With the Affordable Care Act on the irresponsible Tea-Party-Republican chopping block, the health care system – or rather the sickness profiteering system – has been on my mind again. One of the libertarian arguments against single-payer health insurance that I’ve heard is that it would take health care providers’ freedoms away. I never fully understood that argument – possibly because it’s more motivated reasoning than argument derived from a visceral aversion to anything government. Let’s take it a bit more seriously, though, and look at this issue of freedom within the context of health care.

A health care provider, I presume, would want the freedom to treat her patients in ways that would be best for the patients. That treatment would be science-based medicine, incorporating the latest research and best treatments. The assumption seems to be that this happens under the current system and wouldn’t under a single-payer system. Anybody who has ever spent time in a doctor’s office knows that assumption is absurd. Health insurance companies are for profit businesses – that’s why I keep referring to them as sickness profiteers. They try to prevent any costs to them thereby restricting treatment options – a treatment reimbursement is a loss to them, after all. On top of that, they require immense amounts of paperwork that a doctor has to provide in order to get paid. That paperwork is not standardized across companies making it challenging – and time consuming – to file it properly. Insurance companies restrict treatments often seemingly arbitrary. It seems to me that simply streamlining payments would free up doctors to do their jobs better.

What is often lost in these arguments are the patients. There is even more lack of freedom under the current system on the patient side. As I wrote shortly after I embarked on my career change, tying affordable access to health insurance to an employer makes leaving that employer very risky. Such a decision is likely tied to the loss of not only a pay-check but possibly life-saving health care. The Affordable Care Act has provided more of that freedom: The freedom to choose our own path, independent of who we might want to work for.

Let’s say that we are just changing employers, not careers. This requires a change in health care plans. The employer picked the plans that we can choose from (restricting our freedom…). The new employer might have plans that do not have our current doctor in their networks. Establishing a patient-doctor relationship is crucial, especially for those of us with chronic conditions. Being forced to find a new doctor just because we found a new job is another impactful restriction on our freedom. If there were a single-payer insurance, who we work for would not impact our health care choices. That seems to me the ultimate measure of freedom!

When I look at single-payer, I see more freedom all around, not less. Maybe this is why I have such trouble understanding the arguments against it.

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