What does Medicare for All mean to you? Do you get your health insurance from your employer? Would Medicare for All do something for you… or to you? Will you have the same level of coverage? Is it going to cost you money or save you money?
Will the system of healthcare providers remain the same? It is important for Americans to grasp the tradeoffs and sacrifices they will have to make if Congress creates another massive program new program.
The Bills, the promise, the value
118 House Democrats are co-sponsoring legislation (HR 1384) to outlaw virtually all Americans’ public and private health insurance. They intend to replace the coverage with a new government plan. In the Senate, Sen. Bernie Sanders’ “Medicare for All” bill (S 1129) does the same thing. These bills are real and present dangers.
Medicare for All poses this very big question: What is the promise of universal health insurance worth? It will operate under a new government health program. Is the promise worth the intentional destruction of all other public, private, and employer-based coverage? Is that what passes for sound decision making these days? Will Americans take a pocket full of political mumbles in exchange for their family’s healthcare? It is an out of the frying pan and into the fire approach. It’s Bernie’s Boondoggle Medicare for All.
Understanding the stats
In today’s insurance markets, about 30 million American residents are uninsured. Examining the data, American Enterprise Institute (AEI) analysts note that about 15 million Americans already are eligible for coverage under Medicaid and Obamacare. Yet, they do not enroll… why? Before we charge into the fan blades maybe we should have some solid answers as to why the system does not work today.
Almost 4 million are eligible for employer-sponsored insurance but do not enroll. At least 4 million, probably closer to 20 million, are here illegally and thus ineligible for taxpayer-subsidized coverage. An additional 2 million have annual incomes that exceed 400% of the federal poverty level. That is $103,000 for a family of four and they are therefore ineligible for Obamacare subsidies.
About 2.5 million of the uninsured are poor Americans who live in states that didn’t expand Medicaid. This is a problem that can be solved by targeting measures. It can be done without destroying all existing health coverage.
Understanding the cost
Then there’s the cost. The aggregate price tag is estimated to range between $54.6 trillion and $60.7 trillion. That is for the first 10 years of a Medicare for All program. Or so says Charles Blahous, a former Medicare trustee. Comprehensive econometric analyses also show such a program will substantially increase total costs over current law. Groups ranging from the Urban Institute to the Rand Corp. concur. This new program requires doubling our taxes. That will lower everyone’s standard of living. Take it to the bank.
Most Americans will also pay more for their Medicare for All health care than they do today. That’s in addition to the added tax burden. A recent Heritage Foundation analysis says financing such a program requires broad-based taxation. The amount of additional tax is equal to 21.2% of all wage and salary income. That is a regressive tax. It will hurt people at the bottom of the income scale most. It reduces the disposable income of nearly two-thirds (65.5%) of American households. The result makes them financially worse off than they are today. Do you want a reduction in your spendable income? If your paycheck is more than 20% lower what do you lose? It’s Bernie’s Boondoggle Medicare for All.
The care itself
Another big tradeoff would be a decline in timely access to quality care. Bernie Sanders’ Medicare for All plan would cut medical provider rates by an estimated 40%. That’s below the projected private reimbursement. Such a sharp reduction would inevitably mean longer wait times, longer delays, and more denials of care.
Think about it healthcare providers are going to be required to take a 40% pay cut. They probably won’t be happy? Know any hospitals in financial trouble already? They will likely close their doors simply from the financial strain. If you cut your doctor’s income by 40% will they spend more time or less time with you diagnosing and treating your ailments? It’s Bernie’s Boondoggle Medicare for All.
Medicare today sets prices for more than 8,000 physicians’ services and hundreds of hospital procedures. Government price-control often results in medical goods or services being reimbursed at levels too high or too low. In short, either beneficiaries or taxpayers are routinely shortchanged.
Congressional champions of Medicare for All legislation insist a new universal Medicare-like entitlement would centralize all provider payment. The supposition is the centralization will secure significant administrative cost savings. That is compared with multipayer private insurance. The argument is logically pleasing. Unfortunately, it has never been found to be true. The government has never delivered on that promise.
Comparisons between Medicare and private insurance are often apples-to-oranges comparisons. For example, private firms tend to concentrate more heavily and successfully on such items as utilization review, quality measurement, and fraud detection. Medicare does not concentrate as effectively in these areas. Though it records lower administrative costs, it also loses tens of billions of dollars annually, roughly 10%, in waste, fraud, abuse, or “improper” payments. You can pick your euphemism for money spent without healthcare benefits to people.
These are real costs, but they are rarely counted as part of Medicare’s administrative costs. The Government Accountability Office records more than $50 billion annually in waste, fraud, or abuse. If today’s Medicare is the model, taxpayers can expect those large annual losses to increase to scale. That’s what Medicare for All promises. It’s Bernie’s Boondoggle Medicare for All.
Public policy tradeoffs
Public policy is not simply a matter of setting goals. It is also a process of making trade-offs. Medicare for All has some very serious tradeoffs:
—Destruction of existing health insurance coverage, regardless of personal preferences. This means a loss of personal freedom.
—Abolition of alternatives to government care. This means a loss of personal freedom.
—Higher personal and public health care costs. This means less financial freedom.
—Longer wait times and delays and denials of care. This means less choice, less service, and longer waits.
—A more thorough politicization of health care decision-making. This means you may have to have political connections to get what you need when you need it, assuming it is available at all. And what about if there is ever a need for budget cuts?
All of this may be coming to you courtesy of Congress. Whatever presidential administration controls the levers of bureaucratic power. That means your healthcare. Do we want a system where you need political connections in order to get healthcare? Congress can and should take a different approach.
Lawmakers should enact policies giving people greater control over their health care dollars and decisions. They should allow health insurers and medical professionals to compete. We want the delivery of high-quality care at competitive prices. That’s the goal, the best possible service at the lowest practicable price. It’s Bernie’s Boondoggle Medicare for All.