Capitalism, and the market, is a wonderful thing... but there are some
"leveling the playing field" benefits of single payer systems. For one,
if you have multiple companies competing in a cut-throat market, they
will be forced to look at cutting employee benefits to gain advantage.
Walmart, for example, uses labor practices that force a large percentage
of their employees onto the public health care rolls. Another more
obvious example is the problems some older companies are having with
pensions. United ditched their pension obligations under bankruptcy
protection, and now there are stories of GM
looking at the same thing. When GM competes with a company in a country
that has a single payer system, GM may be at a disadvantage, depending
on the relative costs of taxes vs. health care. In addition, a company
like United was at a disadvantage to a newer company like Jetblue
because they have legacy pension obligations that Jetblue won't have for
50 years. And now that United has ditched its pension obligations,
other older airlines like American are at a disadvantage because they
still have their pensions to maintain.
One might argue that if none of these single payer systems existed,
their wouldn't be this pressure for the US to have one as well.
Granted, it would be reduced. But good luck getting other countries to
ditch their single payer systems.
Another aspect of company systems is discrimination against those who
are likely to cost more. That discrimination is probably mostly age
discrimination, but it can also be weight or lifestyle based (obesity,
those who are fans of risk taking sports) or even against those with
families. The recent Walmart health care memo
lead to this type of speculation, for example. We may be a way from
discrimination, but its still there. And I'm not saying that companies
will discriminate, but as long as their is economic benefit to doing so,
some will be tempted.
There are, of course, problems with single payer systems as well, and
generally no one is happy with the level of service of their government,
but addressing the above problems in some fashion would definitely be