Pittsburgh Post-Gazette

Fellow Democrats, Medicare for All isn’t practical

Obamacare has been a great success. Focus on improving and expanding it, urges former U.S. Rep. JASON ALTMIRE

- Jason Altmire is the former U.S. representa­tive for Pennsylvan­ia’s 4th Congressio­nal District, serving from 2007 until 2013. He is the author of “Dead Center: How Political Polarizati­on Divided America and What We Can Do About It.”

It’s been 10 years since President Barack Obama initiated the discussion about America’s health care system, a contentiou­s debate that culminated with the enactment of the Affordable Care Act (ACA).

Now, leading Democrats advocate scrapping the ACA in favor of “Medicare for All” — the litmus test for the party’s 2020 presidenti­al candidates.

Today, more than 24 million Americans have access to health care as a result of the ACA’s limitation on pre-existing condition exclusions, the individual marketplac­e and Medicaid expansion. Since the law’s 2010 enactment, the economy has seen unpreceden­ted growth and added tens of millions of jobs.

Clearly, the sky didn’t fall as was predicted by some ACA naysayers and in 2018 Democrats used these results to challenge Republican­s who still want to repeal the law. They rode the resulting blue wave to a 40-seat gain and takeover of the House of Representa­tives.

So why, after their crowning policy achievemen­t of the past halfcentur­y, do some Democrats want to discard the ACA in favor of a single-payer Medicare for All approach?

Supporters of the plan point to polling showing overwhelmi­ng support of the concept, which was pioneered by Sen. Bernie Sanders, I-Vt., and is now supported by nearly every major Democratic presidenti­al candidate.

In a January Kaiser Family Foundation poll, 71 percent of U.S. adults (including Republican­s) had a favorable opinion of Medicare for All and the guarantee of health insurance for every American.

But the fine print matters. In the same survey, 55 percent of respondent­s said they believed Medicare for All would allow them to keep their own insurance plans, which Mr. Sanders’ bill prohibits. (Currently 180 million Americans are covered through employer-based plans that would be eliminated

under Mr. Sanders’ bill).

When told Medicare for All would eliminate private insurance companies, support dropped to 37 percent. Support continued to drop as respondent­s were told about the higher taxes, longer wait times, and greater financial and bureaucrat­ic burden on the Medicare program that these proposals would create.

The fact is that the Medicare system cannot handle such an expansion. The Congressio­nal Budget Office reports that Medicare spending will double over the next decade, reaching an astonishin­g $1.5 trillion by 2029.

In addition, the Medicare Trust Fund will be depleted by that time, according to the most recent report of its trustees.

Further complicati­ng the issue: The most popular program among Medicare beneficiar­ies is Medicare Advantage, an alternativ­e to traditiona­l Medicare that is run through private insurers. It would be eliminated under Medicare for All.

Medicare Advantage is one of the few issues that garners overwhelmi­ng bipartisan support in Congress. Attempts to limit funding for the program are routinely swatted away due to the grassroots uprising that occurs among seniors.

Rick Pollack, the president and CEO of the American Hospital Associatio­n, has sounded the alarm about what Medicare for All would mean for hospitals, noting that “hospitals are already paid far less than the cost of caring for Medicare patients, and more patients with Medicare would strain hospitals even more and could threaten hospitals survival.”

Despite these facts, the idea of single-payer health care is no longer a pie-in-thesky dream. The center of gravity of the Democratic Party has undeniably moved to the left, making issues like Medicare for All less politicall­y toxic than would have been the case only a few years ago.

In addition, social mediasavvy progressiv­es in Congress have generated extraordin­ary levels of coverage, which makes their proposals more viable as Democratic candidates at all levels are cajoled into supporting policies championed by the left.

This is why voices like Mr. Pollack’s and others who can offer a reality check on what Medicare for All really means are so important. Everyone wants a health care system that offers universal access to high-quality, affordable care. Thanks to the ACA, more Americans have that access than ever before.

Let’s be sure to look before we leap into another contentiou­s nationwide debate and dismantle the system that millions of Americans count on every day.

 ?? Rogelio V. Solis/Associated Press ?? In this April 4, 2018, file photo, Sen. Bernie Sanders, I-Vt., responds to a question during a town hall meeting in Jackson, Miss. Mr. Sanders’ Medicare for all plan would increase government health care spending by $32.6 trillion over 10 years, according to a study by a university-based libertaria­n policy center.
Rogelio V. Solis/Associated Press In this April 4, 2018, file photo, Sen. Bernie Sanders, I-Vt., responds to a question during a town hall meeting in Jackson, Miss. Mr. Sanders’ Medicare for all plan would increase government health care spending by $32.6 trillion over 10 years, according to a study by a university-based libertaria­n policy center.

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