Reply #61: That Hardly Counts As a Pilot Project, Sir, On the Scale We Are Discussing

[The Magistrate]

The 'mechanism' you suggest in commencing this discussing, that the government loan money to people to pay for medical procedures, anticipating repayment out of taxes, hardly alters the situation from that of a government administered single-payer scheme. The patient does not control the expenditure, merely signs a note under duress, in an emergency in which actual possibilities of repayment will be the furthest thing from his or her mind.

Your idea is premised on the belief that people have sizeable amounts of disposable income they could sequester to pay for future health emergencies. Whatever average figures might suggest, this is nonesense in a great many individual instances, and since the stress on the health of poor people runs perceptibly greater than it does on the well to do, health emergencies will occur disproportionately among that swathe of society which has little if any such sequesterable income, and little prospect of repaying any such loan. No matter how you torture it, it is going to work out to a subsidy, and to a great many people necessarily not being able to pay from their own resources for care they need to preserve or extend their lives, or to end pain or alleviate disability.