Imagine a system of health insurance, or even health care, where there’s never an issue with your need to pay. Sounds exciting right?

This is what people think they’ll get, when folks talk about what’s alternately called “single payer,” and “public option,” health care, or insurance.

Those more in the know, will argue the two aren’t the same thing.

“The first,” they’ll insist, “is a system through which health care is paid, by some single mechanism.” What they’ll fail to say most of the time, is that single payer, is almost invariably conceived to be government.

The reality is, it’s almost impossible for it to be anyone else.

“The second,” they’ll argue, “is where some entity offers insurance or care, with costs managed by the government.”

The two ideas sound different. In reality though, they end up being essentially the same thing. Allow me to explain.

When people talk about single payer systems, they’ll almost invariably insist on two things.

The first, is that the system should be universal—that is to say, everybody should be under it.

The second is, it should be government run.

When these two are combined, it can be assumed the reason for their being mashed together, is that by doing so, the government can essentially set prices for various medical services. If someone wants more for their work, than government decides is appropriate, that’s too bad. What they get, is what some sort of payment schedule allows.

We’ll talk about the ramifications of such an idea in a moment.

For now, let’s discuss the idea of a “public option.”

You can’t really call an insurance option public, if government doesn’t manage that option.

Part of doing such management, includes dictating terms of the available “policies.” This results in government controlling payments in much the same way, as a single payer system.

It’s commonly true, that people advancing such concepts, assume there’ll continue to be a private market as well.

The problem? Because the public option will always appear to to undercut private insurers, the private market consistently dies in large measure, when public ones are installed.

You might be asking why that’s a bad thing. Here’s the answer.

There are two reasons public options always seemcheaper.

The first, is that they’re nearly invariably, subsidized with taxpayer money. This will generally make the supposed public option look cheaper than it actually is.

The second, is the government can limit access to care, in ways they would never allow private carriers to.

The result is, they’re able to keep costs down, by making it so people they decide, don’t need procedures or other medical care, don’t get that care.

Though I could go further into this, the time and words needed to do so would be excessive. As such, I’ll leave that be for now. I may talk about it in a subsequent piece.

The point is this, those who know, realize they’ll be required to subsidize the public option, through their taxes. The result is, they either pay higher premiums for insurance and are taxed to help pay for the public option, or ditch their private plan to reduce costs.

Those who don’t know, take the option that’s cheaper, since they assume it means a smaller outlay for them, not realizing they’ll often be taxed to “make up the difference.”

Even if they’re lower wage earners and as a result, don’t see a direct increase in taxes, they’ll almost certainly end up paying for things.

Why? Because those who are taxed will want more income to offset the expense. The result of this is higher prices, which the persons with lesser compensation, will have to pay along with everybody else.

Simplifying, the increase in taxes will cause an increase in wages, that’ll trigger an increase in costs. In a word, inflation.

Again, getting into detail on why this is true, is the subject for about a chapter, of a pretty substantial book, even though it’s pretty simple math that makes it true.

Here’s the important point. Both single payer, and a public option will almost certainly put government firmly in control of healthcare pricing and availability.

Wealthier folks may be able to avoid this, by paying their way privately, if private care is still allowed.

When it’s not, they’ll do what Canadians and others typically do, when they end up on waiting lists in their home country—they’ll find other countries, that will allow them to receive care, on their own terms, and pay to make their way to them.

Here’s the thing. Once government is firmly ensconced in the position of controlling costs as well as the quality, and quantity of care, since they’re not the ones receiving that care, they’ll start doing things that will either make them look better, or enrich them in some fashion.

The result will be reductions in quality, reductions in what they’re willing to pay for procedures, and rationing of care.

Even if this doesn’t happen immediately, you can be pretty well assured it will come.

In all I’ve said so far, I haven’t yet even mentioned the devastation that’ll be wrought on the medical community. When doctors and other medical professionals who’ve spent huge portions of their lives, and sums of money, becoming qualified to do what they do, realize they cannot continue to practice medicine without taking a vow of poverty, you can be certain, many will stop doing so.

As it is, lots of medical folks already have an exit strategy, so they can ultimately get away from jobs, that suck the life out of those doing them. It’s often a long, laborious slog, that takes a heavy toll on their health and well being, to do what they do.

I’ve given a quick overview of what you can expect, if either a public option, or a single payer system is put in place. Doing more, would take many times more space and hours, than I can easily break loose at present. If you want to see more, you can look into the work of folks like Dr Thomas Sowell. If you take the time to do so, don’t count on their words being comforting, if you think either to be a good idea.

Thanks for reading, and may your time be good.