Universal Health Care? Hmmm.

This blog post will deal with Senator Bernie Sanders’ call for universal health care under a single payer program. His proposed system would eliminate all health care premiums, co-pays, and deductibles. Everybody in the U.S. would be covered—nobody would be excluded. He proposes to pay for this kind of coverage by an elevation of taxes.

We need to look at this idea carefully. I believe that Senator Sanders is suffering under a utopian idea that has serious defects in it. He apparently does not have enough experience in health care delivery to understand what his proposal will entail. Let me explain:

Although many people agree with Senator Sanders, they do not understand that free health care will cause a huge increase in demand for this “free” benefit—I’m talking about a FLOOD of patients appearing in emergency rooms for treatment from everything from hang nails to bad dreams. I know this is true because of work that was done several years ago when I was a medical student. The Rand Corporation examined the effect of co-pays on emergency room visits. The study found that a $5 co-pay decreased ER visits remarkably from the going rate of then $0 dollars for each visit. Evidently, this minimal charge was enough to cause anyone going to an ER to think twice about it and try to remedy the situation by using a little common sense before resorting to ER care.

At the present time, states can impose copayments, coinsurance, deductibles, and other similar charges on most Medicaid-covered benefits, both inpatient and outpatient services, and the amounts that can be charged vary with income. All out of pocket charges are based on the individual state's payment for that service.

Even with the United States’ present policy to require minimal co-pays for ER visits, our ER’s are still treating a lot of minor problems because for Medicaid patients the cost is so low, they can’t afford to go any place else. Eliminating co-pays will only exacerbate that problem. (ER care is the most expensive care available for out-patient help.)

Under Sanders’ plan, hospital costs for maintaining ER services will escalate. I believe that health care should be available for everyone. However, I also believe that everyone should work for a living if they are physically able to do so; and they should make a reasonable effort to pay their own way through the health care delivery system.

The present system of entitlement payments for health care, housing, food stamps, financial assistance, and fictitious disability claims incentivizes people from working for a living. Adding another layer of entitlement payment will only make the welfare system worse than it already is. A single payer health care system will add huge numbers of inefficient bureaucratic workers to America’s present overload of government employees.