Single-Payer Healthcare: Pernicious Absence of Choice

“The only thing that worries me is the depersonalization and dehumanization of politics that has come about with the progress of civilization. An ordinary human being, with a personal conscience, personally answering for something to somebody and personally and directly taking responsibility, seems to be receding farther and farther from the realm of politics. Politicians seem to turn into puppets that only look human and move in a giant, rather inhuman theatre; they appear to become merely cogs in a huge machine, objects of a major civilizational automatism which has gotten out of control and for which nobody is responsible.”

— Vaclav Havel, playwright, dissident, President of Czechoslovakia and the new Czech Republic upon acceptance of the Onassis Prize for Man and Mankind, Greece, May 1993

As the discussion about single-payer health care is heating up as the 2020 presidential election season begins, I can’t help but think about little Charlie Gard. If you haven’t heard about Charlie, he was born in the United Kingdom on August 4, 2016, with a genetic disorder called mitochondrial DNA depletion syndrome (MDDS) and he died on July 28, 2017. Although MDDS is fatal, there is at least one experimental therapy that shows promise, and Charlie’s parents wanted to give him this chance. Although they raised private funds to enable him to try this therapy, the state would not allow them. With a socialist (or as some politicians use the term single-payer) health care system, as in the United Kingdom, once a person is admitted to a hospital, they are no longer even minimally in charge of their own care, even if they are willing to pay directly. Charlie’s only possibility for life rested with the state, not with his parents.

State-provided health care sounds like a great idea, but is it? Over the years we have all heard stories of people that couldn’t access not only the best but even adequate medical treatment in places where the state runs the health care system. Rarely covered in the press, most incidents are told directly by the people that came to the U.S. to get the care they required in a timely manner. Yet, this reality seems to elude many of those elected to represent us.

A recent example is Congresswoman Alexandria Ocasio Cortez, a proud socialist, who made clear that she is a fervent believer in the single payer health system based on, as she puts it, being “successful in many different models, from Finland to Canada to the U.K.” She must not have spoken to Charlie Gard’s parents or all those waiting in line in Canada for months just to see a specialist. Or perhaps she doesn’t care about the loss of work or suspension of life, sometimes for over a year, waiting for commonplace surgeries like cardiac bypass or hip and knee replacement. Or perhaps she hasn’t taken the time to read about the patients that were being treated in hospital hallways and being kept in ambulances in the U.K. until there was a place to treat them due to inadequate government funding.

My own understanding of how desperate the situation is in Canada dates back years when working with Canadian artists and production people who bought American insurance for their relatives so that they could access care when the Canadian system’s labyrinth was too painful for their loved ones to endure. But those promoting single-payer health care don’t seem to be aware of this, nor of the crisis in the Department of Veterans Affairs.

As AOC said this month regarding the VA, “All I can think of is that classic refrain that my parents always taught me growing up: ‘If it ain’t broke, don’t fix it,’” she said. “That is the opening approach we have seen when it comes to privatization, it’s the idea that this thing that isn’t broken, this thing that provides some of the highest quality care to our veterans somehow needs to be fixed, optimized, tinkered with until we don’t even recognize it anymore.”

Translation, 22 veterans a day killing themselves doesn’t register as an issue for AOC. Neither do the thousands of veterans who killed themselves waiting for health care. In fact, in the past 18 months, 22 veterans took their own lives at VA centers according to a recent article in the Atlanta Journal-Constitution, and more than 6,000 veterans commit suicide each year. An inordinate percentage of suicides are by veterans, but that won’t stop her from blasting the privatization of even a portion of the VA, so that these brave soldiers can access care in a more timely manner. It also allows soldiers who live far from a VA facility to get care closer to their home. Starting in June, the VA Mission Act will allow at least 1.5 million VA patients to seek care from the private sector with taxpayer funds if they wish, according to Military Times.

And that is what seems to bother AOC. No, you can’t determine your own health care, even with the documented inadequate care, secret waitlists, and long driving times to reach a facility. Interestingly, when people asked her to become a recipient of VA care and forgo her medical insurance options as a member of Congress, she seems to be eerily silent. Oh yes, the rules are for thee, not for me — she is a socialist.

And though she is the recent poster child with her bombastic rhetoric, so many in the current field for president share her vision, and many Americans don’t have the information or the experience of what this single-payer experience means when this is your only option.

One of the most fervent backers of universal health care was the late Congressman John Dingell. He was the longest-serving member in the House (1955-2015) and was succeeded by his wife, Debbie Dingell, representing their Michigan district. Lesser known is that Dingell’s father served before him, meaning a Dingell has represented the district since 1932. Why is this important? When you are removed from the life of a constituent for too long, as Dingell was, you get funny ideas. Rather than understanding that an elected leader is a servant of the people as President Harry Truman reminded so many, there are those that begin to believe that their constituents are to follow them. As Dingell said in an interview in March 2010 during the health care debate, “…it takes a long time to do the necessary administrative steps that have to be taken to put the legislation together to control the people.”

The famous writer and freedom fighter Vaclav Havel, imprisoned for his fight for human rights in Czechoslovakia against the communist, totalitarian repression of the Soviet Union, became the country’s President after the Velvet Revolution. He understood this dangerous phenomenon of empowering politicians and bureaucrats to create rules for which they are never held responsible.

Health care is just one area that many in the current political and bureaucratic class are working hard to cede to the state to operate. If we let this happen, we do it at our own peril. The American character is based on our thirst for liberty, free from the imposition of oppressive restrictions on the way we live our lives, and on rejection of having the state make choices for us; and the importance of personal responsibility.

This is especially important for the Jewish people, who have been able to live freely and prosper here because of personal liberty, the freedom to choose our path, and the ability to be judged as an individual.

Providing health care directly from the state may seem like a good idea, and there are well-intentioned people who support this. But these decisions cannot be taken lightly nor be made by assuming it will all be good. Sacrificing personal liberty is a tremendous and irrevocable price.

Asked what he learned after leaving Scientology after 30-plus years, the multiple Oscar winning screenwriter/producer/director Paul Haggis said in Alex Gibney’s documentary “Going Clear: Scientology and the Prison of Belief”: “What I take away from it is that we lock up a portion of our own mind. We willingly put the cuffs on, we willingly avoid things that will, could cause us pain if we looked. If we can just believe something then we don’t really have to think for ourselves, do we?”

Ceding the power to decide our own destiny is guaranteed to end in pain and, for some, death. Don’t be fooled. Remember Charlie Gard.