Houston Chronicle Sunday
Sanders’ ‘Medicare for All’ is all bad
If you like your health care plan, Bernie Sanders says tough luck; he will take it away from you if elected president.
Give the Democratic candidate some credit for straight talk about his version of Medicare for All. But if Sanders’ plan is the gold standard – after all, he “wrote the damn bill” – it is also the most problematic, eliminating 2 million jobs and creating a system that most Americans don’t want.
The Democratic Socialist from Vermont has proposed adopting a Democratic Socialist health care system that no European country has dared to implement. The government would give residents an ID card that entitles them to the medical attention they require, free of charge.
Doctors, hospitals and other providers would send their bills to the federal government, which would pay them from tax revenues. Patients wouldn’t pay any deductibles, co-pays, and, most importantly, insurance premiums. The plan includes long-term care, but not all prescription drugs.
Every other single-payer system requires at least a co-pay, making Sanders’ plan the most generous in the world.
“We spend twice as much per person as do the people of any other major
country on Earth,” Sanders said during the October Democratic presidential debate. “If we stood together, we could create the greatest health care system in the world.”
Polling shows most Americans support a health care overhaul, and 71 percent of Democrats like Medicare for All, at least until they discover the consequences.
The most obvious bugaboo, which is really the least of Medicare for All’s problems, is the cost. Everyone’s taxes would rise significantly, with at least a 7.5 percent increase in the payroll tax on employers and a 4 percent increase on workers. There’s also a wealth tax, too.
“I do think it is appropriate to acknowledge that taxes will go up,” Sanders admitted. “They’re going to go up significantly for the wealthy. And for virtually everybody, the tax increase they pay will be substantially less than what they were paying for premiums and out-of-pocket.”
Sanders is probably right. His plan will save money by providing more preventive care and treating illnesses quicker and, therefore, at a lower cost.
The problem is that most people will only notice the tax increase and overlook the savings. Or at least that’s what politicians fear, and why they are reluctant to make the swap.
The most significant savings, though, would come from banning employer-based insurance, imposing price controls and eliminating the administrative costs from private insurance. The United States spends more than twice as much on administration than most developed nations, according to the peer-reviewed journal Health Affairs.
Taking insurance companies out of the supply chain would save money, but most of that cost reduction would come from laying off 2 million people, according to an independent analysis.
“We will transition those workers from sitting behind a desk arguing with you … into a more productive area of providing real healthcare,” Sanders promised in the November debate.
Most of those 2 million people would probably prefer to keep their current jobs. Not to mention, investors in the $600 billion health insurance industry would prefer to keep their companies intact.
“The issue is whether the Democratic Party has the guts to stand up to the health care industry, which made $100 billion in profit,” Sanders said.
To recap, Medicare for All would eliminate consumer choice and put the government in charge of setting prices and determining what care is appropriate. The law would eliminate a $600 billion industry that employs 2 million people and generates $100 billion in profit.
In dozens of columns, I have decried every aspect of our health care system. From patients who ignore medical advice, to doctors who overcharge, to insurance companies that put profits over people. The U.S. health care system is indisputably broken.
Medicare for All, though, is not the answer, for political, cultural and practical reasons that have nothing to do with efficiency and everything to do with our nation’s character.
American consumers want choices, employers like using health insurance as a perquisite and competition improves efficiency. The German system, where citizens and employers are required to purchase plans from nonprofit insurance companies, is a better model for the United
Every resident receives a basic plan that guarantees access to care. But if you want bells and whistles, such as a private hospital room, you or your employer can pay more.
Medicare for All is a great slogan, and Sanders is a lively rabble-rouser. But his plan faces certain death in Congress and likely at the ballot box, too.