A frequent
comparison brought forth by those who favor single-payer health insurance is to
make note of nice places around the world where single-payer works well. If it
is good for them, then it must be good for us. I’ll drink to that!
No I won’t.
This kind of comparison is like saying if a shirt fits perfectly on a dwarf, then it should be great for portly me. Suppose single-payer is great in Sweden.
Does that really mean it is great for the USA? Why don’t we see a single-payer
system for all of Europe? Or for the EU countries? Or for the G20? The answer
is simple. They don’t want it. These places I mention are not only big but they
are also dissimilar. People in northern Holland don’t have much in common with
those silly Limburgers. Can you imagine the Hungarians
and the Germans wanting the same single-payer system? I can’t.
But the
US is one country, you retort. States are not the same thing as countries. But pshaw, I say.
I know a few New Englanders who can’t even say Mississippi with a straight
face. The south is where those “deplorables” live. Without getting so silly, I
cannot see folks in South Dakota or Idaho wanting to have the same single-payer
system as the groovy people of California. And then there is the idea of a
frugal state like Indiana pairing up with scofflaws in Illinois. The USA might
be one country but that does not mean that we all live or think alike.
The proof is
in the pudding – or shall we say our governing documents. We purposely created
a federalist country composed of strong states. Today we continue to honor the
federalist state in many ways. We find comfort in the idea that some king
living on the east coast can’t tell us how to run our lives. Sure, we have a
big national government that does a lot of things. But think about all the
areas that are left up to states or cities or counties. Police, fire,
education, zoning, roads, parking, and so on. This is not trivial stuff. State
and local area government budgets and regulations impact us in major ways every
day.
Why don’t we
turn over the police departments to the national government? Why doesn’t the US
Congress run our fire departments? I am sure that it is possible to make strong
statements about the great efficiency or perhaps some sense of fairness that
derives from national control. But the answer is simple. It doesn’t make sense.
Locals better understand the local problems. Locals know how to create local
solutions. And what might be fair in W. Lafayette might not seem so fair in
Bloomington.
Some of our
politicians and ideologues want us to believe that single-payer is a slam dunk
for the USA. Since it is a fait accompli, then it follows that anyone against
it must have ulterior motives. But the truth is that the case has not been
made. Bernie Sanders can rant all he wants but that doesn’t make people in
southern Georgia have the same health issues and problems as those who live in
Brooklyn. It does not mean that because a small European nation finds single-payer ducky that a huge economic space populated by 330 million Hoosiers, Tarheels, and Buckeyes is going
to love it.
Republicans
are trying to make the case for healthcare reform. It is an uphill fight for
many reasons. But one of the reasons is the apparent superiority of single-payer. Why isn’t single-payer being held to the same kinds of debate and
logical standards? Why do we noddingly approve of single-payer as the words are
spoken?
