"Politics, bureaucracy, activism, corruption, and "gaming the system." All the factors that would make universal health care a disaster."
But a single payer system would resemble, say SSI more than a hospital that everyone else stabilizes and transports those with out insurance to. Every major metropolitan area has one like that, and their profile is always grim. I say always. Their might be some that are different. If so, I don't know about them.
The cost overhead for SSI is extremely small and they don't suffer from the effects you name. Look at Germany for example. They've had their system for over 100 years. Everybody has health insurance, the cost of which is scaled according to income. Their mortality rate is lower and their life expectancy is higher across all categories. And their cost per capita is lower, despite having a population weighted more towards older people than we do.
Bureaucracies aren't a bad thing. They held the Roman Empire together, despite the bad caesars, for hundreds of years. While a pain to deal with, they introduce a degree of hysteresis that limits the damage a government can do. A lean, nimble and quick reacting government is one that can take your rights away in a heartbeat. Or maybe your life. When you have an entity that is as powerful as a government, you need the guys who say "wait a minute. Section 5, subsection 18 paragraph C clearly stipulates that..." and refuse to deviate because the only way they can get fired is to Break The Rules. Otherwise, you are at the mercy of the good intentions of the rule breakers. Who, by their nature, tend to be mainly concerned with their own well-being and not yours. To them, you are the eggs for their omelet. |
