- The Washington Times - Sunday, October 27, 2002

Soaring health care costs are a very real problem. A bigger problem, however, is what Oregon voters have on their November ballot, which a dozen other states are also considering: single payer health care. Proponents claim that having the state pay for nearly everyone's medical needs will provide high-quality, accessible, affordable and comprehensive care to everyone. If this is such a good idea for the health care sector, then surely it should first be applied to a sector more important to people's immediate well being, like food.
While proper health care is critical, some people go years without seeing a doctor and are perfectly healthy. Without food, on the other hand, any person would die within several weeks. Therefore, because there are people who do not get enough to eat, let's start with single payer food. From this point on, anyone can walk in to any restaurant or supermarket and take whatever food they need, cost free to them.
Think about it. This would mark an end to the hunger problems that plague our country. Everyone would be eating better quality food than they've ever had and the state would pick up the tab. Rejoice, problem solved.
Then again, perhaps we should stop and think through the likely behaviors that would follow in the event that single-payer food became law. For one, people are sure to take far more food than they do now, not because they would necessarily eat more but simply because its free. Why take four apples, when you can take eight, even if you know you won't eat them all. People would also head straight for the very best restaurants and lay claim to the most expensive food. Why not, it's free?
Obviously, such a system could not be sustained indefinitely. Demand would far exceed supply. So how would the entity paying the bills and the suppliers of the food (restaurant and supermarket owners) likely respond?
We'll start with the bill payer. Without question, the tab would be far beyond the state's (the taxpayers') ability and willingness to pay. The state would therefore have essentially two options: Ratchet down what it pays to restaurants and supermarkets per item and/or be more selective in the food items it covers. One wonders about the criteria they might use. Regardless, this still would not solve the inevitable overconsumption.
The suppliers would be none too happy. How would you like it if someone other than your customers began telling you what you could charge? The suppliers' incentive would remain pleasing the bill payer, only that would no longer be the customer but some faceless state bureaucracy. What they put on the shelves or on the menu would be determined less by consumer demand and more by what the state is covering and how much it is paying. Anyone think this would improve the quality and availability of food? You might if you think the state is a better determiner of your needs than you are.
(By the way, as a fun little experiment, ask the owner of your favorite restaurant if she thinks single-payer food is a good idea and would work).
Of course, let's not forget what the food consumer would inevitably face lines, rationing and lower quality food. Lines and explicit rationing because those are the only ways single-payer systems can keep demand in check, and lower quality food because the better supermarket and restaurant operators would not want to continue operating in a system that discriminates against quality. Call them crazy.
Single-payer food like single-payer housing, single-payer transportation and, yes, single-payer health care hasn't worked and can't work. Look at Canada where single payer health care has been in effect for nearly 20 years. Among the world's 29 richest countries, Canada consistently ranks above only Mexico, Poland and Turkey in terms of medical technology. Months-long waiting lists for critical services and referrals to specialists are common. Cancer survival rates are well below those in the United States and prescription drugs are rationed. Of course, the rich and the political elite use their resources to skip the lines and head south to the United States for treatment, or pay privately, but illegally, for expedited service.
But there is always a first for everything. Maybe the only reason single payer has never worked in any economic sector in any country is because the right people were not in charge. Just try single-payer food first to make sure it works.

James Frogue is director of the Health and Human Services Task Force at the American Legislative Exchange Council.

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