Monday, May 22, 2017

California's Single-Payer Delusion

I somehow managed to miss Colorado's rejection of a single-payer system by a stupendous 80-20% margin in last November's election, with overall tax hikes that would have amounted to a 7% increase on employers and 3% on employees. This followed Vermont's quiet rejection of single-payer on cost grounds back in 2014. Apparently this hasn't fazed California lawmakers, who continue to pretend that the most politically popular fantasy among naive Democrats isn't also impossibly expensive. Particularly, they appear to be soft-pedaling the reality that their proposed system will dwarf all other state expenditures by a factor of nearly four, leaving me to wonder who they will bludgeon to make the whole thing work.

Look, I get it — medicine is expensive, customer service sucks, and nobody can figure out pricing. But that doesn't mean shoveling the mess onto the state will fix those problems. It's not only naive to believe as much, it's incomprehensible: you can't fix costs without dealing with the physician shortage, patent abuse and regulatory moats, and a mess of other, related problems. Single-payer is basically saying, "hey, those things are terrible — and we should totally pay those guys their extortionate fees so nobody at the point of sale has to." It turns Martin Shkreli from a robber baron into just another guy making money in medicine.

Update 2017-05-23: Reason says the figure is only twice the overall state budget. Win!