And how do you think these Scandinavians managed to amass their current wealth in the first place? By embracing free-market capitalism, not rejecting it. Countries like Denmark and Sweden became wealthy in the mid-twentieth century by adopting relatively low tax rates and other free-market principles. It was only later that they started to embrace left-wing ideals.7
You are exactly right—well, in a world where what you just said means the opposite. After decades of low economic growth, financial crises, and failing welfare programs, many Scandinavian countries have rejected the socialism of their grandparents and traded it in for market-based, capitalistic policy reforms.
Take Sweden, for example. In an article for Reason, John Stossel and Tanvir Toy recount an interview Stossel conducted with Swedish historian Johan Norberg. During the interview, Norberg, who is currently a senior fellow at the Cato Institute, explained that one reason Sweden has a reputation of being “socialist” is that during the 1970s and 1980s, the country adopted some radical left-wing policies.8 But as Norberg notes, those policies didn’t last forever.
“Our economy was in crisis, inflation reached 10 percent, and for a brief period interest rates soared to 500 percent,” Norberg said. “At that point, the Swedish population just said, ‘Enough. We can’t do this.’ ”
What, exactly, caused these massive economic problems? Many of the same policies supported by comrade Bernie and other leading American socialists today. Some socialists never learn.
One of the most disastrous programs of the period was one of Europe’s most socialistic: wage earners’ funds. In the 1970s, progressive labor unions bullied Swedish politicians into enacting laws that forced private companies to contribute a certain percentage of their profits into worker-owned funds that would be used to buy shares in those companies. Over time, the funds would essentially force businesses to transfer ownership from lawful individuals to workers, effectively socializing whole industries.
GHOST OF
KARAL MARX
“WAGE EARNERS’ FUNDS? TRANSFERRING PROPERTY TO THE WORKING CLASS ‘OVER TIME’? JUST SEIZE THE PROPERTY. LIKE I’VE SAID BEFORE, ‘THERE IS ONLY ONE WAY IN WHICH THE MURDEROUS DEATH AGONIES OF THE OLD SOCIETY AND THE BLOODY BIRTH THROES OF THE NEW SOCIETY CAN BE SHORTENED, SIMPLIFIED AND CONCENTRATED, AND THAT WAY IS REVOLUTIONARY TERROR.’ ”c
– ACTUAL MARX QUOTE
Yeah, thanks for the crazy interruption, Karl. What was I saying? Oh yeah, the wage earners’ fund program was an unmitigated failure. It turns out that when you take property away from business owners, it doesn’t exactly inspire them to invest more time, money, and resources into growing their business. Who could have ever guessed that?
Klaus Eklund, a former Swedish economic adviser to the nation’s prime minister, recalled that the socialist wage earners’ funds led to significant civil and economic unrest. During this period, “a large part of the population, including small entrepreneurs, small shop owners and so on, became extremely agitated and angry, because they felt the unions were going to take their companies away from them,” Eklund said.9 Hmm… shocking development, I know.
Tens of thousands took to the streets on October 4, 1983, to protest the wage earners’ funds, and by the end of the march, it’s estimated that nearly 100,000 people filled the streets. “People came by buses, by air, and by cars from all over Sweden. And then during the march through Stockholm, people from the streets started to march with us,” said one of the participants.
Keep in mind that Sweden’s population in the 1980s was only 8 million. A similar-sized protest in the United States today would require more than 4 million people.
Wage earners’ funds are perhaps the nicest, kindest way to use an authoritarian government to steal other people’s businesses, and even they proved to be too much to stomach. Despite Sweden’s disastrous history with wage earners’ funds, which the country eventually abandoned altogether, they are still backed by some American socialists in groups like the Democratic Socialists of America.
After years of developing costly and unsustainable new welfare programs and enacting socialist mandates like wage earners’ funds, in the 1970s, “The international oil crisis forced the Swedish government into pure Keynesianism and the currency, consequently, was devalued frequently and extensively over about a decade,” the Mises Institute reports. “The following ‘happy 1980s’ offered no solution to the bankrupt nation state, which financially imploded in the early 1990s as the international markets sobered up after a real-estate boom.”10
The economic destruction caused by Sweden’s socialist policies was so dramatic that researchers found there was virtually no job growth in the country from 1950 to 2005.11 Zip. Zilch. None.
The oppressive taxes levied on the citizenry led to the loss of national treasures like film actor and director Ingmar Bergman and even Swedish icon IKEA. Bergman wrote about his decision to leave Sweden in his autobiography, in which he explained that he felt targeted and humiliated by “a collection of prestige-seeking poker players” in the State Tax Authority.12
Why is it that we never hear that part of Scandinavia’s history from America’s progressive and socialist politicians? Selective amnesia.
The economic chaos didn’t last forever. Beginning in the 1990s, the country started to implement important free-market policies, including spending cuts and reforms to its vast welfare system. As a result of these changes, Sweden’s economy boomed, benefiting everyone.
IKEA, A COMPANY THAT DERIVES HALF OF ITS NAME FROM SWEDISH HERITAGE (E = ELMTARYD, A FARM WHERE THE FOUNDER WAS RAISED. A = AGUNNARYD, THE FOUNDER’S HOMETOWN). A COMPANY WHOSE PRIMARY COLORS WERE DETERMINED BY THE SWEDISH FLAG. IKEA, A COMPANY STEEPED IN NATIONAL PRIDE, LEFT THE COUNTRY IN THE 1970S DURING THE HEIGHT OF SWEDEN’S EXPERIMENTATION WITH SOCIALISM IN LARGE PART DUE TO HIGH INCOME AND CORPORATE TAXES.d
“Sweden went from having half of the economic growth that developed countries experienced in the 1970s and 1980s to having 50 percent growth above the average developed country,” notes the Atlas Network, citing work by Norberg. “Family incomes increased four-fold in that same timeframe.”13
Other Scandinavian nations and regions in Europe experienced similar free-market renaissances in the wake of the collapse of the Soviet Union and the fall of the Berlin Wall.
PIPPI’S REVOLT!
“Astrid Lindgren is the eighteenth most translated author in the world, and one of the most well-known Swedish authors (most known for her stories about Pippi Longstocking). She became an author relatively late in life, and an influential voice on everyday issues even later. Because of her popularity, people listened to what Lindgren had to say.
“At the age of 68 she submitted an opinion piece to the Swedish daily Expressen on the subject of a loophole in the Swedish tax system, which meant that she, as a self-employed writer, had to pay 102 per cent tax on her income. Lindgren wrote the piece in the style of a fairytale, and it had an immediate impact. ‘Pomperipossa in Monismania,’ published in 1976, became front-page news and led not only to a change in the tax law, but eventually to the fall of the social democratic government that had been in power for 44 years.”e
Unlike in the United States, which has steadily expanded many of its welfare programs over the past several decades, Scandinavian countries have moved in the opposite direction. They still have numerous social welfare “safety nets,” sure, but they have largely reversed course on many of the socialist policies they once had in place—policies American progressives and socialists claim would make our country better than ever, despite a mountain of evidence to the contrary.
Having some socialized industries in place doesn’t mean an entire economy can fairly be labeled “socialist.” Imagine for a moment a conservative’s paradise, a true bastion of individual freedom. (Just the thought of people having control over their own money and property is likely making our friend Professor Pete nauseated, but let’s spend a few minutes to think this through.)
In a conservative’s utopia, government’s only function is to protect the rights of individual people and keep communities safe. There are no government-run social safety nets, because charities composed of church groups, philanthropists, and concerned, compassionate citizens take care of those in need. (Contrary to socialists’ beliefs, it actually happens a lot.)
Without massive, multi-trillion-dollar welfare programs, there’s no need for many forms of taxation, including federal income taxes. There’s also no reason to have Social Security, because the elderly, in the absence of huge income taxes, have been able to keep and invest their own money for their entire lives, and families are encouraged to take care of people when they grow old or fall on hard times.
