The current debate over single-payer health care is rooted in a conflict of visions: Will government officials make the key health care decisions for Americans? Or will individuals and families be able to make these decisions themselves? Section 3 presents this debate directly, looking at the arguments for and against government-run care. The adoption of a single-payer system requires major tradeoffs: a loss of personal and economic freedom, the loss of existing health coverage, the imposition of unprecedented federal taxation, major payment reductions for doctors and medical professionals, long waiting lists, and care delays and denials.
One of the reasons why this national debate is so pressing is because public opinion is still malleable. When asked, American opinions vary widely depending on how the question is framed. If you tell Americans that universal coverage will lower health care costs, 72 percent support it. However, as Whit Ayres, PhD, points out in Chapter 8, “All you have to do is tell people one thing—this proposal is going to turn health care over to the government—and you end up with a two-to-one opposition to a single-payer health plan.” And, the more Americans learn about what government-run care means for their lives, the less they like it.
The debate over single-payer health care is far from over. As Robert E. Moffit, PhD, shows in Chapter 8, how the debate ends depends largely on the information, arguments, and policies advanced by the Right and the Left in coming years.