By Alec Pruchnicki, MD

Having been involved in the single payer movement for over 25 years, I have often had to answer mistakes, myths, and outright lies about it. After a while it gets tedious, but it looks like I’ll have to do it again.

1. “It is politically unfeasible.”

—but not impossible. Even right-wing Tea Party conservatives love government programs that help them, like Medicare and Social Security. An improved Medicare with no deductibles, copayments, and much wider coverage would get overwhelming support.

2. “It is economically unfeasible.”

Insurance companies might be hurt (although not if they took the proposed buy-out discussed in previous issues). Every other business in the country would benefit by having the burden of health care costs eliminated. A recent economic analysis by Gerald Friedman, an economist at U. Mass Amherst, showed that new jobs in other industries would be several times more than losses in the insurance industry.

3. “It is an administrative nightmare.”

Every doctor’s office, hospital, and nursing home knows the rules and regulations of Medicare. Dealing with that one insurance source, instead of the hundreds we have now, would give major administrative savings.

4. “Doctors don’t want to become salaried employees of the government.”

The single payer is a claims payment system. Nobody would become a government employee who wasn’t one already, and the decrease in administrative costs would enable private practices to stay independent, instead of selling out to hospitals the way they are forced to do now.

5. “Private insurance can exist through the ACA.”

The ACA leaves out tens of millions of people, and often gives expensive insurance to those who get overage. Administrative savings occur when you get rid of the duplicative insurance companies, not expand them.

6. “They can operate as regulated utilities”

Government regulations in the US are notoriously weak when compared to Europe. The effect of money in politics sometimes makes it seem like the big corporations and big donors are regulating the government instead of the other way around.

7. “Quality would suffer.”

By virtually every study, healthcare results in the U.S. are poorer than almost every other industrial country. And they all have single payer systems to some extent.

8. “More taxes”

Maybe, but every other medical expense would be decreased or disappear completely, and coverage would expand and be permanent. Estimates go as high as several thousand dollars a year for the average household. As the system got more efficient, costs, and taxes could go down dramatically. We already spend as much in taxes for healthcare as other countries spend for their entire systems. We are paying for universal care already through our taxes, but not getting it.

9. “Waiting lines”

There are waiting lines now in the US, and if you don’t have money or the right insurance, you will be waiting forever.

There are many more myths and mistakes about single payer healthcare. Go to pnhp.org, pnhpnymetro.org, or healthcare-now.org to get more information about anti-single payer disinformation and what to do about it.


Alec Pruchnicki, MD is on the executive board of the New York Chapter of Physicians for a National Health Program, a single payer advocacy group.

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