The elimination of most federal regulatory burdens and some unnecessary state and local regulations has allowed for enhanced economic growth and job opportunities. People are wealthier and freer than ever, and in most cases, they have the money to pay for their own children’s education, both at the K–12 and college levels.
Without most taxes, welfare programs, or government regulations, our conservative utopia is about as free as any nation has ever been. But what if our fictional utopia were to retain public, collectively owned roadways? Does that mean that our perfect conservative world would really be just another example of socialism? Of course not. And I doubt there’s a single economist in the entire world—on the right or left—who would disagree.
The truth is, every country on Earth has some government-provided services, and yet no one would say every country has a “socialist” economy. Yes, many Scandinavian nations still have big social safety nets in place and some socialized services—including a few big ones—but they are still worlds away from being what Bernie Sanders, Ocasio-Cortez, and others have been calling for. And Karl Marx—the most influential socialist in world history—would totally reject that Scandinavian countries have systems that come even remotely close to his own vision of what a socialist society should look like—although he would probably approve of their hipster beards.
Any socialist who claims he or she wants America to be more like Scandinavia either doesn’t understand what’s really going on in Nordic nations, is lying, or isn’t really a socialist.
Let’s take a brief look at taxes, for example. Socialists say they are all about forcing businesses and wealthy individuals to “pay their fair share”—whatever that means. They want to dramatically increase tax rates on some middle-income and all wealthy individuals and businesses, so that they can redistribute the wealth to lower-income people.
THE LEFT’S DEFINITION OF “FAIR SHARE”
“FAIR SHARE” = > CURRENT TAX RATE
This isn’t just a policy proposal socialists like, it’s a cornerstone of their whole ideology, one that dates all the way back to Karl Marx. (You know, the whole “from each according to his abilities, to each according to his needs” thing.)
THE 1% IN THE EYES OF SOCIALISTS
Socialists believe that if you have more wealth at your disposal, you should be forced to give it up, because they’ve determined the only reason some people have so much more money than others isn’t because they are more talented or intelligent or innovative or hardworking or anything like that, and it isn’t because they earned it by providing society with a desired good or service. Rather, they say people with wealth—including many in the middle class—should give it up because the only way they got it in the first place is, in part, by exploiting others.
This is exactly why all of the progressive and socialist presidential candidates running in 2020 have said they would fund their numerous proposed trillion-dollar government programs by imposing huge tax increases on the wealthy.
Sen. Elizabeth Warren’s “wealth tax” proposal would create a 2 percent levy on those with $50 million or more in assets and a 3 percent tax on those with assets worth $1 billion or more.14
Bernie Sanders’s tax reform plan would create a new progressive wealth tax structure that would confiscate as much as 8 percent of a family’s net worth.15
Sen. Kamala Harris and Joe Biden said they want to repeal the 2017 Tax Cuts and Jobs Act because, in Harris’s words, it “benefited the top 1 percent and the biggest corporations in this country.”
Indiana mayor Pete Buttigieg said he wants to increase tax rates for the top income brackets only, while also imposing a wealth tax and financial transactions tax.17
If Scandinavians are socialists—or even just progressives—we should expect their tax codes to be in line with many of these proposals, but—brace yourself—they undeniably are not.
It’s true that, generally speaking, Scandinavian countries have very high taxes. But unlike the proposals offered by the leading Democratic Party presidential candidates and socialists, the tax systems in places like Denmark, Norway, and Sweden impose high tax burdens on everyone. Yes, the wealthier in these countries pay higher tax rates than lower-income people, but, in the end, everyone pays a hefty price.
Kyle Pomerleau, the Tax Foundation’s chief economist and vice president of economic analysis, notes, “Scandinavian income taxes raise a lot of revenue because they are actually rather flat. In other words, they tax most people at these high rates, not just high-income taxpayers. The top marginal tax rate of 60 percent in Denmark applies to all income over 1.2 times the average income in Denmark. From the American perspective, this means that all income over $60,000 (1.2 times the average income of about $50,000 in the United States) would be taxed at 60 percent. Sweden and Norway have similarly flat income tax systems.”18
“Compare this to the United States,” Pomerleau said. “The top marginal tax rate of 46.8 percent (state average and federal combined rates) kicks in at 8.5 times the average U.S. income (around $400,000). Comparatively, few taxpayers in the United States face the top marginal rate.”
Put simply: In Scandinavia, middle-class earners are expected to pay much more than they do in the United States. In fact, although socialists and progressives are seemingly always ranting about how supposedly “unfair” the current U.S. tax system is because the wealthy don’t pay enough of the tax burden, the top 17 percent of earners in America already pay three-fourths of all income tax revenue, despite the fact they use relatively few government services. This is a far more progressive, socialistic system than what they have now in many parts of Scandinavia.
SIDE NOTE
So, let’s play this out. If America were to adopt a Danish income tax model and you earn $60,000 per year annually, you would only end up keeping roughly $24,000 of your own money over the course of the year, or about $480 of your weekly paycheck of $1,200.
DOES THAT SOUND “FAIR” TO YOU?
And that’s just income taxes. Many Scandinavians are also required to pay a large value-added tax (VAT). In Denmark, for example, all Danes are forced to pay a 25 percent VAT on goods and services, in addition to numerous other fees and taxes on products. This makes the price of virtually everything more expensive, harming lower-income consumers more than any other group.
So, if Americans were to adopt the Danish income tax model, they would, on top of forfeiting 60 percent of their paychecks to the government right from the start, also be forced to pay 25 percent more on nearly everything they buy. Admit it, you’re starting to feel “taxed enough already,” aren’t you?
Unsurprisingly, most American socialists and progressives hate value-added taxes like these, because they do absolutely nothing to redistribute wealth. Not a single leading Democrat is proposing one as a primary way to raise funds for their big, shiny, new welfare programs.
Taxes aren’t the only area in which Scandinavians differ from American socialists. Consider school choice programs. In Sweden, all parents are eligible to receive a voucher that allows them to enroll their child in any school in the country, whether they are public or private, and the program has proven to be successful for those who take advantage of it.
According to a report by public policy organization EdChoice, “The most vigorous study on the Swedish school voucher system by Stockholm University researchers Anders Böhlmark and Mikael Lindahl concludes that students in non-public (or Independent schools as they are called in Sweden) perform better than their public school peers both in the short term, with increased test results and grades, and the long term, with higher grades in secondary school and at university. Both for-profit and nonprofit private schools showed this positive effect. Furthermore, a recent national survey in Sweden showed that parents who had children enrolled in Independent (private) schools were 10 percent more likely to be satisfied than those with children in municipal schools.”19
In the United States, not a single leading progressive or socialist politician supports creating a universal school choice program. In fact, they have been ruthlessly fighting against school choice for decades. Comrade Bernie isn’t even in favor of charter schools, one of the most moderate forms of school choice. Socialists disdain choice in basically every arena—you know, except abortion.
On Sanders’s 2020 campaign website, Bernie claims “few charter schools have lived up to their promise…. Charter schools are led by unaccountable, private bodies, and their growth has drained funding from the public-school system.”20
Sanders then lamented that “the proliferation of charter schools has disproportionately affected communities of color—17 percent of charter schools are 99 percent minority, compared to 4 percent of traditional public schools. This has led the NAACP, the NEA [National Education Association], AFT [American Federation of Teachers] and others to criticize the charter movement for intensifying racial segregation. The damage to communities caused by unregulated charter school growth must be stopped and reversed.”
