Florida vot­ers re­jected Medi­care for All in the midterms. Thank good­ness.

Miami Herald (Sunday) - - Opinion - BY SALLY PIPES @sal­lyp­ipes

This month, 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 col- leagues last year, is ex­plicit about what it would do. It would force vir­tu­ally ev­ery Amer­i­can — those with em­ploy­er­spon­sored 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.

San­ders and his col­leagues prom­ise that their plan, which they’ll no doubt rein­tro­duce on day one of the next Congress, 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 ten 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 ten 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 this week 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.

JOE RAEDLE Getty Images

Julio Gal­li­garis sorts through mail-in bal­lots that have been cast and re­ceived at the Mi­ami-Dade Elec­tion Depart­ment head­quar­ters in Oc­to­ber.

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