Last week, I was listening to Thom Hartmann’s program on Air America, when a well-spoken seemingly intelligent caller protested in frustration that with single-payer there’s no competition, as though without competition quality and efficiency are sure to suffer.
Americans’ neoliberal braining washing has to be repaired. There is nothing inherently good about free-market competition. It’s inherently expensive, wasteful, and often counterproductive. Advertizing is expensive, duplication of efforts is wasteful, and the competition among insurance CEOs to minimize "health losses," is counterproductive.
Those inherent liabilities of competition are often outweighed, however, by the innovative effort it provokes. But that’s only in cases where that effort is channeled in a socially productive direction, and in the case of health insurance it is channeled toward avoiding paying the healthcare expenses of sick people, which is a serious problem for society.
The key virtue of single-payer is that it eliminates competition and diminishes its attendant expenses:
— advertising budgets
— recision departments
— PR budgets
bribery budgets campaign contributons
— duplication of effort by the insurers
— duplication of effort (e.g., multiplicity of forms) by the providers
It also gives the customers a higher quality of service, i.e., their insurers don’t compete to fuck them over by not paying their bills and by dumping them when they get sick.
But (many) Americans have been so brainwashed by free-market capitalism that they can’t recognize the obvious. They truly believe that if the healthcare market is broken, only more "choice" and "competition" can fix it.