At best, this is a wildly misleading, albeit common, claim spread by socialists like Sanders. There’s no question that racial minorities are “disproportionately affected” by charter schools, but that’s because they disproportionately benefit from them. Countless academic studies show that when individuals have more education freedom, education quality improves—just as it does in virtually every industry. Because government-run schools in many inner-city communities are so terrible, it’s more likely for school choice programs to develop in those communities, and thus more likely that the people living there will use them.
A 2016 analysis by EdChoice examined 100 empirical studies of school choice programs, and the results were nothing short of remarkable.21 In the vast majority of papers analyzed, researchers determined school choice programs improve educational outcomes and/or lower costs.
The benefits of school choice experienced by countless parents across the country are the primary reason why the idea of expanding school choice is widely supported by numerous minority groups, including African Americans. A January 2019 survey found 67 percent of Americans likely to vote in the 2020 election were in favor of school choice policies similar to the program in Sweden—including 67 percent of African Americans, 73 percent of Hispanics, and 56 percent of Democrats. Yes, even Democratic voters support school choice.22
Swedes clearly see the value in school choice, too, so why doesn’t comrade Bernie—the same guy who is constantly raving about how wonderful Sweden is? Let me answer that for you. It’s because it would be an admission that competition and choice are proven to deliver better results than government’s best intentions. But remember, when empirical evidence shatters their socialist fairy tale, they have no choice but to repeat the lie.
SIDE NOTE
School choice programs have also been shown to improve surrounding government-run public schools. This is attributed to several factors, including increased per-pupil spending resulting from a retention of certain government funds after a children leaves, as well as a stronger sense of competition with private school competitors.f
One of the most remarkable differences between American socialists and some Scandinavians is on the issue of energy. While democratic socialists in United States like Alexandria Ocasio-Cortez fight tirelessly to try to rid the world of our most affordable energy sources, like natural gas and oil, the Scandinavian nation of Norway has been getting wealthy pumping oil out of the ground—and a ton of it, too.
The Norwegian Ministry of Petroleum and Energy reports, “In the 50 years since Norwegian petroleum activities began, about 47 per cent of the estimated total recoverable resources on the continental shelf have been produced and sold. Thus, there are large remaining resources, and it is expected that the level of activity on the Norwegian shelf will continue to be high for the next 50 years as well.”23
Again, a good translation of this Scandinavian political-speak is, “We’ve been producing a ton of oil for decades, and we aren’t going to be stopping anytime soon.”
Norway is one of the largest oil exporters in the world. In fact, Norway, which only has a population of less than 6 million, has been so successful at earning mountains of cash selling the very same oil products routinely demonized by American socialists that it now has a sovereign wealth fund totaling $1 trillion.24
In 2019, reports also surfaced showing that Norway is working with Chinese companies and the government of China—the world’s largest emitter of carbon-dioxide emissions—to expand its oil exports in Asian markets and to cooperate with Chinese oil producers on oil and gas exploration.25 Can you imagine anyone in the Democratic Party today supporting such efforts?
These new relationships between Norway and China followed several years of reduced trade and business activities resulting from a decision by the Norway-based Nobel Committee to award a Chinese dissident with the Nobel Prize in 2010. China only agreed to thaw its relationship with Norway after the government agreed not to “support actions that undermine” the Chinese government’s interests.26
Yeah, but they are using the fortune they have amassed from fossil-fuel production to do it. And there’s no sign they plan to stop anytime soon. Norway projects it will within the next decade match or exceed its record for petroleum production, all while we’re being warned by American socialists that the world is on the verge of a climate change catastrophe because of man-caused global warming.
You say you want the United States to be just like Scandinavia, but do you really mean it? You want a culture that’s extremely homogeneous? You want fewer business and financial regulations? You want lower- and middle-income people to pay a greater tax burden? You want school choice? You want balanced budgets (or close to it)? You want the United States to continue growing its fossil fuel production? These policies are “democratic socialism” to you?
Ah, yes, the whole “everything is better in Scandinavia” myth. That’s one of my favorites!
First of all, let’s remember that in order to be like Scandinavians, we would need to flatten our tax system and reduce regulations and government spending. Is that really what you want to do?
Second, although there’s no doubt—none at all—that nations like Denmark and Sweden have a lot to offer and certainly are not comparable to socialist hellholes like Venezuela, there’s absolutely no evidence to suggest the people there are much better off than most folks in America.
For starters, middle-income Scandinavians have to pay outrageously high taxes. As I noted earlier, if the United States were to have a comparable tax structure as the one in place in Denmark, Americans would have to pay a whopping 60 percent of all income earned over $60,000 to the government. Although that would be Comrade Sanders’s dream come true, it would be a nightmare to most Americans.
In Sweden, 44 percent of all total domestic income is paid in taxes, while in the United States, the tax burden amounts to just 26 percent of total income. That’s a big reason why Americans’ average disposable income—which includes what people pay in taxes—is higher than in any of the Scandinavian countries, and even in the entire world.27
This translates to bigger houses, bigger cars, and even bigger appliances. If you ever make a habit out of watching television marathons of shows like House Hunters International, you’ll start to notice terms like “American fridge” or “American-style.” That’s because having a large fridge or even an in-home washing machine or dryer is not nearly as common in other countries as it is in America.
And Americans like it that way, too. According to a 2018 Gallup survey, about 45 percent of U.S. adults say they want more disposable income and that their taxes are too high28—a fact made even more stunning when you consider it’s estimated just 44 percent of Americans pay federal income taxes.29 Do you really think if these Americans had their tax burdens nearly doubled, in line with what citizens pay in Scandinavia, they would think they are better off?
Americans in many parts of the country also have access to lower housing prices and bigger homes than in most of Scandinavia, and Americans pay substantially less for important goods and services, like motor-vehicle fuel30 and many foods.
And there it is. As soon as you brought up the Scandinavian socialism myth, I knew we would eventually end up discussing single-payer health care, the pot of gold at the end of every American socialist’s rainbow.
Whenever people like Bernie Sanders endlessly praise the “achievements” of Scandinavia, they aren’t referring to the relatively free markets of Denmark, school choice programs of Sweden, or the energy policies of Norway. They are nearly always attempting to convince Americans to support government programs similar to Scandinavians’ socialized health care systems.
Look, no one hates the bureaucratic nonsense, paperwork, and absurd rules of the modern health insurance system more than I do. (Just try reading those ridiculous health insurance contracts without having your head explode.) But putting government bureaucrats in charge of the health insurance industry won’t fix our very flawed system. It will only make it worse. Much worse. Much, much worse.
Single-payer health care models are appealing to many because they offer health coverage to everyone, making them far less complex than the current system. Patients don’t need to worry about navigating the health insurance system. Doctors don’t need to worry about hiring staff to comply with impossible-to-understand insurance arrangements. (Although they do have to worry about plenty of additional government regulations.) And people are covered regardless of whether they work, so there is no preexisting conditions problem that must be dealt with.
On the surface, it seems to many like a better, easier to understand system. But for every one advantage single-payer programs provide, there are countless other unavoidable and serious flaws.
One such flaw is that government-run programs almost never spend money efficiently. This is precisely why Amtrak, the Postal Service, and numerous government agencies are constantly operating above their budgets and routinely fail to provide services that match the quality of their privately-owned competitors. I mean, seriously, is anyone still willing to make an argument in favor of the Postal Service? It lost $3.9 billion in fiscal year 2018.31
When it comes to government waste, one of the biggest culprits is Medicaid—which, remember, is a government health care program. In 2017, government officials acknowledged that the improper payment rate for Medicaid is very likely higher than the official 10 percent estimate, and in 2015, the Government Accountability Office reported improper payments totaled at least $137 billion.32 Can you imagine how many trillions of dollars would be wasted if the same federal government that wastes more than $100 billion per year were to be put in charge of the entire health care system?
