Why Single-Payer Health Care Denies Care To Sick Children Like Alfie Evans and the Idea of a Guaranteed Income System

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Single-payer advocates ask what the difference is between Alfie and an American who dies because he is too poor to afford care. It’s not an unfair question, and it deserves an answer.

Alfie Evans, a terminally ill British toddler whose case drew attention from Pope Francis and others around the world, has died, his parents announced Saturday morning.

23-month-old Alfie Evans has died after his parents lost their legal fight to continue his life support

Parents Kate James, 20, and Tom Evans, 21, wrote on Facebook that they were “absolutely heartbroken” that they had lost their son.

and mileage in the most fuel-efficient Wrangler ever.

Alfie was born in May 2016. Later that year he suffered a series of seizures and was admitted to a hospital in Liverpool where he has been since BBC reported.

Alfie developed an incurable degenerative brain condition and was at the center of a legal battle over his treatment.

Medics struggled to precisely identify Alfie’s condition.

Doctors said the further treatment was futile and recommended that Alfie be allowed to die, but his parents — backed by the pope and Christian groups — fought for months to take him to a hospital in Italy so he could be kept on life support.

Alfie’s father, Tom Evans, speaks to the media outside Alder Hey Children’s Hospital in Liverpool, England.  (Associated Press)

The hospital withdrew Alfie’s life support Monday after a series of court rulings sided with doctors who said continuing Alfie’s treatment was “not in Alfie’s best interests.”

Justice Anthony Hayden, a U.K. judge, said the ruling represented “the final chapter in the life of this extraordinary boy.”

Under British law, courts often intervene when parents and doctors disagree over the treatment of a child, who’s rights often take precedence over the parent’s right to decide what’s best.

RIP Alfie Evans. Heartbreaking news to hear this morning, My thoughts & prayers are with his parents, they did everything they could for this little man God rest his soul

RIP Alfie Evans.

My deepest condolences to his parents, who fought so hard for their brave little boy.

Heaven has its newest angel. Alfie Evans

News of Alfie’s death has brought an outpouring of messages from people sending their condolences.

Thomas Wheatley wrote recently that once again, a single-payer health-care system has attracted international attention for its moral depravity. The case concerns Alfie Evans, a British toddler who, by virtue of his slim chance at survival, is barred from seeking treatment elsewhere that might well save his life.

Appropriately, opponents of single-payer health-care have seized on Alfie’s case as an example of taxpayer-funded medicine’s evil nature. In response, single-payer advocates have asked what the difference is between Alfie and an American who dies because he is too poor to afford the health care he needs.

It’s not an unfair question, and it deserves an answer. To do that, however, it’s important to revisit how a situation like Alfie’s came to be.

Single-Payer Is Limited by Tax Revenue.

When a nation enacts universal, taxpayer-funded health care, it effectively builds a wall around its health-care system. Within this wall, resources are finite, which effectively creates a zero-sum game where one person’s gain is necessarily another person’s loss (only so much medication may be dispensed; only for so many hours of the day can a doctor spend seeing patients; only so many hospital beds can be vacant).

Where in a free market health system a patient has the entire global health industry at his or her disposal and is limited only by individual wealth, in a public system, a patient has access only to resources the government has acquisition and made available for use.

The extent of these initial constraints varies on the type of the system (a single-payer system, for example, will have tighter controls than a government health insurance option), but the underlying forces at work remain the same—namely that people prefer quality in health care for themselves over quantity in health care for the masses.

But preferring oneself in a collectivist health care system is problematic. For example, in a public health insurance model, in which the federal government offers an insurance plan that competes with private plans, doctors will generally prefer the payout of private insurance over that of public insurance. This is hardly a theory. According to a 2017 study, in the United States, the average Medicaid acceptance rate among physicians in major metro markets is only 53 percent.

To solve this problem, the government will force doctors to accept a certain quota of publicly funded insurance-holders or restrict access to private insurance altogether. Both options create a de facto single-payer system. The former destroys the incentive to pay extra for private health insurance (chiefly, faster and better care) while the latter simply destroys private health insurance itself.

Offering Unlimited Care Causes People to Use Much More.

