Hours after a raucous celebration for the 1/3 passage of the American Healthcare Act on the White House lawn, President trump sat with Australian Prime Minister Malcolm Turnbull, and praised their country’s single payer healthcare system. Apparently he realized the mistake as he was saying it, but it didn’t stop him from finishing: “I shouldn’t say this to our great gentleman and my friend from Australia, because you have better healthcare than we do, but we’re going to have great healthcare very soon.”
Of course, it’s not that surprising he feels this way, since he’s said it many times before. Remember, he praised Canada and Scotland’s single payer systems during the Fox News primary debate in 2015, and repeated it during his 60 Minutes interview later than month. He has praised it in many other interviews for NBC, The Advocate and on Larry King Live. But, the fact that he did it on international television, just hours after celebrating partial passage of a privatization effort is what is upsetting.
It wasn’t long before Senator Bernie Sanders, bursting into laughter, promised to quote the president on the floor of the Senate when they debate their own version of the bill (see video):
“Thank you Mr. President. Let us move to a Medicare for all system that does what every other major country on earth does: guarantee health care to all people at a fraction of the cost per capita what we spend. Thank you Mr. President. We’ll quote you on the floor of the Senate.”
While I’m happy about movement in the right direction with today’s bill, it’s more of a relief in progress than happiness in accomplishment. The American Healthcare Act is far from perfect, but it’s an improvement on what we currently have. It repeals the two mandates that galvanized us seven years ago, the Individual Mandate and the Employer Mandate. It also repeals eight massive taxes that were draining our economy. That being said, the fact that it took this much effort to move half a step forward is concerning, and it has Charles Krauthammer predicting single payer healthcare for the United States in “less than seven years.” Not if I can help it.
Today’s very public concession that single payer healthcare is better than our own is going to do more to damage our effort than Obamacare’s failure.
THE TIME IS NOW
In the months ahead, we have a one time shot at pushing this further, to an actual free market as Obamacare fully implodes, or single-payer’s failure is our future.
Conservatives have long known that healthcare lacked a truly free market for 50 years. Before the ACA, there were no market forces in play on price, competition or transparency. Any economist knows that these things inform producers how to best deliver service, and help consumers decide where and how to spend their money. This, in turn has led every industry in history to lower prices, efficient costs, greater access and a scale of quality decided on by the customer.
The reality is that truly single-payer healthcare is rare, and for a reason. Sweden is moving back to one with private insurers because it’s system is failing. Most French citizens are covered by supplemental insurance because the government insurance isn’t enough and is going broke. Germany has over 150 different insurance funds to help supplement government coverage. And yes, even Australia knows it’s facing funding issues, despite it’s relatively homogenous population. Finally, the motherland now ranks itself as one of the worst healthcare systems in the developed world.
Interestingly, Ezra Klein, a single payer proponent, has admitted the the US system fails because neither the free market, nor the government determines prices and costs. “That leaves the United States with the worst of both approaches. We simultaneously miss out on the efficiency of a purely private system and on the savings of a purely public one.” The result is we pay more for inexplicable reasons, and the government sets the lowest standard for it’s own inexplicable reasons.
Thank you, Ezra, we should use that on the Senate floor.
Our system is not tenable. It wasn’t tenable before the ACA, and it’s worse now. We need true reform that introduces those market forces for the first time in decades, and allows them to drive down costs, force prices lower, increase access and keep quality in the hands of consumers. In turn, insurance will become cheaper because what it’s paying for is cheaper.
The time is now, not later. With one step forward today, we need to keep pressing for incremental change. It worked for the progressive left for 150 years. We could learn something from that.
And until we get there, we need the president to just stop talking. For the love of God, just smile and wave. Please?