You might think federal officials would be embarrassed by this poor record, but they aren’t. The national government has a long track record of wasting taxpayers’ money on truly outrageous government projects. Just one of the hundreds of examples a simple internet search will reveal is the government’s decision to spend $518,000 “to study how cocaine affects the sexual behavior of Japanese quails.”33 (By the way, are birds really snorting cocaine now? How did I miss this news story? Although, it would explain a lot about Woody Woodpecker.)
As ridiculous as it is to study the sexual proclivities of coked-up Asian quails, there are other even more egregious examples of waste. For instance, the federal government spends an estimated $1.7 billion per year servicing empty government-owned buildings.34 (Of course, maybe that’s a good thing. Better to pay for an empty government building than one full of bureaucrats hell-bent on finding ways to waste even more money.)
And these are just the tip of the iceberg. Citizens Against Government Waste has identified more than 600 recommendations to reduce government waste in its Prime Cuts report. According to CAGW, if the government were to make its recommended cuts, it would save a whopping $429.8 billion in the first year, and more than $3 trillion in just five years.35 There’s your infrastructure-improvement fund.
Given this tremendous amount of waste, it’s clear that government is completely unequipped to operate the United States’ gigantic and extremely complex health care system. At the very least, shouldn’t the government be expected to cut its current level of waste before taking on massive new projects?
A second problem is single-payer health care systems are hugely expensive for taxpayers. An analysis of Sanders’s “Medicare for All” plan by Charles Blahous at the Mercatus Center at George Mason University determined Sanders’s proposal would cost, at minimum, a stunning $32 trillion in additional federal spending over just 10 years.36
And that’s likely an extremely conservative estimate, too. Many of the existing Medicare for All plans, including Sanders’s plan, include provisions that would mandate the federal government only pay the same reimbursement rates given to doctors and hospitals in the current Medicare system. But there’s just one problem: Applying Medicare reimbursement rates across the country would very likely bankrupt most of America’s hospitals. On average, Medicare only reimburses hospitals 87 cents for every dollar spent.37 How do hospitals stay in business? By charging people with private health insurance significantly more for health care services to make up the difference.
But even if we assume that Medicare for All will only cost the lower-end $32 trillion estimate, Blahous notes “doubling all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan.”
Many socialists and progressives say they could pay for Medicare for All by raising taxes on the richest Americans, but this is a lie, plain and simple. The Tax Foundation calculated how much money would be raised by increasing the top marginal tax rate to 70 percent for the wealthiest earners, and it found it would only increase revenues by $300 billion annually.38 That’s less than 1 percent of the 10-year cost of the lower-end estimate for Medicare for All. Less than 1 percent.
Even worse, you could confiscate every dollar from every single person on Forbes’ list of the 400 richest Americans—including Amazon’s Jeff Bezos, Microsoft’s Bill Gates, Berkshire Hathaway’s Warren Buffett, and Facebook’s Mark Zuckerberg—and it would only amount to $2.9 trillion—less than 10 percent of Medicare for All’s 10-year cost.39 Nice try, Comrade Sanders. Your math sucks.
You can’t expect to tax the wealthy and pay for gigantic government programs like Medicare for All. The middle class will also have to pay much more in taxes, too, just as they do in Scandinavia. The Heartland Institute, a free-market think tank, estimates the passage of single-payer health care would mean “millions of middle-class individuals and families would need to pay thousands of dollars more every year for health coverage than they do now.”40
Heartland’s analysis shows if Medicare for All becomes law, households earning $50,000–$75,000 would see their federal income tax bills in 2022 increase by an average of $7,773 to $9,171. Households earning $75,000–$100,000 would pay $12,612 to $14,880 more in new taxes. That increase in tax burden would leave your average American family asking important questions like, “Can we go another year or two without buying a new car?,” and “What flavor ramen do you want to microwave for dinner today?”
A third problem is health care rationing. Because large tax increases such as these often cause so much damage to an economy, in many cases governments choose to combine tax increases with health care rationing, creating harmful and sometimes dangerous increases in the amount of time patients are required to wait before being seen by a doctor.
Although long wait times exist in virtually every single-payer health care system, some of the most detailed reports on wait times come from Canada, whose system is routinely praised by Bernie Sanders and other socialists.
The Canada-based Fraser Institute reports each year the average time Canadians must wait to receive medically necessary elective treatment, from the time a patient is first referred to a specialist by a general practitioner to the moment he or she receives the needed care. The Fraser Institute’s analysis shows Canadians often must wait for months for important treatments and even some forms of medical testing.41
The average wait for Canadian patients needing cardiovascular surgery is nearly 10 weeks. Patients seeking general surgeries must wait for more than three months. Gynecological treatments take on average more than 20 weeks. Orthopedic surgical patients must wait more than nine months. Need brain or spine surgery with a neurosurgeon? You should expect to wait on average more than 26 weeks.
Now, I’m not a doctor—that’s a shocking admission, I know—but I’m pretty sure that people suffering with tumors in their brains shouldn’t wait for six months before receiving treatment. And yet, that’s exactly what’s happening in Canada.
For many specialties, wait times in Canada are significantly longer than in the United States. For example, U.S. patients needing orthopedic surgery wait only an average of 11 days from the moment of referral to the first appointment with an orthopedic surgeon.42 In Canada, the average wait for a similar appointment is longer than 14 weeks. That’s the kind of math even a socialist can understand. Maybe.
Things aren’t much better in England, another country with a single-payer health care system. Rationing has become such a terrible problem there that government health care administrators recommended in 2018 that patients should start meeting with their primary care doctors in groups as large as 15.43 You know, the group therapy approach to all kinds of health care treatments. Sounds great!
“It is billed as an attempt to alleviate strain on family doctors, many of whom complain of being overworked,” The Telegraph reported in October 2018.
EDITOR’S FACT CHECK
GLENN IS ACTUALLY A DOCTOR. HE RECEIVED AN HONORARY DOCTORATE IN HUMANITIES FROM LIBERTY UNIVERSITY AND IS NOW WORKING ON OPENING HIS OWN EAR, NOSE, AND THROAT CLINIC IN IDAHO.
“Group appointments of between 10–15 people with the same condition have been piloted in Slough in Berkshire, London, Birmingham, Manchester, Sheffield, Newcastle and Northumberland. Doctors at the Royal College of GPs’ annual conference… said the groups were a ‘fun and efficient’ way to carry out consultations with patients who shared the same conditions.”
Yeah, nothing says “fun and efficient” like telling 14 of your neighbors about that weird thing growing on the back of your neck, or how that anti-fungal cream you’ve been prescribed just doesn’t seem to be working as well as you’d like. And who doesn’t like discussing hemorrhoids with complete strangers?
SIDE NOTE
Regional Clinical Commissioning Groups (CCG) across the UK are initiating rationing restrictions to cope with budget short-falls. Some CCGs are delaying procedures for smokers and the obese. Others are suspending services, including in vitro fertilization.h
Additionally, let’s not forget the U.S. federal government already operates a single-payer health care system—the Veterans Health Administration—and it’s a complete disaster. Not only are VA hospitals often outdated and poorly funded and managed, they also suffer from numerous service problems, including long wait times. According to a 2019 report by USA Today, “At roughly 70 percent of VA hospitals, the median time between arrival in the emergency room and admission was longer than at other hospitals, in some cases by hours, according to a USA TODAY analysis of the department’s data. That included Loma Linda, where the median wait is more than 7½ hours.”44
Is it any wonder then that patient satisfaction at VA hospitals is much lower than in non-VA hospitals? USA Today reported VA scorecards of patients’ satisfaction with their treatment, “Nearly every VA facility—141 out of 146—scored below other facilities on a majority of questions surveyed.”
IF THIS IS HOW THEY TREAT AMERICA’S HEROES, HOW WELL DO YOU THINK THEY WILL TREAT YOU?
Actually, no, they haven’t. Many of the same problems plaguing the health care systems of government-managed systems around the world are also rampant in Scandinavia.