Regardless of execution, once a government has secured total control over a nation’s health system, it will immediately run into a cost problem. Realizing the enormous fiscal burden that accompanies shouldering an entire nation’s health needs (a nation, mind you, in which individual consumers have no motivation to limit their costs), governments will turn to a mixture of three solutions to reduce spending or increase revenues.

The most obvious of these is to increase taxes. But this alleviates the government’s financial shortcomings only temporarily. A tax plan is only as good as the economy that supports it, and a tax-and-spend plan that excessively saddles a country’s economic engine will ultimately fail. Nowhere is this clearer than in Greece, where public health-care providers have turned to soliciting donations to meet their needs. Even taxing the contemptible “millionaires and billionaires” will provide only short-term relief, if any. There’s simply not enough money there for everyone.

When tax increases inevitably fail to cover costs, the government will adopt a more draconian approach to control spending. Laws will be introduced—like those in Britain—that force doctors to work in the public sector for lower wages. Doctors may be forced to work for free, and despite having obtained years of advanced and highly technical education, will find themselves in wage wars similar to those involving public school teachers.

Understandably, this decline in wages will force some doctors to cease practicing medicine, at least in their home country (see Greece’s “exodus of doctors and nurses”). To be sure, not all doctors will close their doors, but many will—likely enough to exacerbate the already-short supply of doctors, leading to the infamously long wait lines common to all taxpayer-funded systems. A tighter supply of doctors will, by default, increase their demand. Unable to pay doctors their true worth, the government will make a ham-fisted attempt to “reduce” demand—by rationing health care.

Enter Alfie Evans: a toddler destined to die so the government can pay the entire nation’s health bills. It doesn’t matter that Alfie can get treatment elsewhere. It doesn’t matter that Alfie’s parents object. It doesn’t matter that all human decency in the world is screaming in outrage at the barbaric injustice perpetrated by Britain’s single-payer death squads. The sacrificial lamb must be slaughtered in the name of progress.

What, then, is the difference between little Alfie’s case and the case of the poor American who cannot afford the healthcare he needs? Simple: The American’s life was lost. Alfie’s life was stolen.

Warning, could this happen in the United States? Under a government run single-payer health care system my fear is that it is a very real possibility.

Finland to end its universal basic income program by year’s end!

Edmund DeMarche from Fox News recently reported that the Finnish government reportedly announced Tuesday that it will end the country’s universal basic income program by year’s end — and appears to be taking on new measures to cut benefits to those who do not actively seek employment.

In January 2017 Finland became the first country in Europe to pay free basic income in a pilot, which evoked enthusiasm around the world.  (Reuters)

Basically what we are talking about when we consider the European healthcare system is the extension of a socialized system. One of the other benefits that many countries are touting is the guaranteed income for all. I included this article because Canada is considering the same guaranteed income system. A recent article noted that something is happening in the postindustrial pocket of Hamilton, Ontario, a 45-minute drive from Toronto’s gleaming skyscrapers. In its squat downtown, where payday loan services with names like Money Mart and Cash 4 U compete across the street from each other and a beware of dog sign hangs from a church gate, a potentially transformational future is on trial.

Hamilton (population: roughly 500,000 people) was built with steel and smoke, and recent downturns in manufacturing have hit the once-booming steel town hard. A study by the city’s social planning office last year found that in 2014 one in five children there were living in poverty. What’s more, dropping housing prices have made Hamilton something of a destination for would-be Toronto property owners looking for a deal, arguably driving up rental prices in the city even as vacancies increase.

So there was a sense of relief—excitement, even—when the Ontario government announced in mid-2017 that Hamilton had been chosen as one of three cities in the province for a pilot study on the effects of a basic income. A basic income is an essentially social support in the form of lump-sum payments with no strings attached, just like income from waged labor minus the work.

As of January 2018, more than 2,000 people in Ontario were getting basic income checks. All of them have applied of their own volition, though some people who met the criteria were sent application packages by the government as an incentive to check out the program. Ultimately, the government wants 4,000 people to participate in the pilot, which has the potential to be rolled out across the province as real policy after the trial runs its three-year course.

