Paul Waldman gets it right!

THURSDAY, JULY 6, 2017

Though also, he gets it wrong: We couldn't resist the headline at the Washington Post.

"The dumbest criticism of single payer health care," it said. Helplessly, we clicked.

When we got there, Paul Waldman did something journalists never do. He battered two major journalists, by name, for making a dumb presentation.

Needless to say, the hapless pair were on-air at CNN. They'd made a dumb presentation about the alleged cost of adopting a "single payer" health care system.

Their names? John Berman and Poppy Harlow. If you read the Waldman post, you'll see that he got it right.

Along the way, we'd have to say that Waldman also got something wrong. His error lurks in this passage:

WALDMAN (7/6/17): There is simply no critique you can make of single payer health care that is more wrong than “It’ll be too expensive.” That is 180 degrees backwards. Single payer is many things, but above all it is cheap. And what we have now is the most expensive system in the world, by a mile.

"Single payer is cheap?" Tain't necessarily so! You could establish a single payer system which ran the cost of health care to the moon. A great example is found here at home, within our own Medicare program.

As everyone knows, Medicare massively overpays for prescription drugs. Under George W. Bush, the program was designed to do that, as a sop to the industry, and the design has succeeded.

That said, a "single payer" program could overpay for every medical cost and procedure. It's all a matter of the way the program is designed. A "single payer" system isn't guaranteed to be low-cost, inexpensive, frugal, money-saving or cheap.

While we're on the subject of "single payer," we'll recommend an informative recent post by Kevin Drum. It returns us to a question we asked sometime back:

Why do we call single payer systems "single payer?"

Drum listed the various types of programs which provide universal coverage. He then explained what percentage of medical costs various governments actually pay under terms of these various plans:

DRUM (6/11/17): None of these systems cover literally every dime of health care coverage. Canada, for example, is single-payer but doesn’t cover all prescription drugs. Different provinces have different rules. In most countries, it’s possible to purchase supplementary insurance to cover the gaps in the national system, something that’s necessary because they all have various copays and exceptions:

[CHART]

You can put all this together to get a single number that represents how generous a national health care system is. For example, Switzerland covers about 65 percent of all medical costs. Canada covers about 70 percent. France covers about 78 percent. Medicare in the US covers about 80 percent. Denmark and Germany are the most generous, covering about 84 percent.

You can see our problem. If the Canadian government pays only 70 percent of medical costs, why in the world would we call its program "single payer?"

Plainly, there seem to be two major payers—the government and the health care recipient him- or herself. There's nothing "wrong" with that, of course. But if two different parties are paying the freight, what's up with the term "single payer?"

This doesn't exactly "matter," of course, unless you think we should avoid a basic rule of American discourse. Under terms of that unwritten law, every discussion must begin with some built-in point of confusion.

"Flat tax" plans aren't actually flat; "single payer" health care plans involve two different payers. And Al Gore said he invented the Internet! It's how we discuss all major topics in this best of all possible worlds.