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Medicare- or Bankruptcy- For All?

By TCCRI Staff. Mar. 3, 2020

As Texans head to the polls this Super Tuesday, we will be driven largely by the same themes that play out in every federal election- what we believe to be the appropriate role of government in our everyday lives, the right to bear arms, the federal deficit, and national security to name just a few. And while healthcare is always a hot topic, Democratic primary voters are now faced with a rift within their own field of candidates over whether or not “Medicare for All” is the prescription to cure what ails America’s healthcare system.

The answer to that is a resounding "no". Far from solving the challenges currently facing our healthcare system, namely ever-increasing costs and lack of access to care in many areas of the country, moving to what basically amounts to socialized medicine would greatly exacerbate these issues.

Let’s start with the fact that no one can agree on exactly what a Medicare for All plan will actually cost. Senator Sanders finally released his version of a plan and it still doesn’t detail any real costs. It’s an odd calculation of what healthcare would cost over the next 10 years minus what he believes Medicare for all would save to come up with a total number of $47.5 trillion over 10 years, which he proposes paying for with an extensive list of tax increases.

Senator Warren estimates her plan at about $20.5 trillion over ten years, also funded largely by taxes. However, given the liberties she takes with savings estimates from her proposed reforms, we have to say that Bernie’s cost is likely closer to the truth. Closer, but undoubtedly still far too low.

The good news under these plans is that you might get the healthcare you need, assuming you can actually access that care in a single-payer system (although in Britain, which has over 70 years’ experience with single-payer health care, two-thirds of hospitals miss the two-month target wait time for seeing urgent cancer patients). The bad news is that you’ll also get saddled with massive tax increases and employers will likely be hard-pressed to pay their share of employee healthcare costs leading to possible lay-offs, outsourcing, and a whole host of other things that are detrimental to the economy.

The even worse news for both Sanders and Warren is that the astronomical price tags associated with their Medicare for All plans are not the only reason to dismiss them outright. If the federal government had a proven track record of administering healthcare programs or lowering the cost of care with its involvement, this might be a policy notion worthy of some actual discussion for those who are less fiscally conservative. The government does indeed have a proven track record on these issues, but it does not bode well for a healthcare takeover. In just recent history the feds oversaw a VA debacle that resulted in thousands of our veterans not receiving the care they needed; botched the widely touted roll out of the website in 2013 where Americans were supposed to go to buy health insurance; and under the ironically named “Affordable” Care Act, have actually raised the cost of coverage significantly for most Americans while simultaneously lowering health plan choice thanks to overly burdensome regulations.

It also bears mentioning that coverage does not equal access to care. Even if every American received a Medicare card in the mail tomorrow, that would not guarantee access to providers, particularly in large areas of Texas, and similar places, where provider shortages exist. And even if doctors are available, a 2018 report found that under Canada’s single payer system one million patients were forced to wait for medical appointments. Can anyone say, “care rationing”?

Add to this that CMS Director Seema Varna, the woman ultimately responsible for the federal agency that runs the Medicare and Medicaid programs, has stated emphatically that “government is not the answer” to this challenge.

We could not agree more with Ms. Varna. Government is most certainly not the answer, and a Medicare for All approach would only wreak more havoc on a system still reeling from the detrimental effects of the ACA. The challenges facing our healthcare system are complex and require a multifaceted approach that should be rooted in free market principles that promote greater transparency, competition, and consumer education. Only by empowering and incentivizing consumers to take a greater role in the cost and quality of their healthcare will we see a positive change.

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