Paul Waldman gets it right!


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:


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.


  1. "Medicare in the US covers about 80 percent"

    ...of people over 65, disabled and on average pays out only half.

    What the hell is this? You called this piece "informative"? And semantics over deeply uniformed (or worse) bullshit.

    "Single payer" "Universal coverage" "Free". Who the fuck cares what it's called. In Canada, no one of any age gets turned away.

    In the US, you risk bankruptcy or get put in a cab and told to die elsewhere.

    What happened to this blog? Peoples lives are being played around with like this is a reality show and all I have seen in the last year is whining about cosmically petty nonsense. Maybe it's just more evident now that the stakes are higher?

    Half of the US doesn't want free health care no matter who is twisting what in the media. There is a contingent of white nationalist, white privilege, cult like solipsism that has no educational cure. No media informed treatment. It is a malignant tumor and will never be cut out of half the American psyche. Public Broadcasting. Clean water. Public education. Health care. Cut it all.

    And you whine that libs are mean to these people?

    Fuck them. They are: Thick. Dumb. Racist. White privileged. Xenophobic. Cultists. Deluded.

    For fun, talk to one anti-abortion jesus freak and tell them Planned Parenthood actually prevents more abortions then it services. While also providing women the health and life saving services they need in areas critically undeserved.

    See how that goes over. I tried this on several of American cons and their responses ranged from baby killer, Killary supporter, I'm a communist (what?lol), and in actuality it's ME who is the racist since I support genocide as black women use PP as birth control.

    You can't talk to these people. America is doomed while they run it. So fuck them.

    "A "single payer" system isn't guaranteed to be low-cost, inexpensive, frugal, money-saving or cheap."

    This isn't rocket science. Single payer doesn't mean you won't have out of pocket costs, it simply means it is a SINGLE REGULATED system that expressly eliminates the profit motive in key areas that manages costs that can spiral. IE: administrative costs. Maybe you are subconsciously playing your hand here. You know, deep down, Republicans couldn't begin to achieve this because they don't want to govern. Hell, they don't even know how to govern. Republicans would rather people ate dirt and died than learn their civic duty.

    And you're concerned about what the system is called.

    Bobby, Please.

    1. @ 6:31

      I for one don't doubt that Bob agrees with a lot of what you’ve written. He’s tirelessly posted comparative data about our health care costs that most people don’t see. And I see nothing wrong with him disambiguating the term “single-payer.” You yourself even contributed to that in your post.

      I suspect many people who support the idea of single-payer are also not aware that they would have to pay at least something out of pocket, even if a Medicare-for-all system became reality. It’s a hidden but salient point.

      Harpers Index recently posted that the entirety of national nightly news broadcasts covered the topic of climate change for a grand total of 39 minutes last year. I wonder how much was spent on the topic of single-payer? My guess is even less than that.

      That being said, I think you misconstrue what Bob mainly does here. Mainly, he excoriates “leftist” journos for dumbing down the dialogue for their target audience, and in the process miss the opportunity to speak to the other side as well. You’re done with that, understandably.

      But Bob is gonna keep on being Bob, and I’m cool with that.


  2. The analog of "single payer" is "single provider". In single provider, government employees actually provide the care. This is the system in England and the Veterans Administration in the US.

    1. And the Indian Health Service, often overlooked here. That said, here's my "modest proposal" to at least get a partial NHS here.

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