Opinion: Proposed Washington Health Trust shouldn’t have our trust

Elizabeth Hovde of the Washington Policy Center reports that taxpayer-funded universal care would weaken access to care, tax mightily.

Elizabeth Hovde of the Washington Policy Center reports that taxpayer-funded universal care would weaken access to care, tax mightily

Elizabeth Hovde
Washington Policy Center

If we’re looking to lower medical bills but keep health care access and quality, taxpayer-funded universal care for Washingtonians isn’t the way to get there. 

Elizabeth Hovde
Elizabeth Hovde

The pattern of socialized medicine in other countries is high taxes and the rationing of care. Demand always outstrips supply, and patient-centered care is not the priority. We also should have no hope that health care costs will be contained or decrease as long as someone else is paying patients’ bills.

On Tuesday, the state’s Universal Health Care Commission (UHCC) — a committee created by the 2021 Legislature to pave the way to a state-financed system, not to consider the best way for people to obtain health care — agreed to analyze a bill that rightly failed to go anywhere this session after its introduction. I offered public comment that Senate Bill 5335’s pitch for a taxpayer-funded health system continue to go nowhere. (Comments I provided the commission are below.)

Instead of letting SB 5335 collect post-legislative dust, the UHCC passed a motion to honor a request from Democratic senators to analyze the creation of taxpayer-funded care in the way laid out in SB 5335. 

The bill proposes funding universal health care in Washington state by imposing a 10.5% payroll tax on employers – 2% of which can be passed down to employees – and adding an 8.5% tax on capital gains or investment income of more than $15,000. Read more about those particulars in the bill itself or in this article from The Center Square

The analysis the commission committed to will be incorporated into the UHCC’s work plan, and the commission will issue a report on what it finds by June 30, 2024. 

You could tell at the meeting that the task looked daunting to an overwhelmed commission that has already created a Finance Technical Advisory Committee to help it figure out the many moving money parts it will take to make a tax-funded health care system appear viable. 

Hopefully, through all its exploration, the UHCC will begin to see that if trading today’s health care system for a government one seems too good to be true, it probably is. And hopefully, it can communicate that to the public. 

The comments I provided the UHCC Tuesday follow: 

I’m Elizabeth Hovde from the Washington Policy Center. I direct our Center for Health Care and our Center for Worker Rights. Thanks for your time today.

Universal care sounds good until it doesn’t, even before you get to the insurmountable costs that have had other states abandoning their plans. In other experiences with government-run systems, we see that affordability, access and quality do not go together. Individuals’ health care does not benefit from taking away decisions made between doctors and patients. Citizens — not governments — are the best advocates for their health care needs. 

We need to be careful what we wish for. 

As one legislator said in a recent hearing for Senate Joint Memorial 8006, a bill the Legislature is still considering and that asks the federal government to enact universal care or give Washington greater ease in going it alone, “If we actually had universal health care, it’d be interesting to see the other problems that we’d have.” That was Rep. Paul Harris from Vancouver. I agree with him.

As you analyze the Washington Health Trust bill, SB 5335, an idea that did not advance in the Legislature, consider what has happened in other states that abandoned their government health care plans. 

In Vermont, despite being a small and progressive state, more than a dozen financing concepts showed the only way to set tax rates as low as Vermont officials wanted would mean giving residents skimpier coverage than most insured Vermonters already had, wrote Third Way, a national think tank that champions center-left ideas. It added that the estimated cost of the new system would have been over $5 billion in 2021. “For context, the entire budget for the state of Vermont was $5.01 billion for 2012-2013,” Third Way notes. 

Officials in Vermont determined that an 11.5% state payroll tax and a 9.5% income tax would be necessary to pay for the new health care system. ‘Enormous,’ is how the state’s then-Democratic governor described the tax hikes needed to fund the plan.

Right now, our state’s workers are rightly upset about a new long-term-care payroll tax of 58 cents of every $100 they make and a tax for paid family leave that keeps climbing. These taxes, and future ones that would be enacted for more taxpayer-funded health care, take away people’s opportunities to find solutions for life needs that fit their individual situations. 

Even if taxpayers wanted new, substantially higher taxes instead of insurance premiums, the pattern of universal, government-run health care is the rationing of medical care. Some patients are denied care to save money. Patient-centered health care is not the priority. 

Consider what is happening in other countries with socialized medicine. Just this weekend, I read that Ontario, Canada’s most populous province, announced a major expansion of private providers for publicly covered procedures. Premier Doug Ford said the move was needed to address an unsustainable status quo of long wait times.

Access has suffered in both Great Britain and Canada, both of which have taxpayer-funded universal care. The Fraser Institute in Canada found that last year, the average wait time between a primary care provider referral and specialty treatment was almost seven months. 

In Great Britain, a Wall Street Journal article recently reported that people who suffer heart attacks or strokes wait more than one and a half hours on average for an ambulance. The Royal College of Emergency Medicine estimates 300 to 500 people suffer premature deaths each week because of lack of access to timely care. 

Our third-party payer system is a large part of the problem, as it separates patients from knowledge about health care costs. A universal, taxpayer-funded system would make the problem worse. 

We need educated consumers who shop for health care. We need price transparency.  A true free-market system would be free of obstacles that limit choice, innovation and competition. Costs will continue to increase as long as someone else is paying for our health care. And we need discussions about the health care system to start from an understanding that health care is not a right. It is a necessity of life, just like food and housing. We shop for those things, and assistance is available for people in need.

The Washington Health Trust is the wrong solution. Socialized health care leads to the rationing of care. Demand always outstrips supply, and patient-centered health care is not the priority.

The state should move personal decisions about health care away from the political process and closer to the patient. Bills like SB 5335 and SJM 8006 would do the opposite. 

Instead of universal, government-funded care, we should be looking at innovations all around the nation that provide people with affordable access to needed health care. The choices don’t have to be between the hybrid system we have right now and socialized health care. 

I’m happy to help with ideas about cost containment, point you to free-market approaches to health care or help with any research needs you have.

Thanks again for your time,


Elizabeth Hovde is a policy analyst and the director of the Centers for Health Care and Worker Rights at the Washington Policy Center. She is a Clark County resident.

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