Single Payer and Nurse Shortages

Nurses are pitching universal health care. By that, they mean that we should move toward a single payer health care system. They want this because they believe there is a nurse shortage: About this, they are right, and it will get worse, especially with government run health systems.

Now I know that rank and file union nurses are smart people. They have to be to make it through all that training. Of course, all smart people are ignorant about some things, like politics and economics. That’s why they rely on their union leaders to make good decisions for them. So I excuse the rank and file from my criticism here.

The U.S. spends about 16 percent of its Gross Domestic Product (GDP) on health care. A good deal of that goes to health professionals, like physicians and nurses. By contrast, Canada spends about 10 percent of its GDP on health care.

Of that 16 percent, 45 percent is paid by government programs, and 55 percent by private insurance, and out of pocket payments. Or, it could be stated this way: About 7.2 percent of GDP is spent by governments to provide health care services (for 25 percent of the population), while 8.8 percent is spent by private insurance companies and people paying out of pocket.

Very few Americans feel undertaxed. Government health care is paid from tax revenue. In most Canadian provinces, health care spending already reaches 47 percent of all provincial tax revenue; plus the national government tosses in billions more.

If the U.S. decided to move to a government-run, universal health care system, the dollars available through tax resources would be less than are available today. That is, unless governments are prepared to raise tax rates by astronomical margins, or cut other vital programs to the bones – like bridge repair, for instance.

The end result of government-run, single payer health care is this: There will be fewer nurses than today, not more. Unless government health managers decide to dump physicians and replace them with less expensive nurses to deliver health care, and that, my friends, is not a step in the right direction.

Nurses, of all people, should be pushing to reduce the government’s role in health care (and I didn’t even touch on the low, low reimbursement rates they now receive, the rates that make it less possible to employ more nurses).

Nurses, work on your skills. Carve out a niche in an emerging, free market health care system.