We wanted to take a thoughtful look at what’s in store if Colorado passes single-payer healthcare, so here’s answers to five questions about the plan and what it means for you.
1. What is “single-payer” health care?
A “single-payer” system means that the government pays for all health care-related costs instead of private insurers. So imagine Medicare for everyone. Or the Postal Service running hospitals.
Only a handful of nations have a single-payer system, and each has set it up differently. In some places like Canada, the government pays private health care providers for the services they provide. So it’s basically just bureaucratic insurance. In other places, like the United Kingdom, the government actually runs the health care system, meaning doctors are government employees and hospitals are government-run. It’s like the health care options available to military veterans via VA hospitals.
2. Does single-payer health care work?
While single-payer has been around for decades in a handful of countries like Spain, Canada and the UK, only one state has passed and implemented a single-payer system: Vermont. Home of Bernie Sanders (and Ben & Jerry’s), Vermont passed legislation to become a single-payer state in 2011.
Here’s where Coloradans should pay attention though: Vermont quickly abandoned the program, shutting it down in December 2014, “citing costs and tax increases as too high to implement.”
Any price tag you hear about the cost of single-payer health care is certain to change over time, and it’s unlikely to go down.
3. Will my health care be cheaper?
Technically, sort of. But there’s lots of catches.
First catch: Your taxes will go up.
Instead of being able to choose from multiple healthcare plans, and choosing the one with the right coverage and cost for you and your family, you will pay more in taxes (in the case of ColoradoCare, a payroll tax). While single-payer supporters say this makes health care more efficient because it pools all dollars spent on doctors, prescriptions, and more, it also means that you will have to pay the taxes to support the program, regardless of the cost. So if health care costs go up (more on that in a moment), then you will be required to pay more in taxes.
Second catch: Health care costs will go up.
When there is competition (such as competition to be your insurance company, doctor, etc), health care companies have an incentive to find ways to be more affordable. But when there’s less competition, they don’t have that pressure. In fact, they have protection. Why not throw in an extra MRI? Additionally, there’s no incentive not to go to the doctor in a single-payer “free” system, so more people go to the doctor for a common cold, slight sprain, and other issues that could easily be treated at home. Those extra visits have to be paid for by someone.
Third catch: The economy (and other government services) will take a hit.
When health care costs more, taxpayers are footing the tab, and business owners are required to administer new regulations, the economy takes a hit. Many economists have already estimated that Bernie Sanders’ “Medicare for All” plan would cost trillions of dollars and hurt the economy. ColoradoCare would have the same result.
Additionally, Coloradans wisely passed TABOR in 1992, requiring the state to balance its budget and not run up deficits like they do in Washington. However, that also means that as health care becomes more expensive (as is happening now with Medicare and Medicaid), other essential government services are squeezed out. We not only have less choice in health care, but less quality from other services as well.
Fourth catch: Your health care won’t be as good.
We’ve already seen the challenges Obamacare has introduced to actually getting in to see a doctor. A single-payer system makes this problem dramatically worse for a lot of reasons. The result will likely be something like the long-running crisis with Canada’s single-payer system where extended wait times to get treatment currently stretch to more than 18 weeks on average.
All of this to say, yes, you may not have a deductible with a single-payer system like ColoradoCare, but you’ll more than pay for it via higher taxes, a slower economy and bad health care.
4. How is this different from Obamacare?
Obamacare introduced hundreds of new regulations for business owners, insurance companies, families and individuals. These regulations cover everything from requirements that we must purchase insurance to what services must be included in insurance plans.
Single-payer, on the other hand, simply says “whatever you need, we’ll pay for it.” If you think that sounds too good to be true though, you’re right. Once it’s rolled out, like Obamacare, the reality may be very different from the intentions.
5. Are there other options?
Absolutely. Both liberal plans like single-payer and conservative plans focused on the doctor-patient relationship aspire to achieve universal access to quality health care. However, while single-payer delivers equal, mandated access to a broken health care system, other proposals focused on more organic, competitive solutions result in more choices, more innovation and cheaper, better health care.