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The Supreme Court's Obamacare Decision Is By No Means The Final Word

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You'd think that winning one of the most significant cases in the history of the Supreme Court would leave liberals satisfied. But they're not. Soon after news broke that Obamacare would live on, Democrats from all corners were calling for bolder reforms -- including a government-run, single-payer, "Medicare-for-All" healthcare system.

Even Obamacare's biggest defenders admit that it leaves a lot of pressing problems unsolved. But now that the law has received the Supreme seal of approval, big-government types are arguing that those problems can only be solved with a complete federal takeover of health care.

To many on the left, Obamacare is not the end of health reform but the beginning. And their ultimate goal remains the same -- single-payer. Those who care about the present quality of the American healthcare system -- not to mention the potential for future medical innovation -- must fight efforts to increase government's hold over health care.

Several politicos marked last Thursday's announcement of the 5-4 Supreme Court decision upholding the constitutionality of Obamacare's individual mandate as a tax under Congress's taxation power with praise for single-payer. Vermont Senator Bernie Sanders said that "the Affordable Care Act is an important step in the right direction [but] the real solution to America’s health care crisis is a Medicare-for-all, single-payer system."

Progressive Change Campaign Committee co-founder Adam Green called Medicare-for-All "the ultimate destiny at which our nation will arrive." And National Nurses United co-president Deborah Burger said that "stepping up the fight for Medicare for All is even more critical."

President Obama has already hinted at aspirations beyond his Affordable Care Act. At a recent Chicago fundraiser, he told the crowd, "the health care bill that we passed is pushing us in the right direction, but we're going to have more work to do on that front."

It's safe to say that the White House would not mind embedding government more deeply in the doctor's office.

Some states are already moving in that direction. Vermont is trying to set up its own mini-single-payer system. The day after the Supreme Court decision, Governor Peter Shumlin applied for a federal grant worth $118 million to help pay for the requisite information technology and personnel.

A few members of Congress are floating "universal" healthcare bills around Capitol Hill. Notably, there's the "State-Based Universal Healthcare Act," introduced by Washington Democrat Rep. Jim McDermott. The bill would establish a mechanism for states to request federal financing for their own Medicare-for-All programs, installing single-payer nationwide in piecemeal fashion.

Indeed, Obamacare is aiding in that pursuit, particularly with its massive expansion of Medicaid coverage to tens of millions of additional beneficiaries.

This is a dark future. Single-payer represents fully socialized medicine. All medical treatment -- every single interaction between doctor or other care provider and patient -- would run through Washington.

The attraction of single-payer for liberals has always been equality -- everybody gets equal care and doesn't have to worry about shouldering its cost alone.

What proponents don’t dwell on are the tens of thousands of rules bureaucrats will write governing payments to doctors, hospitals, nurse-practitioners, and others -- as well as what tests and treatments are approved and under what conditions.

Demand for care will inevitably outstrip supply available simply because patients bear no direct cost. Rationing is the inevitable result -- long waits for simple procedures, or maybe a government veto of a procedure or treatment deemed not sufficiently cost-effective.

In Canada's single-payer system, for instance, patients wait 9.5 weeks, on average, for treatment after an appointment with a specialist. Last year, Canadians waited 11.8 million weeks collectively for treatment.

In the United Kingdom, regulators approved abiraterone, a drug that treats advanced prostate cancer, for patients in England and Wales two months ago, after initially deeming it too expensive back in February. It's still not available in Scotland.

By contrast, the drug has been approved for use in the United States for well over a year.

Single-payer would operate much the same in the United States. Patients would be equal -- and equally miserable, waiting for a government green light to receive the care they needed.

Instead of pushing for ever greater government control, policymakers should be promoting patient-centered change from the bottom up.

Free up patients to take control of their own healthcare dollars. Give them an incentive to shop around and compare prices. Unleash the competitive market forces that have already led to lower prices and better quality in every other sector of the American economy.

Progressives see the Supreme Court's decision on Obamacare as a stepping stone to the single-payer utopia they've long dreamed of. American patients should stop their march before it progresses further.

Sally C. Pipes is President, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare (Regnery 2012).