WSJ M.D.'s OP-ED for Single Payer Health Care

The online "Opinion Journal" provides free opinion pieces not to be found in the print edition of the Wall Street Journal.

Today's OJ features a piece by a M.D. defending Single Payer Health Care.

It's quite persuasive. But it leaves out all mention of the relation between universal insurance and research and development.

What does that mean? People who don't like health care reforms that uncouple access from ability to pay tend to argue that such reforms would spell the end of America's leadership in producing new technologies. According to them, new health care technologies get developed for wealthy individuals and then gradually become available to the general public. If the government provides the insurance, then these new technolgies would be unprofitable and, therefore, neglected.

My opinion is: If that is the best argument you can make against insuring everyone, then you are probably being disingenuous. Surely we could find some other way to support appropriate R&D. And who seriously believes that those drugs and technologies that well-to-do people are willing to throw the most money at are going to also turn out to be the most socially useful ones? Viagra anyone?

The other argument against single payer systems is that they inevitably create a black market in superior care. Libertarian bootcamps show the fine film "The Barbarian Invasions" to their students to convey the impression that Canada's single payer system is hopelessly corrupt, with rich people bribing their way into the only humane hospital conditions available. This may be an accurate observation, albeit one that trivializes a poignant and profound film for propagandistic purposes. Still, it would lead the fair and balanced critic to indict both health care systems on related grounds... rather than view one as unambiguously better than the other. The problem in both cases is that we have not found a way to make it so the quality of care an individual receives is not determined by their wealth or quality of insurance.

I'm not myself a defender of single payer systems. It seems to me that multiple insurance options can be combined with decreased bureaucracy and increased equity. But this is a very interesting and persuasive op-ed.