Talk Back: A Reply to the CNA Talking Points


By: Warner Todd Huston

Unions are spearheading the attack on our healthcare system and none more so than the Service Employee’s International Union and its sister organization the CNA. The ten talking points that the California Nurses Association has put out in order to rev up its membership to support a universal, single payer healthcare system is interesting, to say the least. In this posting, I’d like to reply to each of them with a little rebuke of my own.

But first I’d like to remark on the ham-handed style in which these talking points were written. The class warfare rhetoric here is more reminiscent of a protest placard than any serious discussion of public policy. But, be that as it may, here we go…

1. Everybody in, nobody out. Universal means access to healthcare for everyone, period.

–Well, it certainly sounds nice, doesn’t it? Of course, we already have such a system as it stands now. If you cannot afford your own care, the government already has programs to cover you. So, essentially, everyone is already “in” to one extent or another. Additionally, the devil’s in the details, we all know, and the main question is not one of if everyone is “in” but what does “in” mean? If we all have the worst care possible, but we are all “in” it, that isn’t very reassuring, is it? So simply the having of universal care is no guarantee that such care will be of good quality.

2. Portability. Even if you are unemployed, or lose or change your job, your health coverage goes with you.

–This is certainly a good point. But it is not one that can only be solved by a single payer, socialist healthcare system.

3. Uniform benefits. No Cadillac plans for the wealthy and Pinto plans for everyone else, with high deductibles, limited services, caps on payments for care, and no protection in the event of a catastrophe. One level of comprehensive care no matter what size your wallet.

–Once again, what is that “one level of care”? Is it the worst possible “level”? If you happen to be able to afford a “Cadillac plan” why should anyone tell you that you shouldn’t be allowed to have it? This is still America, right? This is simple-minded class warfare that has no place in a serious discussion of public policy.

4. Prevention. By removing financial roadblocks, a single payer system encourages preventive care that lowers an individual’s ultimate cost and pain and suffering when problems are neglected, and societal cost in the over utilization of emergency rooms or the spread of communicable diseases.

–Of course, the only way to assure the outcome of this talking point is to have government control what it is you do to “prevent” things. When a patient arranges an exercise, or health regime with his doctor he does so with his own interests in mind. He is free to observe or ignore his doctor’s advice, too. But to fulfill this talking point it will be government insisting on your lifestyle. And if you refuse to take heed of that government proclamation you will be punished by having life-saving healthcare removed from you otherwise the government strictures have no teeth and may as well not be made (is paying taxes a mere “suggestion,” for instance?). Is this the sort of power we want to hand over to government?

5. Choice of physician. Most private plans restrict what doctors, other caregivers, or hospital you can use. Under a single payer system, patients have a choice, and the provider is assured a fair reimbursement.

–This is simply a lie. It is seen over and over in other countries where universal, socialist healthcare is the norm, that doctors are trained by and paid by government, their doctors are placed around the country by government, and they are given specialties by government. Therefore, once a single payer system is well underway, there is no “choice of doctors” except that of the ones government offers. Choice is a chimera that doesn’t really exist because government controls how many doctors are in a given area meaning that the “choice” is government’s not the patient’s.

6. Ending insurance industry interference with care. Caregivers and patients regain the autonomy to make decisions on what’s best for a patient’s health, not what’s dictated by the billing department or the bean counters. No denial of coverage due to pre-existing conditions or cancellation of policies for “unreported” minor health problems.

–Currently, government already controls what doctors charge in many respects. Medicare and Medicaid only pays about 40% of the fees that doctors charge and many doctors simply stick to the arbitrary fees as set by government now. So those “bean counters” so thoroughly despised in this talking point are often already under the thumb of government price control policies. This talking point misleads people into imagining the whole price issue is currently free of government meddling already. It is not.

7. Reducing administrative waste. One third of every health care dollar in California goes for paperwork, such as denying care, and profits, compared to about 3% under Medicare, a single-payer, universal system.

–This will likely not change much if government took over all healthcare billing. Again, most healthcare billing is conducted using government guidelines already. Further, what government office is anyone aware of where red tape and administrative costs have ever been reduced? How can we merely assume that such will happen with a government run healthcare system?

8. Cost savings. A single payer system would produce the savings needed to cover everyone, largely by using existing resources without the waste. Taiwan, shifting from a U.S. healthcare model, adopted a single-payer system in 1995, boosting health coverage from 57% to 97% with little if any increase in overall healthcare spending.

–I cannot speak to this statistic used. But I can say that if there is any government program that ever saved money or even came close to estimated costs, I’d like to see it. Medicaid and Medicare went billions of dollars over costs and are still outpacing expected spending. Why would this new plan be any different?

9. Common sense budgeting. The public system sets fair reimbursements applied equally to all providers while assuring all comprehensive and appropriate health care is delivered, and uses its clout to negotiate volume discounts for prescription drugs and medical equipment.

–I like that, “uses its clout,” as if those being “negotiated” with have any choice. In truth there is no “negotiation.” There is only government dictation. Additionally, I like the use of the word “fair.” Who says what the government forces on people is “fair”? What is “fair” based on? It sure isn’t based on any market conditions. No, this talking point is just a load of hogwash. And when we look at what government dictation means we realize that it leaves no room for innovation, invention and improvement. There will be no reward to strive for. In the end, new drugs, new procedures, new equipment will simple end up nonexistent. There won’t be any reason for anything new to be worked for because nothing but what government allows will be extent.

10. Public oversight. The public sets the policies and administers the system, not high priced CEOs meeting in secret and making decisions based on what inflates their compensation packages or stock wealth or company profits.

–And this one is the funniest of all. Of course, this talking point is more class warfare disguised as healthcare advice and nothing else. It is all hate and no help. You see, in a free market system, we all, collectively, already have the “public oversight” that the CNA is talking about. We have it by patronizing or withholding our healthcare dollars from doctors and institutions that work well or don’t work well for us. If a hospital or doctor does not fit the needs of patients, they will eventually go out of business and deservedly so. Additionally, if there is one hospital that is being badly served by the decisions of its eeeevil CEO, patients may go to other hospitals instead. We have all sorts of choices in this way.

But imagine a world were the bad CEO is the national government and there is nowhere in the whole country to go to avoid the bad public policies of the nation’s CEO? That is what you’ll get when government controls the whole ball of wax. You’ll get no choices at all. No way to escape the bad polices. No way to use the power of your healthcare dollars to better effect.

And let’s remember one thing, here. What do you hear from every person you know concerning the federal government and our nation’s politicians? Do we hear constant praise about how responsive they are to the voters? Do we hear a gushing love for Washington? No? Or do we rather hear how our politicians are selfish, disinterested, inside traders that are padding their own pockets instead of doing what is best for the people of the United States? And, now think about just who it will be replacing those eeeevil CEOs out there! That’s right, it will be the very politicians in Washington that everyone says are already so badly serving the country. Only now they will be in charge of our health! Do YOU want that?

I sure don’t.

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