Now that we have entered fully the Presidential election cycle, as well as embarked on a large national healthcare odyssey brought to us via the COVID-19 virus, we will hear an increased drum beat about many policy proposals tied to the nation’s healthcare, and very few, if any will have any tangible details on either the implementation process or actual expected outcomes. And, to be honest, there isn’t any reason to expect such details, because in many cases, the policy proposals are completely theoretical. As an engineer by education, I have always wondered why more of our national leaders are not eager to implement their national policies at home rather than thrust them on to the nation at large without the least bit of experimentation and why more people aren’t willing to call them out on their reckless behavior.
As brilliantly stated by U.S. Supreme Court Justice Louis Brandeis during the case of New State Ice Co. v Leidmann, a “state may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.”
He is referring to the concept that within our federal framework, state and local governments have a level of autonomy where they may at as “Laboratories for Democracy” testing various laws and policies in a similar manner to the scientific method. This would not only allow insulate the larger population from the impacts of potentially adverse outcomes, it would also provide a more manageable way to refine details not only of the specific policies but also of the specific methods of implementation.
Let’s ponder for a moment the following metrics for a certain country that is part of the G8:
- Population – 66.1 million
- Total GDP – $2.81 trillion
- Per Capita GDP – $42,360
Which country is this might you ask? Great Britain.
For much of the last decade, Democratic Politicians have touted the National Health Service of Great Britain as a model for how the United States not only could, but should, have a single payer health care system.
Now, to be clear, I am not advocating the policy from one side of the other. In fact, based on a myriad of difficulties with private health care coverage my family has experienced over the last few years, I would very much welcome the idea of just showing up to the doctor, surgeon, dentist, etc. and having the necessary procedures performed. However, even if a single payer system is the answer, is it something we should simply pass into law on such a large scale and trust that government can implement? After watching a similar scenario unfold with ObamaCare, I give a vociferous NO!!!!!!!
The roll out was horrific. Technology was drastically inadequate. Financial impacts were woefully inaccurate. Access to coverage was lacking (did everyone get to keep their doctor, I know my wife didn’t).
Comparatively speaking, that program was minuscule when compared to completely transitioning from our current system to a single payer model, so forgive me if I’m not very enthusiastic to blindly back such a proposal.
For the sake of comparison, much like we did for a certain G8 nation above, let’s ponder for a moment the following metrics :
- Population – 43.3 million
- Total GDP – $3.43 trillion
- Per Capita GDP – $79,399
Which country is this might you ask? Well, it isn’t a country at all. This is merely a collection of seven states, specifically: New York, New Jersey, Vermont, New Hampshire, Connecticut, Rhode Island, and Maine. Do these states sounds familiar? They should, because many of the most vocal proponents for a single payer system, Bernie Sanders, Elizabeth Warren, Kirsten Gillenbrand and Cory Booker, represent some of these states in the United States Senate.
My question to them would be the following: Why don’t you take your Medicare for All proposals, implement them within this block of New England states, and let the rest of us know how it works? Within New England, you have more per capita GDP than the fifth largest economy in the world.
- Based on the high level comparative models, there should be more than enough financing to implement without assistance from the rest of the country (i.e. the Federal Government).
- You can refine the policies, including but not limited to pay schedules for doctors, which treatments to include, how best to include private insurance, and how to restrict access to only folks that are citizens of New England, as well as the cost impact to providing services to those who are not (whether they be business travelers, tourists, or people not living there legally).
- You can refine the implementation processes, to ensure that while nothing of this magnitude will be simple or painless, it can be made to have minimal impact to everyone else.
If your policies are the smashing success being promised on the campaign stump, then you will have everyone lining up to replicate. But if your policies are not, then there was no risk brought to the remainder of the country and the rest of us were not forced to expend time and treasure on what inevitably turned out to be a fool’s errand.
Math Colored Glasses 