However, no one wants to see people dying on the streets because doctors and hospitals have turned them away. Already, the law requires that anyone who makes it to an emergency room must be at least stabilized regardless of ability to pay.
This provision effectively neutralized the ability of capitalism to create artificial scarcity in healthcare. If people realize they will get care regardless of their ability to pay it presents an option that allows them to use the system without paying into the risk pool and forces it to shift their cost to those who can/do participate. This has been particularly damaging to a system that requires healthier (younger) people to pay for much sicker (older) demographics.
We would have had this conversation decades ago if not for Medicare absorbing the most at-risk demographic to isolate it from the risk pool of private insurance. Those wishing to eliminate the vastly popular program aren’t really thinking about the impact of moving those high-cost patients back into the insurance pool would have on their premiums. Most of them are simply low information voters knee-jerking to the overused term “socialism” that is bandied about casually by politicians. Very few things are more “socialist” in nature than insurance.
4. The role of a backstop fund.
The nature of our monetary system precludes any benefit from “funds” beyond reducing the national debt. All money/revenue received by the federal government “must” be applied to the debt that created it as a first-order process and can’t survive to “fund” anything. This is the weakness built into the current Medicare and Social Security funds that will force us to acknowledge the true nature of our money and require that we adapt our methods to it very soon.
We can’t continue to draw down money in circulation for such high-cost items when doing so offers no benefit to enable paying for them. The major threat to our economy posed by single-payer healthcare lies in the obsession to “pay for” every expense of the federal government with revenue it neither needs nor uses. Until we understand that we don’t “fund” our federal government and that the opposite is far more accurate, the math will never work.
Otherwise, the contradictory illusions of American exceptionalism and the need for austerity fiscal policy are going to continue to create division and discord until a boiling point is reached. No civilized society will accept widespread misery and death to promote a political ideology for very long without revolting. Bernie is offering the oligarchy an opportunity to ease into that realization without the necessity of guillotines, and I believe they know it.
