Law & the Courts

If Single-Payer Makes Sense for Doctors, It Makes Sense for Lawyers

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The Case for a Single-Payer Legal Profession

An attorney and friend told me recently that a single-payer health-care system is ideal because (I’m paraphrasing): (1) Health-care choices can dramatically affect quality of life and even determine life versus death; (2) sometimes, patients must make gravely serious health-care decisions with harrowing speed under stressful circumstances; (3) health care is too complex for laypeople to make rational decisions about treatments and financing; (4) rich and poor alike deserve equal access to health care; and (5) someone knowledgeable and impartial must determine fair, rational prices for medical services. Single-payer health care, he argued, solves these problems by freeing befuddled patients from self-interested doctors and drug manufacturers, replacing dysfunctional markets with detached, rational experts.

Let me borrow my friend’s logic in order to restructure his own profession.

A single-payer legal system is ideal because: (1) Legal choices can dramatically affect quality of life and even determine life versus death; (2) sometimes, clients must make gravely serious legal decisions with harrowing speed under stressful circumstances; (3) the law is too complex for laypeople to make rational decisions about actions and financing; (4) rich and poor alike deserve equal access to legal counsel; and (5) someone knowledgeable and impartial must determine fair, rational prices for legal services. If my friend’s logic is correct, then single-payer legal services would solve these problems by freeing befuddled clients from self-interested lawyers, replacing dysfunctional markets with detached, rational experts.

Legal outcomes can destroy a life. A post-accident lawsuit, IRS action, disputed will and testament, clouded land title, potential bankruptcy, ugly divorce, or fractured business relationship can hurl one overnight from comfort and happiness into destitution and despair. Sometimes, the law literally determines life or death: Who has medical power of attorney when a doctor eyes your do-not-resuscitate order? Can your insurer deny you a life-saving drug? Can your former business partner seize the money you saved for your father’s transplant? Will your innocent son die in the electric chair? I’ll guess more people commit suicide over legal than medical problems. For all these reasons, legal services are too important to entrust to markets.

Law firms must not be for-profit entities. They should be social instruments, serving the public good.

Sometimes, circumstances demand rapid-fire legal decisions, made under debilitating stress. But, counsel protests, such cases are uncommon. Most legal questions are routine, allowing leisurely comparison of options and attorneys. The same, of course, is true of medical decisions, yet single-payer health-care advocates routinely cite heart-attacks-on-gurneys as reason to nationalize all health care. Accepting their argument, we’ll combine all legal services under a single public-sector umbrella.

With years of training and practice, attorneys’ vast knowledge is impenetrable to clients, who can no more comprehend contracts than patients can MRIs. Asymmetric knowledge lets lawyers lure clients into dubious expenditures that imperfect markets don’t restrain.

#share#It’s unfair for the wealthy to have access to more and better legal counsel than the poor. Such inequality is especially unjust to minorities and other disadvantaged socioeconomic groups. So, law firms must not be for-profit entities. They should be social instruments, serving the public good.

Americans spend more on lawyers than any other country, and yet we get the worst legal outcomes of any developed nation.

Our grossly unfair legal system must give way to an equitable, humane, single-payer system, 100 percent financed by federal revenues. Copying Canadian health care, we’ll prohibit wealthier clients from jumping the queue via out-of-pocket payments. We’ll need experts to determine fair, sensible, and rational prices for legal services. For this task, teams of economists in Washington, D.C., are ideally suited. Just as Medicare standardizes doctors’ fees without regard to reputation, so all lawyers shall receive precisely the same scientifically determined fee for a given service. To meet overall budgetary targets, Congress will cap total attorney reimbursements, with Justice Department economists identifying and eliminating “unnecessary” legal services.

Single-payer-health-care advocates dream of consolidating all American health care into “Medicare for All.” Following their lead, we’ll combine all branches of law — criminal and civil — into a socially just “Public Defender for All.”

Outrageously, Americans spend more on lawyers than any other country, and yet we get the worst legal outcomes of any developed nation. Surely, members of Congress will see the wisdom of removing their future K Street and Wall Street employers from the chaos and injustice of markets and placing them serenely on the government payroll.

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