Yet the Ontario government has had substantial difficulties onboarding people for the pilot, which is why it enlisted the help of community groups like the Hamilton Roundtable for Poverty Reduction. At the Roundtable’s office in downtown Hamilton, I met a pilot participant, Dave Cherkewski, who chalked up the slow uptake to people’s fear of losing the benefits they already receive or getting caught in bureaucratic quagmires. This, he said, is the attitude created by living under existing social programs.

In Ontario, the basic income trial is open to anybody in the trial areas aged 18 to 64. Single people making under $34,000 annually receive up to $17,000, and couples earning under $48,000 will get up to $24,000 (as a whole sum or as a top-up), minus 50 percent of any earned income. People with disabilities receive up to $6,000 more per year, although they must stop receiving disability supports for the duration of the trial (“basic needs” disability payments in Ontario max out at roughly $8,000 per year for singles with no dependents and $12,000 for couples), which will run for three years.

By contrast, Ontario’s current last-resort social support program, Ontario Works, gives single people roughly $4,000 annually to live on, treating them as “clients” to be managed with caseworkers and regular check-ins.

Still, this isn’t Canada’s first experience with a basic income. The province of Manitoba first tested the idea in the 1970s, and the results suggested that people don’t become lazy slobs when freed from the struggle for survival. Instead, they go to school, get jobs, care for their families, and engage in their community. And while a basic income does cost more than many existing social programs, the cost of persistent poverty to provinces—reinforced, some argue, by services that seek to reduce poverty rather than eliminate it—amounts to tens of billions of dollars annually, through healthcare costs and lost productivity.

That a basic income lets people rethink their relationships with work, and one another, gives it a revolutionary aura for those who want society to move beyond capitalism to something more egalitarian. In a recent book called Postcapitalism and a World Without Work, authors Nick Srnicek and Alex Williams argue that we should automate as much work as possible and distribute the proceeds from robot labor to everyone as a basic income.

It’s these kinds of ideas that proponents say a basic income unlocks—that life freed from waged labor engenders more, fuller life. What new kinds of social cooperation, recreation, or work might emerge?

“A basic income makes people’s lives easier now, and I don’t think capitalism is going to end imminently,” said Evelyn Forget, an economist at the University of Manitoba who studies basic income and is consulting on the Ontario pilot. “But I also think it lets us have these wider conversations.”

But other countries have tried the same and it seems to work if you have the finances and the restrictions are realized. Here is an example of the turning tide and may be indicative of the other socialized delivery systems including healthcare.

Finland was considered the first European country to pay a monthly check of $685 to its unemployed between ages 25 and 58. It was considered a pilot program — serving 2,000 randomly selected jobless people — that its founders hoped to expand.

It may seem premature to establish a long-term plan at the beginning of your executive career. But the failure to act now could have serious consequences.

“It’s a pity that it will end like this,” Olli Kangas, who oversees the Finnish government agency that focuses on social welfare and helped design the program, told the New York Times. “The government has chosen to try a totally different path,” Kangas said. “Basic income is unconditional. Now, they are pursuing conditionality.”

“The government has chosen to try a totally different path. Basic income is unconditional. Now, they are pursuing conditionality.” – Olli Kangas, designer of Finland’s basic income program David Whitley summed up Finland’s decision in the Orlando Sentinel.

“Proponents said the program wasn’t comprehensive enough to gauge its merits,” Whitley wrote. “Critics say it would have required a 30 percent tax increase on an already over-taxed population to be viable.”

But some cities, including San Francisco, continue to look into the basic income theory, the Times wrote. Facebook CEO Mark Zuckerberg in 2017 said that basic income should be explored “to make sure that everyone has a cushion to try new ideas.”

That was essentially Finland’s theory when announcing the pilot program. The initial move was met with skepticism from citizens who questioned whether an unemployed young person would be motivated to find a job if they were making a steady income, albeit small.

“There is a fear that with the basic income they would just stay at home and play computer games,” Heikki Hiilamo, a professor at the University of Helsinki, told the paper.

Also, as I traveled the Danube River and questioned many Europeans that the guaranteed income system was a great idea as long as everyone was contributing to the economy as working constituents or at least the majority of the country’s citizens. I believe the same should be considered for a socialized universal health care system. There has to be a way to financially sustain the system chosen!

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