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The fallacy of the “more-expensive” criticism of Single Payer [Adam Gaffney / Jacobin]

June 20, 2017

The fact is, the major added cost of single payer is the price of covering the uninsured and expanding coverage for the rest of us.

So if universal health care is “too expensive” with single-payer financing — with its widely agreed upon efficiencies and capacity to substantially reduce drug prices — it would be absolutely too expensive to attain without it.

This link is to a brief rebuttal to a WAPO editoral opposing single-payer healthcare on the grounds that it’s too expensive. As the above quote says eloquently, what is too expensive is the US system of privatized healthcare, which encourages profiteering, for lack of a better word.

As a personal note, most of the work I have and had has been funded in some way by US health care. (largely design of research equipment that ultimately feeds into either pharma or biology underpinning medicine, more recently the odd process equipment project for manufacture of med devices). I’m certainly thankful for it, but from my limited contact with both pharma and med devices at least (I am typically separated by 3-5 layers of intermediary companies), as well as working briefly at clinical diagnostic labs a while back, I can say first-hand that there are incredible resources and wealth available to the industries making up the US health care system, and a lot of talented people who focus on the business above all, and a lot of other talented people who know better than to fight the system and go along for the ride. Meanwhile, the direct care providers are relatively few in number and are usually overworked. We are capable of great things, but the system is not set up for that – not until a dense ecosystem of insurance, equipment, pharma, hospital management, law, finance etc all get a piece. Each of them has a vital part to play, but the goal of delivering a public service is a distant by-product at best.

Privatization here is not automatically bad, the system does produce fantastic technologies after all, but the balance of power of the existing US system is tilted severely against the interests of the public.



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  1. Would it be OK if I cross-posted this article to I’ll be sure to give you complete credit as the author. There is no fee, I’m simply tryingr to add more content diversity for our community and I liked what you wrote. If “OK” please let me know via email.


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