The Road to Socialized Medicine



Dave Mann

I don’t generally like slippery-slope arguments. The people who can’t tell you why they’re opposed to something — save for some imagined slippery slope — might be the only debaters more irritating than devil’s advocates

So normally I’d be skeptical of conservatives — and insurance industry advocates — who argue that a government-run health care plan (which Congress is considering as part of a major reform bill) would be a slippery slope toward single-payer public health care or, as conservatives prefer to call it, “socialized medicine.”

But, in this case, they have a point.

We talked a little about the so-called public option part of the health care reform bill last week. More info is here.

Members of the administration have said that a single payer system — in which everyone is covered under a government plan, as it’s done in much of Europe and in Canada — isn’t on the table. And they also claim that the public option is in no way, you silly dears, a path to single payer. “This is not a trick. This is not single-payer,” HHS Secretary Kathleen Sebelius told NPR recently.

I suspect that Sebelius is being disingenuous, as are other Democrats who claim the public option isn’t leading toward single payer.

Of course it is. Just look at the basic economics.

The insurance industry knows full well it can’t compete with a public plan.

For one, the private sector has enormous overhead, mostly spent on disqualifying from coverage anyone who will be too expensive to insure. A government plan won’t have to worry about that.

And two, a public plan also needn’t concern itself with making a profit.

Once a public plan enters the market, it’s likely that hordes of individuals and employers will flock to it. Under that scenario, the public plan would keep expanding until we essentially have single payer.

That’s the scenario envisioned by George Will. (His preferred cliche for the public option is “stalking horse.”) And it’s hard to argue.

On the other side, if you want single payer, you shouldn’t feel betrayed, as some lefties clearly do. You should be supporting an unfettered public option.

Meanwhile, the insurance industry is desperate to put constraints on a possible public option — by either limiting how low its prices can go, or by capping its enrollment.

We like to think of the insurance industry as some kind of all-powerful behemoth. And, quite often, it is. But right now insurers should be fearing for their survival — no matter how many assurances they get from public officials. 

Single payer may not be in the administration’s plan right now.

But it’s a slippery slope.