Chapter 3 of Goodman, Musgrave, and Herrick's Lives at Risk: Single-Payer National Health Insurance Around the World attacks the myth that "single-payer systems make care available on the basis of need alone". The primary evidence they cite against this claim are the growing private healthcare markets in many nation-states with single-payer national health insurance, particularly Britain and Canada. More damning, however, is the information that many single-payer health care systems provide preferential treatment to private pay patients, mostly foreigners. The Cuban state healthcare system, for example (not mentioned in the book), is well-known, primarily due to cinematic propaganda from filmmaker Michael Moore, for its medical tourism practices. Ultimately, this book chapter demonstrates that the "need alone" assertion is rhetorical bullshit, even without utilizing basic economic theory, which proves the impossibility of providing any scarce good in a just manner via a "need alone" system.
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Don Stacy is a 47 yo libertarian writer and physician. His articles have been published by multiple libertarian-themed websites. He practices medicine as a radiation oncologist in Hazard, KY.