Commentary: What you don't know about Medicare for All can hurt you
In November, Democrats took the House of Representatives. But many of the party’s most progressive candidates outside deep-blue coastal enclaves fell short at the polls.
Voters in Nebraska, Wisconsin, Pennsylvania, Kansas, Florida and Maryland all rejected Democratic candidates who campaigned on Medicare for All. And thank goodness.
The idea polled well before the election - a Reuters/Ipsos poll pegged public support at 70 percent.
But once people learn it would outlaw private insurance, require trillions of dollars in new taxes, reduce access to care, exacerbate our nation’s doctor shortage and effectively allow the government to take over one-sixth of the economy, support dwindles.
Democrats hoping their stay in Congress lasts beyond 2020 should take note – and temper their enthusiasm for Medicare for All.
The Medicare for All Act of 2017, introduced by Sen. Bernie Sanders and co-sponsored by 16 of his Democratic colleagues last year, is explicit about what it would do. It would force virtually every American – those with employer-sponsored coverage, those who buy insurance on the individual market, those without insurance, those covered by Medicaid, even those in the existing version of Medicare – into a single government-run health plan.
But many don’t realize that. Roughly half mistakenly believe they’d be able to keep their current health plans under Medicare for All.
Sen. Sanders and his colleagues promise that their plan would cover everything from hospital stays to primary care, prescription drugs and dental work, with no co-pays or deductibles. That would make it even more generous than the current version of Medicare.
That kind of generosity with other people’s money would require gargantuan tax hikes. Medicare for All would increase federal spending by $32.6 trillion in its first 10 years, according to an analysis conducted by Charles Blahous of the Mercatus Center. Even doubling both corporate and individual income tax revenue would be insufficient to foot the bill.
That’s assuming healthcare providers swallow the payment cuts Medicare for All has in mind for them. The Sanders plan would reimburse doctors and hospitals at Medicare rates that are about 40 percent below what they receive from private insurers. Some providers are certain to respond by closing their doors, working fewer hours or leaving the medical field altogether. That will be a problem for our nation’s healthcare system, which already faces a shortage of up to 121,000 doctors by 2030, according to the American Association of Medical Colleges.
Yet only three-quarters of voters believe their taxes will rise to fund Medicare for All. The other 25 percent must not be paying attention.
More than six in 10 voters believe they’ll be able to access the care they need under Medicare for All. Wrong again. When governments foot the bill, they ration care to control spending.
Just look at Canada. Last year, patients who received referrals from general practitioners waited a median of 21.2 weeks before receiving care from specialists, according to a report from the Fraser Institute, a Canadian think tank. And a recent report from the Fraser Institute found that among 28 countries with universal healthcare systems, Canada spent the fourth most as a percent of its GDP but was 26th for its supply of physicians.
Among 10 countries, it was ranked last for speedy access to care. They pay dearly for the privilege of waiting. The average Canadian family of four paid almost $13,000 in taxes just for public healthcare.
These long waits can be deadly. In a 2014 report, Fraser Institute researchers analyzed two decades of mortality rates and wait times from 10 Canadian provinces. They found that long waits contributed to the premature deaths of 44,000 women from 1993 to 2009.
British patients fare no better in their 70-year-old government-run National Health Service. Forty percent of the core services at acute hospitals – which provide short-term treatment – require improvement, according to a new report from the Care Quality Commission, an independent body that reviews NHS performance.
Things won’t get any better this year. Hospital administrators warn that much of the funding originally set aside for this coming winter was spent over the summer, according to a report in The Independent.
Progressives may be tempted to read their victory as a victory for single-payer. But that would be a mistake.
Voters in no less than six states made clear that they have little appetite for a government takeover of the healthcare system.
Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The False Promise of Single-Payer Health Care (Encounter). Follow her on Twitter @sallypipes.