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State-based single-payer health reform is fiscally, constitutionally, and morally conservative

Apr 13, 2017 | Blog | 0 comments


What is state-based single-payer health reform?

Rather than legislating all aspects of health policy out of Washington DC, state-based health reform envisions that each state capitol would be the leader in setting health policy and managing health care delivery. This makes sense because health care delivery is inherently a regional phenomenon. Trauma care, for instance, when done best, is done on a cooperative, regional basis. In many instances, trauma care (and other intense hospital-based services like burn units, cardiac care, organ transplantation, neonatal intensive care, etc.) regions will roughly correspond to state boundaries. Single-payer reform envisions all healthcare payments originating from one source. Many are advocating for ‘Medicare-for-all’, which would be a federal single payer or one payer for health services for the whole nation. In contrast, state-based single payer reform would be fashioned such that each state would organize its own health care financing system. The federal government would set minimum standards for the states and would provide significant funding, but the states would be responsible for setting policy and managing health care delivery.

Why is state-based single-payer health reform fiscally conservative?

As a nation, we are wasting $1 trillion per year on quality waste and inefficiency driven in large part by the inadequacies of the private, for-profit health insurance business model. Most of the money spent on health care in the US is public funding from the taxpayers. Americans tax themselves at the highest rate in the world for healthcare, funding health programs like Medicare, Medicaid, CHIP, and many many others with federal, state, and local taxes. A tax credit to employers granted originally during WWII funds the lions share of employment-based health insurance. Single payer health system reform would make it possible to efficiently use those tax revenues by both eliminating the enormous inefficiency waste of health insurance with its gigantic overhead and by allowing health care financing which will focus on best practice patient care, eliminating the waste associated with poor quality care.

Why is state-based single-payer health reform constitutionally conservative?

The 10th amendment to the Constitution requires the federal government to cede all policy arenas not explicitly given by the Constitution to national governance to the states. Health policy is not explicitly the domain of the federal government; therefore, constitutionally, it should belong to the states.

Why is state-based single-payer health reform morally conservative?

All belief systems, from Christianity to humanism, espouse the moral necessity of coming to the aid of the sick and injured. Nothing short of finding a way to provide health care to all of our citizens will satisfy our national intent to do well for everyone.