US Consequences of Single Payer

Hand+Grasping+MoneySingle payer in the UK insures the whole population from cradle to grave, is immensely popular, causes many grumbles about treatment, wasted time for chronic conditions, raises life expectancy and lowers Infant mortality in the UK, with better results than the US medical system.

It also only consumes 8% to 10% of the UK’s GDP.

The US system by contrast consumes about 18% of the US GDP, and is rising towards 20% of the US GDP, and employs 30 to 40 million people.

Doctors in the US graduate with enormous student debts, where historically Doctors graduated debt-free in the UK until the first Tory leader of the UK labor party, Tony Blair, copied the US’ poor lead and impoverished the next generations of Graduates.
We’d note we believe education is an investment in the next generation – not an expense for the current generation, and it is monumentally stupid to believe otherwise. Why would you deliberately choose to saddle your kids with debt that prevents them from buying a house and having a family? Isn’t that the whole purpose of families? To look after each other from one generation to the next?

If the US adopts Bernie Sanders’ single-payer proposal, it will sharply improve the US Medical system. It will also cut the US Medical system’s share of US GDP, to which there will be consequences, including 10 to 15 million new unemployed. Three major needs will be are:

  1. A job Guarantee program, for those leaving the medical “support” fields (bill collectors, credit workers, and other nasty jobs)
  2. The return of manufacturing to the US,
  3. A complete overhaul of the finances of higher education. These changes will do a great deal to make the US more self-sufficient, and will bring our university programs back to their former high standards.

The Job Guarantee Program

First, unemployment for all those Medical Insurance people, from sales of medical insurance through underwriting to medical billing. Approximately 6% to 10% of the US GDP in salaried people will become unemployed, because that is what cutting that level of cost requires. These people need to be retrained and re-educated for jobs in the economy as they are displaced from cost-centered jobs in the the US’ parasitic health care sector.

This massive layoff of a parasite on the body economic of the United States requires retraining them for gainful employment using different skills. The only readily apparent employment program which could be implemented is a combination of infrastructure maintenance and erecting tarrifs to protect a “Made in the USA” employment program. This may conflict with some of the treaties we have been pushing, under the Obama administration.

Reform of University Education Financing

To retrain all these people requires free education. If they have to incur debt for new jobs, the loss of wealth for that segment of the population will cause a recession/depression due to the impoverishment of the private sector of the US economy.

In addition we really need to understand what the financial stress of acquiring an MD degree has actually taught a graduating Doctor. He may have learned to practice medicine, but the accumulated debt actually prevents him from caring for people, because he is forced to spend substantial amounts of time and effort toward repaying his student loans. Learning to grasp for money like a 19th century skinflint becomes necessary, if he wants to pay back the loan, and then find a spouse, buy a home, have a family and save money on which to retire.

And all this to be accumulated between the years of 30 and 55, a Doctor’s practical working years. How can we expect our children to carry a load like this, when no previous generation was ever able to do so?

In other words, the new Graduate Doctor has received a strong incentive to learn how to grasp and snatch every dollar in sight – an objective which seems completely at cross-purposes to to the societal goals of patient care and the Hippocratic Oath’s promise “Do no harm.”

Student debt need to be fully paid off, abolished, and all those currently in the Student loan business need to be helped to move into the new manufacturing economy, which should be focused on items for sale, and NOT methods for rent extraction.
Made in the USA

We need a goal of full employment based on self-sufficiency in the US. No more exporting jobs to low paying, environment-polluting regimes just to provide a temporary lift in profits – temporary because as demand falls due to loss of jobs, so inevitably will revenues and profits.

Similarly we can become energy self-sufficient. Our jobs and our energy are intertwined, and unlike times past, this time we gain no benefit from low oil prices, because in conjunction with low oil prices, we have massive layoffs and collapsing businesses in our oil industry.

Where does the money come from, for the jobs program? Re-purpose some of the money we give to the Pentagon. As initial projects for the new workforce, start by super-insulating every building in the US to minimize wasted energy in winter and in summer. Second, fix our infrastructure – roads, bridges and railways. Notice we do not include airlines because of their carbon footprint.

And yes, income and estate taxes must rise, especially estate taxes.

Keep the jobs and profits at home.

Ok Bernie – the ball is in your court – let’s see the complete package. (And I’m certainly one of your supporters).

Let’s fix the system. When do we start?

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4 CommentsLeave a comment

  • Single payer has been on the Democratic radar for a long time. ACA was as close as Congress would allow. Bernie has a lot of popular ideas but no way to achieve them beyond “we need a revolution”. I’m happy to debate the feasibility of your favorite platform plank.

  • Bernie’s plank.

    I doubt the US will achieve single payer. The dogma of “private enterprise can do it better” needs to be punctured, probably by a huge depression, before that eventuality.

    Climate change will be the trigger for huge change, and the US will adopt solutions when the profit opportunity becomes clear. I suspect it will be real estate/housing driven solution.

  • Perhaps jay and Synoia are right, but that does not means that we should not strive to achieve single payer. The Democratic Party has gone from advocating single payer to criticizing Sanders for doing so. Perhaps that is the real legacy of Obama’s presidency, not “hope and change,” but “don’t hope for change.”

    This country has gone from sending men to the moon in a decade and “we do these things not because they are easy but because they are hard,” to being unwilling to even attempt that which is difficult. My issue with Obama is not that he failed to achieve single payer, but that he started the discussion of the reform legislation by saying that single payer could not be part of that discussion, because single payer would be “too disruptive.”

    • I worked for IBM. The driving force in their development labs was – do nothing to affect the revenue stream. Which did much in and of itself to destroy any lead in any market segment, and denied any new entry into any market segment.

      That’s where one perceives the US now. Do nothing to affect profits.

      Building new things – easy. Modifying the existing – impossible.

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