In a legitimate debate about health care, Democrats would want single payer system assuring coverage for everybody. Republicans would want a system that reduced costs. What actually happened with Obama Care, however, was that the Republican insistence on using private heath insurance companies actually increased costs by increasing the power and profits of insurance companies without reducing doctors’ or hospitals’ costs. A single payer system would have given the government leverage to bring down costs; whether it would have actually done so will never be known. Congress was quick to restore doctors’ Medicare fees to the old, higher level when they were in danger of being reduced by some of the automatic budget reductions.
Some doctors refuse to accept Medicare patients because Medicare pays less than private insurance. If Congress had passed “Medicare for everybody,” however, doctors would have had less opportunity to earn the high rates they currently do, although for the doctors who treat the richest “one-percent” price is irrelevant.
In a New York Times report on the richest one percent,they found that after a general category called “managers,” physicians made up the next largest portion of the one percent, with those working out of their own offices earning the most. Almost none of these rich doctors work in a world where fees are set by a free market; they are either paid by insurance companies or the government, in both cases with fees set in advance. A patient who walks in the door of a doctor’s office has no bargaining rights. The doctors make sure up front that they are will paid.
The Republicans did nothing to insert free market principles in the health care law. If anything, they strengthened the hands of the doctors in negotiating with the insurance companies and the government, assuring that the most expensive health care in the world will become even more expensive.