Once again, a single-payer health-care system has attracted international attention for its moral depravity. The case concerns Alfie Evans, a British toddler who, by virtue of his slim chance at survival, is barred from seeking treatment elsewhere that might well save his life.

Appropriately, opponents of single-payer health-care have seized on Alfie’s case as an example of taxpayer-funded medicine’s evil nature. In response, single-payer advocates have asked what the difference is between Alfie and an American who dies because he is too poor to afford the health care he needs.

It’s not an unfair question, and it deserves an answer. To do that, however, it’s important to revisit how a situation like Alfie’s came to be.

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