Nowhere has this been more obvious than in Finland. In 2019, Finland’s coalition government, including Prime Minister Juha Sipila, resigned after failing to push through reforms that would have restructured the country’s collapsing single-payer health care system.45
The primary problems in Finland are skyrocketing costs and demographic changes. Like the United States—and most of the Western world—Finland’s population is aging, pushing the country’s already outrageously high tax burden on a shrinking group of working-age Finns. By 2030, more than one-quarter of the country is expected to be 65 years old or older.46
In order to keep Finland’s health care model afloat, policymakers need to raise taxes even higher, ration care and cut costs, and/or make substantial changes to the way the system is organized. Sipila’s proposed reforms would have cut health care funding by billions of dollars by 2029. “We need reforms, there is no other way for Finland to succeed,” Sipila said.
When Sipila failed to garner enough political support to make the necessary reforms, much of the administration resigned.
As one Reuters report noted, Finland isn’t the only Scandinavian country struggling to keep its single-payer system from falling apart: “Other Nordic countries have also grappled with the need to cut costs…. Denmark will gradually increase the retirement age to 73—the highest in the world—while cutting taxes and unemployment benefits to encourage people to work more.”47
In Sweden, not only are policymakers raising the retirement age to force citizens to work later into their lives so that they’ll keep contributing tax revenues, they have also done the unthinkable: They have “opened up parts of the healthcare system to the private sector in a bid to boost efficiency.”
Wait a second. Let’s read that again. Swedes are turning to the private sector “to boost efficiency.” Huh. It turns out there’s nothing magical about Scandinavians’ government-managed health care systems after all.
It’s easy to understand why you might think life expectancy is a good indicator of how well a health care system is functioning, but the more you look at health care data, the more obvious it is that life expectancy isn’t a good way to judge a country’s quality of life or the quality of available health care services.
The reported life expectancies of Chile, Greece, and Slovenia are also better than the United States’ life expectancy, but you don’t see Americans rushing to move to Greece or raving about the high living standards in Slovenia.
In fact, the Organisation for Economic Co-operation and Development’s Better Life Index ranked the United States seventh in its “Health” category in 2019, higher than every Scandinavian country and dozens of others with single-payer health care systems.48
You might be wondering why the United States has a lower life expectancy if it’s not directly related to differences in the quality of health care systems. The answer is complex, but here’s the CliffsNotes version: Americans are too fat and love to drive cars.
Due largely to cultural differences, Americans are considerably fatter than people in many other countries around the world—and much heavier than Scandinavians. (Trust me, I know. I’ve got a donut hanging out of my mouth as I write this.) Diet plays a critical role in determining life expectancy because many of the deadliest diseases in Europe and North America are directly or indirectly related to diet, especially heart disease, the United States’ number-one killer.49
In fact, despite having less than 5 percent of the world’s total population, the United States is home to about one-quarter of the world’s severely obese men.50 Ladies, you’re not off the hook, either. There are more severely obese women in America than anywhere else on Earth.
The situation in Scandinavia is very different. Many Scandinavian countries have much healthier diets and lower BMIs. For instance, Denmark’s average BMI is among the lowest one-quarter and one of the lowest in Europe.51
Some have argued that access to health care is the primary reason for these differences, but Scandinavians have long had better diets and lower BMIs compared to many parts of the United States,52 dating back well before the development of modern health care.
If we want our fellow Americans to live longer lives, we don’t need a bureaucratic takeover of the health care industry, we need to replace our love for donuts, Twinkies, and Big Macs with fruits and—eh, those green things everyone is always talking about.
During an interview for a 20/20 special titled “Sick in America,” John Stossel spoke with liberal activist/filmmaker Michael Moore. Stossel explained why America’s life expectancy is lower than some countries in perhaps the most blunt way possible. Stossel, responding to Moore, says, “In America, we kill each other more often, we shoot each other, we have more car accidents—forgive me, MORE OF US LOOK LIKE YOU.”
Since the early twentieth century, Americans have been absolutely in love with the automobile. By as early as 1913, 80 percent of the world’s cars were being produced in the United States.
There’s nothing better—or more quintessentially American—than getting the family together and hitting the open road. The feeling of freedom, the wide expansive roadways that stretch for thousands of miles, the sense of adventure, the screaming children in the backseat—okay, I could do without the screaming, but you get my point.
Americans love cars, but their constant driving comes with a much higher risk of motor-vehicle fatalities. The World Health Organization reports the likelihood of dying from a road traffic accident is significantly higher in the United States than in Scandinavia. In 2016, Americans were more than three times as likely to die from a traffic accident as Danes and more than four times as likely as Norwegians or Swedes.53
When you take traffic-related and obesity-related deaths into account, the life expectancy differences between nations drop. These aren’t the only factors, of course, but they are important ones that often get ignored by those who think, based on no hard evidence, that increased government involvement can fix the U.S. health care system.
America’s health care system is far from perfect, and one of its biggest problems is that health care is much more expensive than it ought to be. But, as I already explained in Chapter 1, much of the problem is being driven by government’s involvement in the industry.
The health insurance and health care systems are significantly flawed because the forces that normally exist in markets have been removed, blocked, or weakened by regulations and the tax code. Making health care more affordable would require unleashing innovators, entrepreneurs, and consumers from the shackles of the current government-manipulated marketplace.
But that’s only part of the issue. Sometimes, it’s true that you get what you pay for. And while Americans do end up paying a lot for health care, they also have access to the best health care facilities and doctors the world has ever seen. Many of the world’s most talented physicians and medical researchers travel from across the globe to come to the United States, where they can worship (or not worship) God in the way they choose, own a home, speak freely, and enjoy equal treatment under the law—all while earning a heck of a lot more than they can elsewhere.
America is home to many of the most important and exciting medical innovations, in large part because of the promise that those who provide important, breakthrough medical technologies and innovations will be rewarded financially for their achievements and hard work. I know it’s hard for socialists to acknowledge, but history, anthropology, and even biology clearly show people are generally motivated by self-preservation and personal (including family) enrichment.
There isn’t a flood of medical doctors, researchers, and other professionals banging down Finland’s door to join its failing health care system, but that’s exactly what’s been going on in the United States for decades.
Because there is a doctor shortage. But that’s not because there aren’t enough people wanting to become licensed U.S. physicians, it’s because the current system has numerous bureaucratic controls that significantly limit the number of doctors licensed every year. Without those requirements, many of which are unnecessary, we’d have more than enough physicians.
No one is suggesting that it’s good for individuals or society that some Americans are still living without health insurance coverage. But the goal ought to be to create a system that makes health insurance and health care affordable for everyone—a goal that really can be achieved. It shouldn’t be to put the same ridiculously irresponsible people in charge of health care who have run up a $22 trillion national debt.
I’m glad you referred to the importance of “freedom,” though. Liberty has real value. In fact, it’s the foundation of our society. Without freedom, everything else would collapse: the economy, our families, our faith—everything. But history has repeatedly shown that freedom and socialism are completely incompatible. They literally can’t coexist, because at the heart of socialism is the belief that individual rights don’t mean as much as accomplishing the goals of whoever is in charge of the government—you know, the people with all the guns and tanks.
Even in the most peaceful countries that have socialized health care systems, there is some degree of tyranny. There must be, because without it, there’s no way to manage the system effectively.
GHOST OF
KARAL MARX
“HERE, HERE! FINALLY, YOU SAID SOMETHING I CAN GET BEHIND.”
Single-payer health care models only allow for one option—hence the “single” in “single-payer.” Whatever the government decides, goes. And if that happens to conflict with the rights of individuals, well then, that’s unfortunate, but at the end of the day, whatever is considered to be in the best interests of the collective must be the primary goal. And who decides that? The tiny minority of people at the top of society who claim they are representing the best interests of the collective—whether they actually are or not.
