There's no free market in healthcare. They are selling services without providing prices... it completely breaks any market that might exist.
And it takes a state license for them to operate. The state could require them to provide an accurate and up-to-date price menu in order to remain in business.
I think the problem is also related to the opaque negotiated prices that "in network" providers negotiate with insurance companies, driving up the cost for uninsured or "out of network" consumers.
There are perfectly rational solutions short of single-payer.
In Charlie Gard's case, the parents have raised the money to take him to the US for the pioneering 'treatment'. The court's barred them from taking him because they've ruled that doing so is not in his best interests, and that he should be allowed to die. Which is pretty damned unusual for the English courts, to be honest. And given he got a full hearing at the supreme court, and his own advocate, and it's not a matter of money, I'm inclined to believe the doctors and the judges.
But even if you think they're wrong, it's still not about single payer.
The state has power, even in the USA, to make decisions for the benefit of children if the state decides that the parents aren't acting in the best interest of the child.
There is a perfectly valid argument to be made that the state should not have intervened (this is subjective), but it had very little to do with the NHS being single payer.
And by choosing to use the single most emotionally charged case, you are also skipping all of the perfectly rational arguments against the broken health care system we have now.
I think it does concern single-payer. I can only think of the quote, "A government powerful enough to give you everything you want, has the power to take everything you need away". In this case, where the government controls healthcare, it can make decisions for you, even if that is not what you want, or are willing to pay for yourself.
However if we look at the facts of this case: http://www.gosh.nhs.uk/frequently-asked-questions-about-char...
"One of the factors that influenced this decision was that Charlie’s brain was shown to be extensively damaged at a cellular level. The clinician in the US who is offering the treatment agrees that the experimental treatment will not reverse the brain damage that has already occurred.
The entire highly experienced UK team, all those who provided second opinions and the consultant instructed by the parents all agreed that further treatment would be futile – meaning it would be pointless or of no effective benefit."
Edit: oh yes, and the court submissions are interesting reading (via twitter:) https://t.co/Wjs7KrRWMU
> When the hospital was informed that the Professor had new laboratory findings causing him to believe NBT would be more beneficial to Charlie than he had previously opined, GOSH’s hope for Charlie and his parents was that that optimism would be confirmed. It was, therefore, with increasing surprise and disappointment that the hospital listened to the Professor’s fresh evidence to the Court. On 13 July he stated that not only had he not visited the hospital to examine Charlie but in addition, he had not read Charlie’s contemporaneous medical records or viewed Charlie’s brain imaging or read all of the second opinions about Charlie’s condition (obtained from experts all of whom had taken the opportunity to examine him and consider his records) or even read the Judge’s decision made on 11 April. Further, GOSH was concerned to hear the Professor state, for the first time, whilst in the witness box, that he retains a financial interest in some of the NBT compounds he proposed prescribing for Charlie. Devastatingly, the information obtained since 13 July gives no cause for optimism. Rather, it confirms that whilst NBT may well assist others in the future, it cannot and could not have assisted Charlie.
My concern is that if there is a single payer health care system here in the U.S., the patient will lose control of their health care decisions, as it appears the parents of Charlie Gard did.
Even ignoring that fact though, the idea that hundreds of thousands of people should face financial ruin and all the negative societal effects that carries with it because extreme outliers need to be handled separately is an utterly broken way of running a healthcare system.
This is why people are talking about Charlie Gard and not, say, Maatthew Stewart http://theweek.com/articles/666799/how-american-health-care-...
(Does anyone track suicide rates linked to medical bankruptcy? That's got to be the ultimate negative outcome.)
The cost side works in every other developed nation? Surely you're aware of how much more expensive health care costs are in the US, so what might you be referring to?
There are other effects as well - nobody is getting away with billing $600 for a 5 minute visit, for instance.
Which isn't to say that single payer wouldn't be an improvement on the current system. Just don't get your hopes up for how much money it'll save.
No, we don't. Medicare is not single payer, though it has (for a subset of the services covered by Medicare) a default public option; it also has private, partially-public-subsidized pland; Medicaid, at least in many states, is not single-payer, either, even at the state level, even before considering overlap with Medicare and other insurance.
http://data.worldbank.org/indicator/SH.XPD.PUBL.ZS?year_high...
https://ourworldindata.org/the-link-between-life-expectancy-...
America isn't special.
Apparently, states are unable to restrict entry into state benefit programs such as healthcare. They can't set up a waiting period for people moving into the state before they are eligible; that was declared unconstitutional by a previous Supreme Court. So if states were to do their own single payer system, in theory sick people could move into the state and immediately gain free healthcare simply by virtue of being a resident. Conversely, they could then move back to their home state that doesn't charge higher taxes.
So it wouldn't be feasible on a state-by-state basis unless a future SCOTUS reverses their precedent. This is unlikely in the short term, given the current Court's make up.
Government programs set maximum reimbursement rates and also mandate cost accounting mechanisms to assure that actual reimbursement is not merely within pre-set rates but also justified by actual provider costs. The government isn't buying services with no advance information about what the charges may be.
Private insurers impose similar controls.
So single payer (or even universal coverage through private insurers) eliminates the particular kind of “robbery” from undisclosed charges being discussed.