Charlie Gard has nothing to do with single payer. In the UK, if the NHS won't fund something (normally because it doesn't work or is horrifically expensive - see NICE for the gory details) you're free to go private.

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.

Single payer wasn't the problem with his case. No health insurance company would have voluntarily paid for an experimental treatment for him.

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.

In the U.S., the doctors do not have standing to appear in court and order treatment, or non-treatment, for a patient. That is solely up to the family, and if there is no family, the court appoints a guardian. There is no way this situation could have happened in the U.S., where the parents were forbid to pay for own treatment.

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.

I'm not entirely sure that's true in the US, that people can make medical decisions on behalf of a minor without any legal coverage of whether it's in their best interests, but I'm not familiar enough with US law.

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.

The issue is who gets to decide for the child. In the U.S. it's the parents, not the doctors or the court.

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.

No, sometimes it's the court in the US. http://journalofethics.ama-assn.org/2006/10/hlaw1-0610.html - and this has nothing to do with who pays for it.

Charlie Gard's parents were free to pay for experimental treatment throughout the course of his illness up until the point where legally they were stopped from doing something that was considered bad for him. Here in the UK we have a single payer public health service and privately paid services. People are free to choose which they use.

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.

Note to bystanders: Trump mentioned Gard on Twitter; he's clearly being invoked in the context of the attempted Obamacare repeal. There is a very large industry invested in convincing people that healthcare that doesn't arbitrarily bankrupt people is a bad idea.

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.)