Time to Support Single-Payer
For over two decades, Reality Is Truth has been a faithful supporter of Health Saving Accounts (HSA) as the "fix" to the current unsustainable, out-of-control, healthcare industry. However, over the past 6 years, it has become clear that the realities of life and politics in the United States show that there is really only one answer to the healthcare question. Single Payer is the only plan that currently has any chance at all of achieving a workable, yet imperfect, balance of quality, cost, and time for healthcare.
The Realities
Reality Is Truth was created in 1989 as a weekly newsletter that examines culture and current events from a conservative/libertarian point of view. We chose the name "Reality Is Truth" specifically to be a contrast to the political elite mantra that, "Perception Is Reality." Many of the left's political points of view are 100% perception and not based on reality, at all. Being that reality is king when we examine the truth, let's discuss the realities that exist today in the United States regarding healthcare. We will cover 5 realities to explain the change in our editorial position on healthcare:
- Coverage is not care.
- The Republican Party killed its own Obamacare alternative by standing against government mandates.
- The American people do not love their insurance plan, they hate insurance companies, and rightly so.
- Bernie Sanders was right, single-payer puts $17 billion (in 2020) every 6 months back into actual healthcare costs.
- It's too late to do nothing, the American people want healthcare and it is currently bankrupting the middle class.
Let's take a deep dive into each of the realities.
Coverage Is Not Care
The Obama administration spent 8 years selling the perception, that health "coverage" was actually healthcare. Selling this lie was important to Obamacare because they were developing a system that was designed to fail. They wanted single-payer from the start, but Democrats are very good at playing the long game. So they worked with the Republicans to create a system that could never succeed. In fact, they knew it would fail and require the federal government to eventually do a financial takeover. They also knew it would become so expensive that Americans would beg for single-payer.
Killing Mandates Killed Alternatives
When the Republican Party decided that it would stand against the insurance mandates it killed its own healthcare alternative. If the government is going to subsidize and or pay outright for healthcare, they have to get the money from somewhere. The Republican plan identified Health Savings Accounts (HSAs) as the free-market fix for healthcare. However, for HSAs to work they must be mandated from a citizen's 1st day of work. If you don't require citizens to maintain and invest a minimum percentage of their income in an HSA they won't, and there will be no money in those accounts when it comes time to pay the bills.
People Don't Love Their Plan
During the Obamacare debate in 2010, Republicans resorted to the argument that citizens love their insurance plans and don't want to lose them. The problem with this argument was that it was/is a myth. People hate insurance companies and they hate paying thousands of dollars a month for something that they may not use in a given year. The insurance industry is directly responsible for the mess our healthcare system is in today. For the last 40 years, the insurance industry has broken the free-market healthcare system with the advent of negotiated rates, reasonable & customary price indexing, patient co-pays, deductibles, HMO, and PPO networks. The insurance industry has created a privately owned, socialized medical bureaucracy that is losing a collective $32 billion a year to non-healthcare-related costs. There is no realistic scenario where any system that includes interaction with insurance companies will make things cheaper or better. If we really want to fix healthcare, we have to retire insurance companies from the center of the system. Insurance companies need to be forced back into the free market by being pushed out of government-sponsored healthcare. Insurance can go back to providing the one thing they were created for, premium services and coverages that are not part of the basic needs of the average person.
$32 Billion A Year Problem
During the 2016 presidential race, Bernie Sanders began promoting a "Medicare For All" healthcare system that would recover $17 billion every 6 months (2022 number) that could then be rolled back into actual healthcare to help pay for a government-sponsored plan. Republicans loved talking about how Medicare for all would cost an additional $30 billion over 10 years. Republicans were right, but Bernie was right too. In 2022, the healthcare industry, in its own annual report, admitted that indeed $32 billion a year are spent on non-healthcare related costs. These costs represent the insurance industry's "take" from the $780.8 billion* paid by citizens on health insurance premiums in 2022. The health insurance industry costs the insured 33% of every dollar spent on healthcare in the United States.
You see, the free market was broken long ago, by insurance companies, not the government. There is no scenario, anymore, where having insurance companies involved in healthcare will ever make healthcare better or cheaper. Insurance companies must return to providing premium, Cadillac, and gap coverages as they do today for Medicare recipients. Anything beyond that is a huge weight that most Americans can no longer afford. Insurance companies cannot be part of what the government is subsidizing, they need to be standalone companies that have to fight for business by offering extras that people are willing to pay for.
* $780.8 billion doesn't include co-pays and deductibles
People Want Healthcare
Survey after survey shows that the American people want access to healthcare. Most Americans believe that healthcare should be available to anyone who needs it when they need it. The reality Is that this is already true and has been true, legally, since the 1980s. Most Americans do not understand that the "right" to healthcare is already law and any institution that refuses care based on a person's ability to pay can lose its license and open itself up for an onslaught of lawsuits.
We are far past healthcare becoming an expectation, a right, an entitlement. We are already there and the American people will never be willing to give that up. This is a paradigm that Republicans have been unable to understand or they are just pretending to be against it. The reality is healthcare [not health insurance] has become a perceived right that the vast majority of Americans want, need, and expect, whether we like it or not.
Summary
Healthcare "coverage" is not care and we are spending over $32 billion a year just to be able to say we have a "health plan" before we spend one dime on actual healthcare. We have to get insurance companies out of the center of healthcare, as it is one of the things that makes healthcare expensive and will always be the driver for higher costs. When Republicans came out against mandates and for insurance companies, they killed even their own HSA-centered reform plan. There is a 0% chance of going back to the old 1950s model where doctors would compete with each other on price and services, sometimes even coming to your home when you were sick, and where patients paid for most or all of their healthcare out of pocket and insurance provided catastrophic coverage only. Americans see healthcare as a right, an entitlement, and a requirement of a humane society, and the only way to meet that expectation is to have a single-payer healthcare system in the United States, one that crosses state lines and is funded 100% by taxpayers. Most Americans cannot afford to have healthcare being the most expensive expenditure in their lifelong budget. This is why Reality Is Truth has made the decision to support efforts to create a system for healthcare that; 1) Removes insurance companies from the process 2) Provides healthcare for all, and 3) Doesn't require the user to jump through hoops or take action to participate. The three-legged stool of "single-payer" is the only thing that can provide the balance of quality, cost, and time required for a healthcare system that is perceived to be humane. Although this is certainly not ideal, and destined to be mediocre at best, it is the reality that is true for us in today's America.
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