I understand why people who care about the poor support government single payer plans. I once did too. No more. Single payer permits coverage refusals and restrictions that would never be permitted by private polices have turned me away from the centralized approach.
Fact: States have stripped Medicaid patients from benefits because it hit a budgetary wall in bad times–most notoriously causing one patient to lose an organ transplant for which he had already been approved. Private insurers c0uld never get away with that, and besides, are required to have sufficient funds to withstand bad times. Fact: Medicaid in Oregon explicitly rations care, which no private company could do without government pouncing like a cougar. And now, we see advocacy for more rationing under Medicaid, not less, and by a medical association, no less. Fact: The Obama Adm. has locked the lawyers out from being able to do anything about cuts. No private company could insulate themselves from legal redress by fiat.
And now, Medicaid regulations are responsible for gender discrimination: A breast cancer patient is being denied coverage because he is male. From the ABC story:
For Raymond Johnson it was bad enough being diagnosed with cancer when he was just 26 and with no health insurance, but his shock was only aggravated when he was denied Medicaid, because rules say men are not covered for breast cancer…Though Johnson wouldn’t normally qualify for Medicaid in the state of South Carolina because he is a single, non-disabled man with no children, he was advised to apply for a special supplementary program created specifically for those diagnosed with breast cancer whose income is 200 percent of the poverty line ($21,780 per year) — even those with no dependent children. What Johnson didn’t know is that the program, created by the Breast and Cervical Cancer Prevention and Treatment Act, is women’s only...Medicaid told Johnson that the supplemental breast cancer coverage is for women only…
If a private company did that, the bad faith and discrimination lawsuits would force the company to sell their headquarters.
The problem with single payer is they are budget limited and depend on centralized bureaucratic control. That leads to cases such as this. Time to change our approach for covering the poor.