Skip directly to content

Shin: Single-payer Is Not The Answer

on March 24, 2018 - 8:11am
Candidate for House Rep. District 43

Obamacare had thousands of pages of job-killing mandates, regulations, and taxes. Why should we be surprised at rising costs and skyrocketing premiums? We should have learned that more government regulation over health care is disastrous. Instead, we have Councilors Sheehey and Chandler competing to be the louder voice for single-payer: the most control government can have over health care.

Be wary of those who tout the merits of socialized medicine. They love to talk about access to preventative, primary, and specialty care, but avoid the crucial questions: “How are we going to pay for it?” and "Who will be the providers for it?" Briefly, these are the reasons why a single-payer system would not work for New Mexico.

It would dismantle and bankrupt the private health insurance that people rely on for their care. Blue Cross Blue Shield of New Mexico simply cannot compete with a government subsidized, tax payer funded “public option.” Nevada’s Governor vetoed a “Medicaid for all” bill because “Moving too soon,without factual foundation or adequate understanding of the possible consequences, could introduce more uncertainly to an already fragile health care market, and ultimately affect patient health care.” Remember President Obama’s promise “if you like your plan, you can keep your plan; if you like your doctor, you can keep your doctor”? Turns out that in a single-payer system, you can’t keep your plan or your doctor.

New Mexicans can’t afford it. New Mexico is facing budget deficits due to Medicaid expansion, making it difficult to pay for education and public safety. President Obama promised families a $2,500 reduction in premiums. Instead, premiums have increased an average of 105 percent. For 40 percent of all New Mexicans, the average health insurance premium increase for 2018, will range from 36 to 41 percent. Obamacare took away the ability to design a plan specific to an individual or family’s needs. Why should single men and childless couples be forced to pay for maternity care and pediatric benefits? Allowing individuals and families more choices in their coverage, expanding catastrophic options, and removing the cap from health savings accounts, can go a long way towards more affordable plans.

New Mexico can’t generate the massive tax revenue to pay for it. Everyone loves single-payer, until they get the price tag. State lawmakers in Sacramento, CA figured out that it would cost a whopping $400 billion annually for a single-payer system. It failed in Bernie Sanders’ Vermont for the tax revenue that would be needed to finance it. Scott Ehrlich aptly said: “As states like California, New York, and Vermont have found out when they’ve journeyed down that road, high-quality single-payer is bankruptcy expensive.”

New Mexico has a doctor shortage. Single-payer doesn't work when you don't have the providers. In order to meet national benchmarks, as of 2017, we needed 124 primary care physicians, 201 nurse practitioners and clinical specialists, 109 psychiatrists and 292 pharmacists. We must do more to recruit and retain providers, especially in our rural areas.

Single-payer doesn't work unless you force all health care providers into the system. Doctors deserve choices when it comes to the quality and quantity of care they give. Doctors should be able to choose which health plans, public and private, allow them to best take care of their patients. When regulations become onerous and reimbursements become unsustainable, they have the right to terminate their provider contracts. Not possible when all you have is single-payer. I applaud Florida’s State Legislature for protecting the “direct primary care” model. No insurance company or government, federal or state, should have the right to interfere with the doctor-patient relationship.

In 2012-2013, I served on the Financial Sustainability Subcommittee for the NM Health Insurance Exchange Advisory Task Force. I learned about the insurer assessments, user fees, provider fees, revenue diversion away from our state’s high risk pool, and excise taxes required to pay for our Exchange’s operations. Wait! We’re going to take money away from the most vulnerable, to fund our Obamacare Exchange? Free market principles serve to strengthen the safety net and charity-based health care, while Obamacare weakened both.

Instead of single-payer fantasies, our Legislature must put forth policies that bring job creators to our state and get New Mexicans working again. If we really want more people covered by health insurance, we need a robust economy and low unemployment. As someone who has direct experience with patient care, I know that single-payer is unworkable, unsustainable, and is not the answer. You can reach me at and on Facebook: @betterwayforNM