Single-Payer Healthcare

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Geez, I don’t know, it kinda sounds like a good idea sometimes, right?

Ever been so hopelessly, helplessly sick that you could only depend on others? Ever had no one else to rely on? Or only people who themselves are too poor to really help?

Ever wonder what we could do as a society to make sure that people aren’t suffering and dying of curable ills just because they’re poor?

Well, so what about “single-payer,” or “Medicare for all”? I mean it’s not full-communism socialized healthcare where every doctor is a government employee holding your health over you like another gun in his holster-belt, right?

Well there’s a problem. Just like with all sorts of “privatizations” in the economy, such as vouchers for private schools, what happens is market forces and businesses become corrupted by perverse incentives. Even though it sort-of seems like you’re the customer, in fact, he who pays the piper calls the tune. So while the debit card may be in your hand, the money still comes from the state, and it’s their priorities that are parmount.

Just read about this family’s nightmare in dealing with Florida Medicaid. They’ve had to flee the state in search of better healthcare, convinced as they were that Medicaid was “killing” their tiny helpless daughter.

Siren songs sound nice sometimes. Society making sure that poor and sick people are not simply left helplessly to die or suffer otherwise avoidable permanent injuries should be and remain the highest priority of civilization, but government just doesn’t work.

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Scott Horton is Managing Director of The Libertarian Institute, host of Antiwar Radio for Pacifica, 90.7 FM KPFK in Los Angeles and KUCR 88.3 in Riverside, podcasts the Scott Horton Show from, and is the Opinion Editor of He’s conducted more than 4,000 interviews since 2003. He is a fan of, but no relation to the lawyer from Harper’s.

Scott lives in Austin, Texas with his wife, investigative reporter Larisa Alexandrovna.


  1. This should be a continuous topic to allow people to talk about their horror stories dealing with government healthcare. My wife works for a doctor, as a libertarian herself, this puts her in a unique position to see the gross incompetence and backwards incentives that our third-party run healthcare system places between doctor and patient. She routinely has to kick patients off of medication that, in some cases, they had been on for years simply because arbitrary standards were handed down from Medicare/Medicaid. The worst stories are those of elderly patients losing a few pounds and having their insulin prescription taken away and my wife has to consul them as they cry through the realization that they cannot afford the out of pocket expense. As is quite often the case, the very next caller will be a twenty-something, Medicaid recipient, seeking opiates and they have no problem gaming the system into submission for their habit. This will always be what budgeting/political incentives in healthcare will look like with government running the show.

      • Ha! Someone could make an entire website dedicated to people griping about the major agencies. I did want to point out that I do not think that anyone should be receiving healthcare paid for by the state. But I still see the elderly women that my wife had to give that bad news to as a victim. She rationally expected something that she had been told would be available to her. It is hard for me to blame someone for not taking the time to understand economics and why incentives in government healthcare will always lead to misallocations and rationed care.