Box A or Box B?
April 28, 2018
Single-payer healthcare means that a single government agency pays everyone’s health bills for the ills that are covered. The money comes from taxes.
A number of libertarian alternatives are available, including markets in health care that are free from government controls. However, since there are many Americans who like the idea of single-payer healthcare with government as the single-payer, let’s explore a libertarian single-payer alternative that allows for government and also produces freedom for those who want it.
It works like this. The government issues a sheet with Box A and Box B. You may choose one of these boxes. Healthcare freedom is restored to every American by giving them the option of checking Box A. Box A says that you are no longer enrolled in any government-sponsored healthcare plan, and you are relieved of all taxes now and forever for that purpose. You are also no longer subject to any of the government’s many regulations of healthcare. You are free to go your own way healthwise. If the government at any time reneges on this promise, the officials who do so are subject to severe penalties.
You may also check Box B. Box B says that you now belong to a government single-payer healthcare plan for a period of 2 years, renewable at your option. You may leave the plan when the 2 years are up. You will now be subject to taxes to support the plan. The government determines the level of taxes, and you are bound to pay. Non-payment results in penalties imposed upon you. The government promises to fund this program only through the taxes earmarked for it and no other. The government is not permitted to borrow to fund the program.
Those who want single-payer can have it. Those who don’t want it can reject it. They are not forced into it, and they don’t have to pay in.
Prediction: The single-payer plan will succumb to the competition of free markets in health care, which will provide higher quality at lower prices.
There will still be a number of interest groups that will bemoan the fact that some people are not covered, some people receive inadequate healthcare, some people die from malpractice, services are not available in certain areas, etc. Some will complain that health is a human right and that everyone is owed health care by virtue of being a human being. Who owes it to them, the coercion required to extract wealth from them, and how to avoid the moral hazard problems of free healthcare are fudged over as non-problems. Some will see through the plan and realize that it destroys the State. They will argue that we all have to be in one society and accept government coercion for our own good.
There are reasonable replies to all of these objections, but they can’t be made to disappear. The best “reply” will be that most Box B people will shed the single-payer option when they see with their own eyes that the Box A people have it a lot better than they do.
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