John C. Goodman

There is stirring on the left.

Now that the odds that ObamaCare will crash and burn have ticked up a notch or two, the words "single payer" are being heard more frequently.

[For those who have been living under a rock, "single payer" is what we used to call "national health insurance," and before that "socialized medicine" and before that "government-provided health care," by people who today call themselves "progressives" but used to call themselves "liberals" and before that "socialists" in some cases — all in the hope that continual re-labeling will make the ideas actually seem sensible.]

Take Dennis Kucinich. The other night on Fox News he announced that the Affordable Care Act was a bad idea from the get-go. "Everybody should be in Medicare," he said, and "We should get for profit companies out of health care." My problem with people on the left is that they are so obsessed with "public" rather than "private" and "non-profit" rather than "for-profit" that they become oblivious to basic facts, including these:

• Most government health care programs are mainly managed by private companies — for-profit companies more often than not.

• One in four Medicare enrollees is actually in a private insurance plan and almost all the rest of Medicare is being managed by private companies (Blue Cross, Cigna, etc.)

• 70 percent of Medicaid enrollees are in private plans — a number that is expected to grow — and I believe all the rest are mainly being managed by private companies.

More importantly, THERE IS NOT A SINGLE MAJOR PROBLEM IN OBAMACARE THAT WOULD BE SOLVED BY MOVING EVERYONE INTO MEDICARE. And any minor problems that might be improved by universal Medicare could have been easily solved by tweaks to ObamaCare as well.

Paying for the expansion. Sometime back,the NCPA calculated that we could pay for national health insurance with a 15% VAT tax. But if it were easy to impose such a tax the Democrats would have financed ObamaCare that way. Bottom line: the easiest way to fund universal Medicare is the same way we are funding ObamaCare. That means:


John C. Goodman

John C. Goodman is President of the Goodman Institute and Senior Fellow at The Independent Institute. His books include the widely acclaimed A Better Choice: Healthcare Solutions for America and the award-winning Priceless: Curing the Healthcare Crisis. The Wall Street Journal and National Journal, among other media, have called him the "Father of Health Savings Accounts.”


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