There are endless examples of how government has used its power to silence individuals or take away their rights, especially on the issue of health care. But let’s turn to one both of us are old enough to remember—although I’m willing to bet only one of us will: Barack Obama’s war on the religious rights of Catholic nuns.
Following the passage of the Affordable Care Act in 2010, the Obama administration’s Department of Health and Human Services issued a regulation mandating many employers offer their employees health insurance coverage that included “free” contraceptives, including birth control—even if it violated the religious beliefs of the employer.
Following the mandate, several religious nonprofit organizations—including Little Sisters of the Poor, a Catholic order of nuns—refused to provide the contraception coverage and sued, alleging, among other things, that the mandate violated federal law and their religious liberties. The Obama administration imposed tens of millions of dollars in fines, and the case ended up in the U.S. Supreme Court.
In May 2016, the Supreme Court ruled against the Obama administration in Zubik v. Burwell on narrow grounds, blocking the fines and sending the cases back to lower courts. At the time of this writing, the nuns and other religious organizations involved in the lawsuit are still fighting in court, a decade after the Affordable Care Act first became law, despite efforts to resolve the issue by the Trump administration.
Regardless of what you think about abortion or contraception, at least two things are crystal clear from the nuns’ saga: First, the Obama-era contraception mandate would force the members of these nonprofit organizations to violate their religious beliefs, and second, the Obama administration knew it was trying to impose its views on these religious groups, but thought that its goal of providing affordable birth control pills was more important.
Although Obamacare isn’t a single-payer system, these problems only become more frequent and more extreme when government has total or near-total control over health care. And it also serves as an important illustration of how socialists and many progressives view individual rights. Do socialists and progressives care about religious freedom? Some do, sure, but only if that freedom doesn’t get in the way of some other, more important goal of those in charge, like making nuns pay for birth control.
In single-payer health care systems, religious liberty—and indeed, many other kinds of personal freedom—never survives. It can’t survive. Its mere existence means those in charge don’t have absolute power, and even though they rarely admit it, obtaining power is nearly always one of the chief goals of government officials operating socialist programs.
Consider, for example, the heart-wrenching case of Alfie Evans in the United Kingdom—a country in which the health care system has been completely socialized. In 2018, Alfie, a 23-month-old boy from Liverpool, was suffering with a deadly degenerative neurological condition. Alfie’s parents, Tom and Kate, did what any parent would do in a similarly tragic situation: absolutely everything they could to save their son’s life.54
Unfortunately, the health care professionals at Alfie’s hospital, the government-managed Alder Hey Children’s Hospital in Liverpool, England, determined they should withdraw care and allow Alfie to die, despite pleas from the parents for care to continue. The parents then requested to move Alfie out of Alder Hey Hospital, potentially to another country, but the staff at Alder Hey refused.
Alfie’s parents sued, hoping to obtain permission from a U.K. court to send Alfie to Italy, where officials even went so far as to offer Alfie citizenship in a last-ditch attempt to have the boy sent to a children’s hospital in Rome. But the courts refused and instead allowed Alfie’s life-support to be removed.55 Alfie died soon thereafter. Or, put more bluntly and accurately, the government-run hospital in England killed Alfie by withholding care.
In its final ruling on the Evans case, the United Kingdom’s Supreme Court issued a truly stunning and horrifying decision about the rights of parents that will hopefully serve as a warning to all who desire to put government in charge of the health care industry in the United States.
“[P]arental rights are not absolute…. [existing laws] make it clear that when any question of the upbringing of a child comes before the courts, the child’s welfare is the paramount consideration,” the judges wrote, adding that “the best interests of the child are the ‘gold standard’ which is not only adopted by our law but also reflects the international standards to which this country is committed.”
And who, exactly, decides what’s in the best interests of Alfie Evans? According to the United Kingdom, it’s not the parents, who don’t know enough to make that decision. It’s hospitals, doctors, other medical professionals, and, of course, the courts.
“It is therefore clear law that the parents do not have the right to use the writ of habeas corpus to acquire the custody of their child if this will not be in his best interests,” the justices continued. “The decisions of the trial Judge clearly amount to decisions that the parents have no right to direct Alfie’s future medical treatment. This is not a criticism of them. How could it be? It simply means that they cannot take Alfie away from Alder Hey for the purpose of transporting him at some risk to other hospitals which can do him no good.”
And as if that weren’t enough, the judges also wrote, “It has been conclusively determined that it is not in Alfie’s best interests, not only to stay in Alder Hey Hospital being treated as he currently is, but also to detain him… for that purpose. The release to which he is entitled, therefore, is release from the imposition of treatment which is not in his best interests.”
Put more bluntly, because the doctors and courts think Alfie should die, that’s in his best interests. Keeping this baby alive is nothing more than an “imposition.”
What can we learn from this tragedy? Maybe the doctors at Alder Hey and the judges and lawyers involved in the ensuing legal battle really did have the best interests of Alfie and his parents in mind when they determined Alfie’s life wasn’t worth living. It’s true that it’s unlikely Alfie would have survived had he ended up in Italy, or anywhere else for that matter. Yes, miracles do happen, but the chances of survival were slim, and the chances of Alfie living a normal life were virtually nonexistent.
But this case isn’t about whether it was time for Alfie’s life to end, and I hope that’s not what you take away from the story. It’s about who has the right to make that decision, and upon what basis does that right exist. We’re not talking about your run-of-the-mill bickering over regulations, gas taxes, or bans on saturated fat. This is about life and death, and who has the power to make those choices.
In the United Kingdom, just like in many Scandinavian countries and most of the rest of the world, the answer couldn’t be clearer: Government has the ultimate authority to decide what happens to you. Government has the ultimate power to determine what’s in your “best interests”—even if it that means death.
-GEORGE BERNARD SHAW
Do you think your life is worth living? Do you think your child’s life is worth living? Or even just worth trying to save? In socialistic systems of every kind—even if a system’s policymakers are democratically elected and relatively peaceful—it doesn’t matter what you as an individual think or feel or believe. Your “rights” are nothing more than permission slips granted to you by the only higher power that really matters to socialists: government.
SHOULDN’T YOU HAVE THE RIGHT TO DEFEND YOURSELF AND MAKE YOUR OWN HEALTH CARE DECISIONS?
Every single American should have access to affordable health care services—and they could, too, if government were to just get the heck out of the way of health care innovators and entrepreneurs. I support ideas that will increase access to health care, and I even support allowing states to create safety nets for those who truly can’t take care of themselves.
But on the issue of whether health care is a “right” that must be provided to everyone, I couldn’t possibly disagree more. If everyone really is entitled to health care services, then that means others have lost their fundamental rights to work for a wage they believe to be fair, control their own lives and property, and to make health care decisions for themselves.
Or, to put it into terms even Alexandria Ocasio-Cortez can understand: The only way to make health care a right is to take away other people’s rights, and any “right” that requires the destruction of others is really no right at all.
I know it’s popular for socialists and progressives to claim people are entitled to various goods and services. Virtually every one of the gazillion 2020 Democratic presidential candidates insisted health care must be provided to everyone because, as Elizabeth Warren said during one of the presidential primary debates, “Health care is a basic human right. We fight for basic human rights, and that’s why I’m fighting for Medicare for All.”
I know this sounds appealing at first, but the more you think about it—I mean, really think about it—the less it makes sense.
If health care must be provided to all people, then that means some person—who also has rights—must provide it and pay for it, right? (At least until the robot uprisings.) This means doctors, physician assistants, nurses, and others in the health care industry must give care to those in need, but certainly no one would argue they would have to provide it for free. That would make them slaves. But if health care providers aren’t to be forced into slavery, then they must be paid a wage. How much should they get paid?
