What if everything you thought about single payer was wrong? What if the reason we don't have it and there's so much opposition to it is not because of the greed of the insurance companies, corruption, or the influence of private interests at all? This is what most progressives believe is getting in the way of single payer, that there are people and institutions with deep pockets who stand to lose from single payer. But what if the conspiracy goes much deeper? The central observation that ties everything in this post together is that we already have single payer for people who work for the government in whatever capacity. The central thesis is: What if the reason the rest of us don't have single payer is because it's in the interest of the government bureaucracy to limit taxpayer-funded healthcare to themselves alone? Below, I'll make the case as to exactly why that is in their interest, and why a deep-state cabal of high level government officials, if such existed, would oppose single-payer for everyone. Disclaimer: This post is long. If you don't like reading long posts, please just go on to another thread. Let me first start by making an analogy and posing a question that is seemingly unrelated. Why doesn't the government simplify the tax code? Why is it so complicated? I think it's without question that part of the reason why it's so complex and there are so many rules is because the government likes having the ability to incentivize people to make certain choices in life that they believe are "good for society" or "for the greater good." For example, married couples get significant tax benefits over single people, even though there is no purely economic justification for it. It's perfectly reasonable to suggest that married couples are given tax incentives because the government and society wants to encourage the institution of marriage. (I'm not saying that the government shouldn't do this, by the way). Also, homeowners get tax benefits that owners of other types of properties don't get (for example, I don't get tax benefits for owning gold bars, luxury cars like I do with owning a home). Clearly, the government wants to encourage homeownership, and the tax code is the way it is with regard to homeownership for this express purpose. These claims aren't controversial - most would agree that this is one of the reasons, if not the reason why the tax code incentivizes marriage and homeownership. (Again, I'm not condemning this or making a value judgment here). What if the powers that be oppose single payer healthcare for essentially the same reason that they oppose simplifying the tax code? If everyone were to get the same tax benefits regardless of their marital status or homeownership, the government would lose a policy tool that allows them to incentivize people from making certain choices that the government feels are "good" as they see it? Likewise, if everyone had the same healthcare plan as in a single payer system, the government would lose their ability to incentivize people from making certain career choices based on the different healthcare plans that come with these different career choices. What are some differences in healthcare between different groups of people? Here are some: 1) Military vs. civilian 2) Employee vs. Self-employed 3) Government worker vs. Private sector worker 4) Senior citizen vs. Non senior citizen 5) Union member vs. non union member Under a pure single payer system, veterans and the military and civilians would get the same healthcare. People working for big companies and self-employed and freelancers would get the same healthcare, private sector and government workers would get the same healthcare, senior citizens and everyone else would get the same healthcare, and as would union members and non-union members. How is this a problem for the government? The government needs to be able to recruit enough soldiers to man a giant military, and can't reinstitute conscription because it would be political suicide for any party that suggested it. The difference in health benefits that soldiers and veterans get versus civilians is undoubtedly one of the selling points that armed forces recruiters use to encourage enlistment. What if there were a single payer program? The recruiter would basically say, hey, "so you're not going to get any health benefits that a civilian won't get, but you will get to serve your country and the civilian will just be doing a job!" You could argue that the military is always going to get better health benefits than a civilian even with a single payer system..i.e. there will always be special perks for service. I agree to a point, but health care isn't something like cash more is better. That's because healthcare is a service whose value diminishes beyond a certain point, especially for a healthy person. A typical single payer health plan would be "good enough" for the vast majority of the populace and the additional benefits one would get by joining the military would have rapidly diminishing returns. The difference between potentially having no healthcare for you and your family or really expensive healthcare and the current military/veteran plan is a significant one, whereas being on a single payer plan that all civilians would get and the slightly better military plan is minimal for reasons I've described - thus in a single payer system the government would lose much of its ability to incentivize young men to join the armed forces. In the same way, the government needs to man its vast bureaucracy and workforce of millions, including administrators, clerks, mail carriers, parks and recreation, teachers, police officers, and firefighters. Because the private sector generally has greater income potential and growth as a rule, there would be much more employee turnover if all of these government workers and private sector workers were under the same single payer health plan. Without there being a meaningful difference in the health plans between the private sector and public sector, one of the major draws of working in government would be gone, and government would have to raise salaries across the board in order to prevent losing its workforce to the private sector. I could go on but I think I've made my point. Single payer means the government loses much of its power to influence and incentivize our life and career decision-making by giving certain preferred classes (like government workers and military) more secure and better health benefits than the general populace, who either have to buy healthcare on the health exchanges and pay their own way (freelancers, contractors), pay for some of their health insurance out of pocket (employees at larger companies). In other words, this theory of why the "power elite" opposes single payer doesn't necessarily require the government to have been "corrupted" by health insurance lobbyists, big Pharma, the medical-industrial complex or other private interests who most liberals and progressives advocating for single payer believe are responsible for obstructing the passing of single payer. Now I'm not saying that these private interests don't benefit from the government's decision to oppose and demonize single payer, but I'm saying that the tail isn't wagging the dog as is commonly believed, but that the dog is wagging the tail. The government decided from the very beginning to oppose single payer and the private interests that benefit from this policy stance just go along with it because it's good for them. In my theory, the real reason the government opposes single payer isn't because the private sector has corrupted them, but because the government wants to be able to recruit and attract people to work for it, and passing single payer reduces the ability of the government to fill its positions and increases turnover. I think this explanation's biggest advantage compared to the theory that the government has been corrupted by private interests is that it's simpler - it's basically undisputable that the government really does need to attract and retain a massive workforce, so that the primary motive for demonizing single payer is really a human resources problem, as a zero benefit differential or reduced differential means private sector employment would be much preferred. It's just a matter of an organization doing what it needs to do to continue to exist. In that sense, it's less of a conspiracy than the belief, pushed by the progressives, that the government has become corrupted by the health insurance companies, big pharma, etc. I have several questions: 1) Is it fair that people who are employed by the government, without exception, get all of their healthcare paid for by the taxpayer while those not employed by the government don't? 2) If I am correct about the analogy between why the government likes to keep the tax code complicated and why the government likes keeping the health insurance system complicated; i.e. the government wishes in both cases to have a policy tool at their disposal to encourage people to make certain life choices like homeownership and marriage versus others, and to encourage people to make certain life/career choices like joining the military, working for the government in administration, teaching, police, etc by providing benefits significantly above and beyond the average private sector job...is it morally and politically acceptable to do so? 3) For conservatives in particular, IF my analysis were somehow found to be absolutely correct, would your opinion on single payer change? 4) For liberals, do you think that it is worse if single payer were opposed by the powers that be primarily for the reason I've suggested a. (because it's necessary to create differences in quality and cost and security of health insurance in order to attract public sector workforce and retain them against the superior pay and growth potential of private sector jobs, and putting EVERYONE in the same health plan would eliminate or dramatically close that differential, thus making it harder to retain and attract public sector workers), or b. Because the government has been corrupted by lobbyists from private interests that would lose if a single payer system were passed (highly paid medical specialties, private health insurance companies, drug companies, etc)?