The deficits shown are a per capita
deficit for every taxpayer. Single payer health care has many of the same
pluses and minuses as as Universal Prepaid Managed
Care. However, the negative slope and per capita negative deficits are
greater because of the government picks up the full cost of all care provided,
including the catastrophic coverage. In
nations with universal single payer systems of health care, the necessary
response by government has been to limit or ration care.
Even taking into account the supposedly lower overhead of operating a single payer Health Care system (which is frequently achieved by leaving out the cost of collections and capital expenses such as buildings), the general experience is that these programs run significant deficits. They are a drain, not boon, to the national economy.
Politicians, under such single payer system are faced with the unrealistic task of having to balance compassion to help by expansion of benefits with fiscal reality that expanded benefits usually cost more than can be afforded. Once benefits have been expanded, there is little that can be done to reign in out of control costs without facing significant political problems from the entitled public.
If any one lesson is to be learned from these single payer experiments, it is that democratically controlled health care benefits are no substitute for a properly defined and balanced marketplace. If given the opportunity, the marketplace is fully capable of properly balancing fiscal reality with desires and has little difficulty adjusting to (as well as promoting) changes in the marketplace to improve the quality of service offered. The same can be said of most every conceivable social benefit program.
As a final comment, it should be pointed out that catastrophic reinsurance of all coverage in a common pool (whether operated by the private or public sector) can perhaps be considered a form of single payer catastrophic coverage. If limited to catastrophic coverage, this is perhaps a valid application of the single payer concept to prepaid health care financing.