In a free society, compensation is determined by free exchange: You have money. I have something you want to buy. We agree on a price, and then we trade. That can’t exist in a socialized medical system—or any socialized system, for that matter—because if health care providers are only required to work under conditions they freely agree to, then it’s possible that their compensation will be higher than what the socialized medical system can afford to pay, or even just lower than what the system is willing to pay. So, doctors and other providers in a socialist system don’t have any power to negotiate prices. They get paid whatever the people in society say they deserve—even if it’s much lower than they would receive in a free-market model.
Imagine how absurd this would be if applied to almost any other industry. For example, let’s say Americans get together and demand socialized fast-food joints. Everyone has the right to a juicy burger. In a socialized system, burgers would be paid for through tax revenues. Everyone who wants a burger would be free to have one, whenever he or she (or xe) desires.
In such a scheme, how much do burger-flippers get paid? Well, whatever we, as a society, choose to pay them. So, to keep our taxes low, let’s say we choose to pay burger-flippers almost nothing, maybe just a few dollars an hour. Even if the burger-flippers think the wage is “unfair,” because they think their time or talents are worth more than what they are being paid, it wouldn’t matter. All that would matter is that we, the people, demand burgers, and since we have a “right” to as many juicy burgers as we want, they would have to make them for whatever we decide to pay. If this isn’t a form of exploitation, I don’t know what is.
And as silly as it might seem on the surface to compare universal access to health care to universal access to burgers, remember that in socialism, “rights” are whatever the majority of people say they are. So, what’s to stop the collective from deciding there really is a “right” to free burgers or free cars or free internet or free housing or anything else?
No, you can’t. Because deciding what is “fair” requires freedom on the part of the worker. If health care workers have absolutely no ability to negotiate their wages, then they don’t have “freedom” in any meaningful sense. They are forced to either find a new profession or work for whatever society—represented by the government—decides to pay, whether it’s a “good” wage or not. In socialized medicine, health care workers have virtually no rights. All the power rests with the collective.
You might think so, sure. It’s easy to take away the rights of others. But think carefully about what you’re calling for here. You want to give nearly endless power over health care to the very same government socialists say is constantly engaging in crony deals with large corporations and special interests. The same government many socialists claim is “racist” and “sexist.” If you don’t trust the way the system works now, why would you want to give those in power even more power?
Once you put a socialist system in place, you’re at the mercy of the rest of society. Now, maybe today you’re not worried about that. You think the tides have turned in your direction and that most people will generally support your positions. (That seems a little delusional, by the way—since, you know, Donald freaking Trump was recently elected president and Republicans have had control of at least one chamber of Congress in all but four years since 1995.) But even if you think the socialism wave is going to last for a few more years, surely you can’t be so crazy to think it will last forever.
Even if socialists sweep the next few elections, someday, people will once again control Washington who hold views you find reprehensible, and they could use their power to force you to live in ways that violate your personal beliefs. Socialism is dangerous because unbridled power is dangerous—not just for people like me, but for everyone, including you.
We’ve already seen governments in countries with single-payer health care try to control personal behavior or even punish people because they have been deemed by the bureaucrats in charge to be less than ideal, for one reason or another. For example, The Guardian reports, “Couples are being turned down for NHS [National Health Service] fertility treatment in some areas of England because the man is too old or too fat, despite neither criteria forming part of national guidelines or being proven to affect the success of IVF [in vitro fertilization].”56
England’s National Institute of Health and Care Excellence—which goes by the insanely creepy Orwellian acronym “NICE”—also produced a report estimating the cost-effectiveness of in vitro fertilization and concluded providing obese women with IVF resources is probably not a good investment of the government’s limited money and time.57 If translated into official policy, wouldn’t this reform be the very definition of oppression? Because a woman is deemed “too fat,” the health care system won’t help her have a child? Sounds an awful lot like eugenics to me.
Government-managed systems have also been caught rationing care for people based on age. For instance, the London-based Times reported in April 2019, “Tens of thousands of elderly people are left struggling to see because of an NHS [National Health Service] cost-cutting drive that relies on them dying before they can qualify for cataract surgery, senior doctors say.”58 Death as a health care policy seems a little counterproductive.
So, the supposedly compassionate, bleeding hearts running England’s health care system are now allowing people to go blind so that they can prioritize health care spending elsewhere. Is this what advocates of government-run health care mean when they promise Americans they will all have “quality” health care? Blindness?
And eyesight isn’t the only thing Americans should be worried about losing under a single-payer plan. Rationing could be implemented for almost anything based on age. Under a single-payer health care system, if grandma is “too old” to warrant a costly hip replacement, well, that could be too bad for grandma—and you, too, if you’re stuck taking care of her.
The same could be true for brain tumors. Maybe it’s not worth spending limited government resources to keep an older person’s cancer from spreading when there are younger people waiting for a similar procedure.
Of course, many of those who want to ram single-payer health care down Americans’ throats aren’t admitting that there will be significant rationing. Why would they? Admitting that rationing could be a problem would undermine their efforts to create a single-payer system and obliterate the notion that we have reached a post-scarcity world.
Recent history has shown socialists and progressives routinely make health care promises they can’t deliver—and many they never had any intention of delivering in the first place. When Barack Obama was peddling Obamacare to a very concerned American public, he promised, “If you like your health care plan, you can keep it,” despite countless warnings from health care experts that the provisions of the bill would almost certainly require numerous individuals and families to purchase new, much more expensive health insurance policies.
After the Affordable Care Act became law, millions of people lost the health insurance coverage they liked, as well as access to their doctors. Even PolitiFact, which is hardly sympathetic to free-market causes, acknowledged Obama misled the public, naming Obama’s promise its “lie of the year” for 2013.59 (Why can’t we get awards shows for things like this? I’d watch the Fibbie Awards.)
Allowing people to keep their health insurance wasn’t the only broken promise Obama made, either. He also repeatedly pledged that his health care legislation would “cut the cost of a typical family’s premium by up to $2,500 a year.”60 Instead of having their health insurance bills cut, premiums and deductibles increased dramatically, in many cases more than doubling.
And when the Obama administration wasn’t busy writing—along with a bunch of far-left special-interest groups—one of the worst pieces of health care legislation ever devised, it was scheming up ways to lie to the American people so that it could get it passed.
One of the architects of the Affordable Care Act, Jonathan Gruber—an economics professor at the Massachusetts Institute of Technology who was paid hundreds of thousands of dollars to help write the legislation—admitted during an October 2013 event that the Affordable Care Act was deliberately crafted to mislead Americans, who he said suffer from “stupidity.”
“In terms of risk-rated subsidies, if you had a law which said healthy people are going to pay in—it made explicit that healthy people pay in, sick people get money—it would not have passed,” Gruber said. “Lack of transparency is a huge political advantage. And, basically, call it the stupidity of the American voter or whatever, but, basically, that was really, really critical for the thing [the Affordable Care Act] to pass.”61 Isn’t it comforting to know how much your government believes in your “stupidity”?
Yeah but Obamacare wasn’t the first time health care promises have been broken. Both political parties have been making and breaking health care promises for decades. And many of the same politicians who supported Obamacare and repeated the false promises made by President Obama are now making similar wildly unrealistic commitments and predictions about Medicare for All. If they misled you before, what makes you think you can trust them now?
This is always how progressives and socialists behave. They promise you the world, and when they fail, they blame it on someone else—usually the opposing political party or some unlucky group of scapegoats they can pin their failures on. Then they make even more promises they know they can’t keep: “Just give us a little more money. Just sacrifice a little more of your freedom. In the end, it will all be worth it. Trust us.”
