PRI: Coronavirus could break ‘Medicare-for-all’ — single-payer systems struggle with outbreaks

Link to source.

The “lottery model” for health care is uniquely vulnerable to collapse during black swan events, such as a pandemic.

The reason is evident in the key feature of the lottery model: its many pay/few benefit structure is prone to failure when the many demand or require benefits.

Sally Pipes describes systemic failure of the “lottery model” in prosaic terms: “In the not-too-distant past, Canada and the United Kingdom have struggled to handle outbreaks of everything from severe acute respiratory syndrome (SARS) to the seasonal flu.

“That’s largely because these countries’ government-run, ‘Medicare-for-all’-style systems lack enough health care personnel, hospital beds and other resources to meet the needs of their populations even in good times. A public health threat like a pandemic can stretch single-payer health care to its breaking point…

“Containing pathogens like the novel coronavirus requires fast action and close coordination among physicians, hospitals and public health officials. That’s tough to do when there aren’t enough doctors or hospital beds to accommodate the sick.”

Pipes has more to say about the inherent vulnerabilities of socialized medicine at the link. The lesson to learn is that the “lottery problem” (many give/few get) has no solution.

7 thoughts on “PRI: Coronavirus could break ‘Medicare-for-all’ — single-payer systems struggle with outbreaks

  1. “That’s largely because these countries’ government-run, ‘Medicare-for-all’-style systems lack enough health care personnel, hospital beds and other resources to meet the needs of their populations even in good times. A public health threat like a pandemic can stretch single-payer health care to its breaking point…”

    That would be a problem regardless of how healthcare is funded. Is the author suggesting that there are a bunch of doctors in the US sitting on their hands waiting for business? Don’t privatized, for-profit business models encourage providers to staff exactly enough “resources” to meet average demand? If anything, it would seem the US would be more likely to experience shortages. Seems like this type of system would be the most vulnerable to the black swan event.

    One of the right’s favorite talking points about public goods are that they are overstaffed and inefficient because they’re not subject to the same profit motive and tight budgeting of the private sector. So which is it?

    Another point worth mentioning: many, many of the low-wage service workers we all interact with on a daily basis will continue going to work with flu-like symptoms since they don’t have healthcare or sick leave. Something to consider.

    Liked by 1 person

    1. RE: “Don’t privatized, for-profit business models encourage providers to staff exactly enough ‘resources’ to meet average demand?”

      Not necessarily. Decentralized markets then to produce excess capacity in the normal course of events. For example, if you go to the web site for Sentara Norfolk hospital, you will find them assuring the public that they are already prepared to handle a surge in quarantine demand in their existing facilities, should a coronavirus outbreak occur here.

      RE: “One of the right’s favorite talking points about public goods are that they are overstaffed and inefficient because they’re not subject to the same profit motive and tight budgeting of the private sector.”

      Public goods is a technical term in economics which you may be misusing here. True public goods, such as water and sewage systems are often capable of being managed well, even if sometimes they are not. But not all public services are public goods. A public school system, for example, doesn’t necessarily meet the definition of a true public good and some, like me, argue that failing to be a true public good is one reason public school systems tend to be managed poorly.

      https://en.wikipedia.org/wiki/Public_good_(economics)

      RE: “Another point worth mentioning: many, many of the low-wage service workers we all interact with on a daily basis will continue going to work with flu-like symptoms since they don’t have healthcare or sick leave.”

      That’s certainly true. What do you think can be done about it?

      Like

  2. @Roberts
    This piece is among the most stupidest “analysis” ever. A lot of people getting sick at the same time will strain ANY healthcare model no matter how it is financed.

    You keep calling insurance – any kind of public or private insurance – a “lottery model.” But, you have presented no viable alternative. “Pay as you go” is not a viable model and certainly would be a disaster in the face of a plague.

    Liked by 3 people

    1. RE: “But, you have presented no viable alternative.”

      The only viable alternative to gambling is to stop gambling. In terms of healthcare, some combination of protected savings accounts and access to credit for commoditized services, such as pregnancy and broken bones, might usefully replace our predominant reliance on the insurance model or other versions of socialized medicine.

      As I see it, too many people wrongly imagine they are getting or can get something for nothing with “lottery style” financing. Until that perception changes, nothing useful will happen.

      The basic problem is that medical science and technology are more in their infancy than we are willing to admit. So we indulge in fantasies about them.

      Liked by 1 person

      1. @Roberts

        You have obviously spent your entire life in the safety of the socialist military-industrial cocoon since you have no idea how real people outside of it live. A significant majority of our people have no ability to build up a “protected savings account” that could even touch the typical cost of even a minor injury or illness.

        And, instead of “gambling” by responsibly paying for insurance or Medicare-for-all taxes you would have them sink into catastrophic debt for “commoditized services” such as pregnancy and birth. And, don’t forget, broken bones. That only leaves about a gazillion other medical problems that are common and will bankrupt anybody. We going to “commoditize” service for them too?

        By the way, how would this non-gambling finance system deal with those simply not able to pay? Just let them die? If not, who would be paying for the care they need?

        What you have done here is a reductio ad absurdum. You have taken the concept of “pay as you go” for financing healthcare to where it logically leads – disaster.

        Like

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