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Why “Single Payer” is inevitable, take 2

Because a) voters want it and b) no one cares about the federal budget deficit or national debt.

Seriously, that’s all there is to it. If you want more details, read on!

I’ve had numerous email and phone conversations about my series of posts on Single Payer and Medicare for All. Unlike past dialogue, it’s been generally apolitical and more fact- and less emotion based.

What’s striking is the conversations haven’t been about how awful “socialized medicine” is, rather what’s preventing Single Payer from happening. There’s been a bit of nonsense – the typical apocalyptic scare stories about pharma not developing new drugs because we don’t keep overpaying for the ones we take today, visions of patients dying while waiting to see a doctor, uninformed comparisons to Canada and the UK – but overall most people want to talk about why Single Payer can’t or won’t happen.

Deficit? No one cares.

Republicans have long branded themselves as the part of fiscal responsibility; that went out the window when they passed into law the Trump Tax bill. Screw the deficit, just cut taxes and growth will explode so all will be fine – a theory that been totally discredited in theory and has never worked in practice.

The thick black line show the budget deficit exploding due to the Trump Tax cut

Plus, the average voter is profoundly ignorant – including about deficits. So, deficits don’t matter.

What voters want

Voters do. And polls clearly show voters are warming to Single Payer.

And, they have opinions on different versions, with big majorities wanting a public option.

Yes, I know when you tell people that it will cost more in taxes, or possibly eliminate their employer plan, they like Single Payer less.

But they REALLY like the Public Option.

So, what does this mean for you?

Some form of Single Payer – likely a public option allowing folks over 50, those who don’t get health insurance thru work, to buy into Medicare or Medicaid. – is going to happen.

2 thoughts on “Why “Single Payer” is inevitable, take 2”

    1. Thanks Richard.

      I respectfully disagree. Ms Archer fails to note THE problem with US healthcare – prices for healthcare. She blames health insurers – who are by no means blameless, and have shown themselves completely incapable of fixing the cost/quality problem.

      Moreover, Archer assumes MFA would keep the same deductibles and other patient cost-sharing currently in place in employer – and individual health plans. That’s nonsensically, OF COURSE patient cost sharing would be drastically altered.

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Joe Paduda is the principal of Health Strategy Associates




A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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