You’ve probably heard of the Affordable Care Act, a legislative measure signed by former President Barack Obama that sought to address some of the underlying issues in our national health care system. Now, however, Democrats are overwhelmingly supporting “Medicare-for-All,” a dramatic replacement of the already-controversial “Obamacare” program that would effectively move all control of health care to the federal government.
Health care in our nation undoubtedly needs some fine-tuning. In a December 2017 survey, Gallup found that 71 percent of Americans believe our system “is in a state of crisis” or “has major problems.” Though the situation has improved in recent years, tens of millions of people remain uninsured, while households continue to be plagued by rising health care costs.
Supporters of this proposal widely argue its ability to bring coverage to all Americans (including those who have experienced difficulties with accessing care), reduce costs and improve public health across the board. And they seem to be winning over supporters, with some poll numbers revealing that 70 percent of Americans support enacting the Medicare-for-All system.
But while Medicare-for-All is well-intentioned and aims to deliver a better health care system — especially for struggling Americans — its promises seem to exist more in fantasy than reality. I’d like to challenge this broad support and argue why such a model would wreak havoc on our economy and our lives.
A good place to start is the sheer cost of Medicare-for-All. PBS NewsHour reported that under the plan outlined by Senator Bernie Sanders, I-Vt., the cost would near “$34 trillion dollars over 10 years, more than the total cost of social security, medicare and medicaid combined.” With the United States already in the midst of a dangerous national debt crisis (our total deficit already stands at nearly $23 trillion), many puzzle over how our fiscally irresponsible government would be able to handle this hefty price tag.
In addition, it’s clear this amount of money won’t materialize out of thin air. It is going to have to be covered somehow, and amid existing financial problems, many experts agree that our economy is going to suffer. According to Robert E. Moffit, senior fellow at the Heritage Foundation, substantial tax hikes under Medicare-for-All are inevitable. “Taxpayers would face enormous burdens,” Moffit stated. “Roughly 70 percent of working households would pay more than they do today.” While advocates have assured the American people that most people will be saving money somehow, a Bloomberg article published in July advises readers to take a closer look. “The 181 million taxpayers with employer-sponsored coverage could miss out on the benefits of the Sanders plan, and even those receiving Medicaid could pay more,” according to writer Laura Davison.
Ultimately, without substantial tax hikes (including on the middle-class), the bulky Medicare-for-All system won’t even be able to get off the ground. Even a 100-percent increase in federal individual and corporate income tax revenue would not be enough to pay for Sanders’s plan, as Charles Blahous, former member of the Medicare Board of Trustees, predicted. Blahous went on to conclude that this kind of increase in the scope of the federal government operations would precipitate a correspondingly large increase in federal taxation or debt and would be unprecedented if undertaken as an enduring commitment. More than anything else, rising taxes and expanding debt equals bad news for our economy.
And if this isn’t enough to sway your opinion, there’s even more evidence against the Medicare-for-All model. With the idea gaining popularity, many health systems across the country continue to warn Americans that they will see dramatic reductions in the quality of their care. According to Lauren Crawford Shaver, executive director of the Partnership for America’s Health Care Future, “Medicare for all would force Americans to pay more and wait longer for lower-quality health care” (Shaver notes a public option could potentially have this issue as well). We have already seen from other countries, such as Canada, that these single-payer systems can produce greatly undesirable results. “Waiting for treatment has become a defining characteristic of Canadian health care,” as stated by the Fraser Institute in a December 2018 account of the issue. “Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish … In many instances, patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general.” While Sanders and others argue that access across the board to health care will widen, it is clear that there will be a significant underlying cost that we don’t hear about much.
On top of this, all Americans, even those who are happy with their current health care plan from the private market, will be forced to switch to the single-payer platform, something that will surely be a logistical nightmare and lead to extensive frustration. Single-payer health care advocate Rep. Pramila Jayapal, D-Wash., affirmed this, telling NBC News that Medicare-for-All is “a system where there are no private insurance companies” whatsoever.
Finally, if history is to serve as a guide, it tells us that central government control of large programs is a perfect recipe for substantial waste, fraud and abuse, and Medicare-for-All will be no exception. One of the most glaring examples of this is the Veterans Health Administration, which takes after the single-payer model and truly displays the inability of our federal government to effectively manage large-scale programs. Furthermore, the current, smaller Medicare system has already seen significant abuse that officials have been unable to effectively deal with.
Many people may wonder how a plan this absurd, with such evident flaws, could gain such prominence and make it this far, to the point that it is one of the centerpieces of the Democratic agenda. Ultimately, broad misunderstanding exists over the sheer price tag of Medicare-for-All and who will have to bear the burden of this health care system. In the end, proponents of this system have routinely dodged facts, cut corners and disregarded the greater effect on the American people.
Already, a number of more modest proposals have been floated, and while I do not personally support many of them, they offer some of the benefits of Medicare-for-All and are safer and truly better options for the American people. Many Democratic presidential candidates, including former Vice President Joe Biden and others, realize the inherent limitations of Medicare-for-All and have set forth more modest options that deserve serious consideration.
In the end, it is obvious that something needs to change. It is our duty, as Americans, to help our fellow citizens and work to deliver quality health care to those in need at a fair cost. But given our wide range of options, that duty assuredly does not entail implementing this disastrous proposal.
Evan Stern can be reached at erstern@umich.edu.