They’re not worthy of your trust. Remember, these are the same people who spent half a million dollars to study the effects of cocaine on the sexual behavior of Japanese quails.62
And we don’t need to speculate about the possibility of government-led rationing. In recent years, some politicians have openly called for it. For example, in an effort to shore up the state’s skyrocketing Medicaid budget—which, by the way, is largely the result of Medicaid expansion policies put into place by the Affordable Care Act—Massachusetts submitted a proposal to the federal government to reform its Medicaid program so that it could cut drug coverage options. (The Trump administration eventually rejected the plan.)
Writing for the Washington Examiner, Hadley Heath Manning, a senior policy analyst and director of policy at the Independent Women’s Forum, explained the “Massachusetts’ proposal includes… a ‘closed formulary’ for Medicaid beneficiaries. This means the program may offer only one drug per class (a class is something like antidepressants or anticonvulsants used to prevent seizures). For patients, this means the government will essentially dictate to physicians how to treat patients, interfering between patients and doctors.”63
For patients who rely on pharmaceuticals, this concept could lead to serious health care problems. People often respond very differently to multiple drugs in the same “class.” It is not uncommon for patients to try out a number of drugs to determine which one fits best with their body’s biochemistry. Effectively forcing patients to take drugs that might not work well for them would have a profound impact on people’s health and well-being. And yet, that’s exactly what Massachusetts attempted to do—all in the name of cutting costs, also called “rationing.”
A whole lot, actually. For starters, any good doctor—or even an honest crappy doctor—would tell you that the best kind of health care decision-making occurs when doctors and patients work directly together. The human body is incredibly complex; it’s not like an old tractor or something. “Just plug in that new heart, Jeb. Should work just fine.”
The best treatment is deeply personal and occurs when doctors have a complete understanding of their patients. In many cases, hundreds or even thousands of variables are taken into account. Sometimes, it takes years for patients to find the right treatment. You can’t have a high-quality medical system and a system in which health care decisions are made by a board of doctors who have never met a patient and don’t know the intricate nuances of that person’s medical history.
THE GOVERNMENT DOES NOTHING MORE EFFICIENTLY OR EFFECTIVELY THAN THE PRIVATE SECTOR—OTHER THAN OPERATE THE MILITARY, WHICH MEANS THE ONLY THING GOVERNMENT DOES REALLY WELL IS DESTROY.
And this all assumes, of course, that federal and state health care agencies would be composed mostly of real health care experts. In reality, this rarely occurs. Throughout the world, health care decisions are being made by government bureaucrats with no actual medical expertise. In some cases, they are appointees chosen purely for political reasons or even as a favor. This system is notoriously prone to corruption, inefficiencies, and downright stupidity.
Government-run health care systems also incentivize government agencies to further restrict personal freedoms and implement policies that try to change people’s behaviors. If government is paying for your health care, why would it allow you to smoke tobacco cigarettes or eat burgers every night for dinner? Government doesn’t necessarily need to restrict these freedoms, of course, but it could, and there are good reasons to believe the U.S. government would do exactly that under any kind of a government-run health care scheme. Is a government with an Anti-Burger Bureau really the kind of America you want for your children?
Progressive and socialist lawmakers in some of the largest cities in America have already imposed taxes on sugary drinks like soda, including in Boulder, Colorado, Philadelphia, San Francisco, Seattle, and Berkeley, California.64 Hefty cigarette taxes have been imposed in more than two dozen states, and in some of the most liberal states—Connecticut, New York, and Rhode Island—cigarette excise taxes top $4 per pack, even though numerous studies show these taxes disproportionately affect the poor.65
The People’s Republic of San Francisco has not only banned candy and soda from its schools, it also imposed a ban on chocolate milk.66 “Sorry Tommy, chocolate milk is just too dangerous for kids to drink.”
If the only “solution” to the problems facing our current health care system you can come up with requires significantly worsening health care and/or reducing access to services for more than 100 million Americans, then that’s not much of a “solution” at all.
Our health care industry is dysfunctional, slow-moving, and full of inefficiencies, but the way to fix the system isn’t to give more power to the same dysfunctional, slow-moving, and inefficient people who broke the system in the first place, or to force some people to suffer so others’ lives can be improved. Helping people at the expense of hurting many others is never a good option, and it’s not the way people behave in a truly free nation.
That doesn’t mean we should just throw our hands up in the air and give up, either. There are really smart, tested health care policy solutions that can significantly lower costs and provide people with access to affordable health care without restricting choice or putting government in charge of our burger consumption. (After all, what’s the point of living without burgers?)
One great option that has been shown to lower costs and improve access is permitting physicians to offer direct primary care (DPC) agreements. Direct primary care agreements allow primary care doctors to contract directly with their patients. Under a direct primary care agreement, patients pay a monthly fee, often less than $100, in exchange for a long list of primary care services, like check-ups, physical exams, and blood tests. These agreements can save thousands of dollars per year in health care and health insurance costs, because contracting directly with doctors cuts out health insurance middlemen and overhead for providers. It also frees up physicians to spend more time with patients and less time dealing with paperwork. That’s not a small benefit, by the way. About half of a doctor’s time is spent dealing with administrative activities.67
DPC practices can reduce a health care practice’s overhead by as much as 40 percent, according to the Docs4PatientCare Foundation, and some research shows patients enrolled in direct primary care agreements are significantly less likely to need hospital services.68,69
This might sound like a radical change, but it’s not. It’s common sense. Health insurance should only be used to cover expensive health care costs, like broken arms and heart surgery, not vaccinations and physicals. Using health insurance to pay for relatively inexpensive health services is like using your car insurance to pay for oil changes and tire rotations. There’s a reason almost no one buys car insurance that covers routine car maintenance—it’s really, really expensive. So, why do we use our health insurance to pay for routine health care?
A second, potentially game-changing policy reform that could completely change the way the health insurance system works is to allow people to band together to buy health insurance as a group, commonly called “association health plans” (AHPs).
Under the current system, most people either get their health coverage from an employer or the government, through Medicaid or Medicare. This puts those who don’t qualify for Medicaid or Medicare and don’t receive health insurance from their employers left to buy insurance as individuals, which is really unfortunate, because the Obamacare health insurance plans they are stuck purchasing are extremely expensive.
There are a lot of reasons why individual health insurance plans are so costly, but one of the biggest is that individuals have almost no consumer power when they buy insurance plans. They are often forced to buy plans loaded with coverage they might not need or want, and because they are only buying coverage for themselves and their immediate family members, they can’t negotiate prices the same way a large employer or unions can.
If private groups of individuals could get together and buy health insurance, they could negotiate much better prices, and the bigger the association, the better the prices. Just imagine the deal groups like the National Rifle Association or AARP, both of which have millions of members, could negotiate with health insurers. And because associations with members in multiple states could purchase health insurance across state lines, people would have more options than ever. Further, health coverage wouldn’t be tied to an employer. That means if Bill loses his job, Bill and his family wouldn’t automatically lose their health insurance.
Association health plans have tremendous potential for helping lower-income people as well. Charitable organizations, churches, and other groups could form associations that provide health insurance at reduced rates, or even for free, to lower-income families. People with more money in their pockets might pay extra for these health insurance plans than they otherwise would, but they would do so voluntarily, knowing that they are helping another family at their church, business, or someone who is committed to a shared cause.
Instead of being reliant on a massive government bureaucracy that spends more money than Joe Biden on teeth whitener or Bernie Sanders on adult diapers—yeah, that’s a lot of cash, I know—people would instead benefit from the generosity of their neighbors. Communities would once again be empowered to take care of each other, and to do it without massive tax hikes and threats from the IRS.
Charity, not coercion and manipulation, can help America’s uninsured population, but only if the American people are given the ability to do so. Current laws make all these ideas unworkable or even impossible. Again, it’s clear government is often the biggest roadblock to improving people’s lives—not some greedy corporation or middle-income families who don’t want to pay more than half their income in taxes, like they do in Scandinavia.