health-care benefits (for example, long-term care and dental care).

After neglecting to mention the benefits that actually animate most single-payer advocates, the Post proceeds to critique what it views as single payer’s “astonishing” price tag. It notes that while single-payer proponents point to the much less expensive public health-care systems of other nations, public health-care spending in the United States is already quite high:

The public piece of the American health-care system has not proven itself to be particularly cost-efficient. On a per capita basis, US government health programs alone spend more than Canada, Australia, France and Britain each do on their entire health systems. That means the US government spends more per American to cover a slice of the population than other governments spend per citizen to cover all of theirs.

At first glance it seems here that the Post is making something of an argument for single payer, arguing — as colleagues have put it — that we are already “Paying For National Health Insurance — And Not Getting It.” But they aren’t. They are contending that US public health-care spending is inefficient relative to international comparators, so making the whole system public wouldn’t bring costs in line with other nations.

Now they are right that transitioning to single payer would not reduce US health-care spending, as a percentage of GDP, to the levels seen in the United Kingdom (nor would we want it to: the UK is currently spending too little on its National Health Service).

Nonetheless, the underlying logic of the editorial board’s argument is still very flawed. The Post fails to acknowledge a widely known fact: Medicare is run at a far lower rate of overhead as compared to private insurers, while a single-payer system would produce additional efficiencies throughout the system via reduced spending on administration and billing. Even if we didn’t reduce overall health-care spending through Medicare for All, there would still be enormous savings from the transition that we could use to cover single payer’s costs: more than $500 billion annually, by one estimate.

After essentially dismissing this as a source of savings, the Post proceeds to assert that if single payer is to wring any real savings out of the system, they will be by necessity painful and divisive. Here it engages in a divide-and-conquer approach which we will likely see more of in coming days: doctors will have to be paid less, rural America will have to give up its “expensive medical facilities that serve relatively few people,” and “patients would have to accept different [i.e. worse] standards of access and comfort.”

This is nonsense. Canadian doctors get reimbursed perfectly well for their labor. Rural areas might actually be better served, not worse, under a national health program (NHP) that consciously plans the construction of new health-care capital. And the whole point of single payer is to improve access for all patients: as we replace insurance networks with “one big network” of NHP providers, and eliminate uninsurance and underinsurance, barriers to care — financial and otherwise — will decline.

The editorial concludes by noting that “universal coverage” and controlling costs should still remain the goal, albeit within the edifice of the “Obamacare system.” Yet they neglect to demonstrate how any incremental reforms would actually take us to universal coverage.

The fact is, the major added cost of single payer is the price of covering the uninsured and expanding coverage for the rest of us. So if universal health care is “too expensive” with single-payer financing — with its widely agreed upon efficiencies and capacity to substantially reduce drug prices — it would be absolutely too expensive to attain without it.

It’s Washington Post editorial board writers — not single-payer proponents — that are selling snake oil.

  • Steve1027

    To have the profit motive anywhere near a system that concerns life and death is immoral, plain and simple.

  • chetdude

    “On a per capita basis, US government health programs alone spend more
    than Canada, Australia, France and Britain each do on their entire
    health systems. That means the US government spends more per American to
    cover a slice of the population than other governments spend per
    citizen to cover all of theirs.”

    I’m constantly amazed that even in most articles that defend “Single-Payer”, the real reason that the “US government spends more per American” is seldom revealed. That is the fact that even (especially?) under the ACA the cost DRIVERS of USAmerican sick care are the need of those corporations driving costs for constantly increasing quarterly profits NOT a commitment to the Health of the population is dominant in the only remaining nation that tinkers with for-profit sick care…sick care as a commodity rather than Health Care as a Human Right.

    Remove the insurance industry profits, the drug pushers of Big PhRMA, GE and other “equipment and supplies” manufacturers (GEs MRI machines cost 4 times what an MRI costs in Japan, for instance) and the AMA’s stranglehold on the costs of USAmerican sick care and replace them with a system that combines the best of other country’s systems and we’d have universal Health Care at 2/3 the cost…

  • Robert Hodge

    Completely agree! Everyone talks about the ‘costs’ without mentioning WHERE this money is going! Yes a large part is going for ‘care’, but a substantial part goes for Corporate Profits and CEO pay. YEARS ago, I read somewhere that the CEO of (I think it was) CIGNA received 5.6 MILLION dollars a YEAR as compensation. That could certainly buy a LOT of ‘healthcare’ in my view…But as Winston Churchill said “You can always count on the Americas to do the right thing…after they’ve exhausted every OTHER opportunity.” Evidently we’re not done exhausting “every other opportunity’ yet. Those CEO mansions/yachts and/or limo’s don’t come cheap dontcha know…

  • DHFabian

    First, the Washington Post is not exactly a bastion of liberal ideology. Secondly, as persistently as we ignore it, nothing resembling universal health care would make sense in a country that is 20-some years into a war on the poor. There is no way to avoid the fact that lack of adequate food and shelter takes a heavy toll of human health. So far, the overall life expectancy of the US poor has already fallen below that of every developed nation.

    The middle class want low- or no-cost health coverage for the middle class. There’s no need to expand this to low wage workers because we currently have an abundant surplus of job-ready replacement labor.

  • DHFabian

    That’s what capitalism is. Humans need adequate food, shelter, and medical care to survive. These are listed (UN’s UDHR) as the most basic human rights — even for the jobless poor. Today’s Americans disagree.

  • DHFabian

    The issue of controlling high costs has come up fairly regularly since at least the 1960s. Nations that have been implementing something close to universal health care, also have legitimate welfare programs for their very poor. We don’t. And remember, it was the mainstream middle class that was all gung-ho for Reagan’s deregulation agenda.

  • DHFabian

    As your post indicates, we know all this because people HAVE been talking about it.

  • kevinzeese

    A National Improved Medicare for All especially makes sense for poor people. It would be a step toward beginning to reverse the war on the poor — or are you so negative you cannot imagine a positive step. Stop your negative commenting. If you do not want to do anything but complain, go somewhere else.

  • chetdude

    “it was the mainstream middle class that was all gung-ho for Reagan’s deregulation agenda.”

    So said the corporate press…

    The real “Middle Class” was struggling to hold on…