Inspire Confidence in Your Expertise by Mastering ‘Medicare for All’ Argument
The diminished presidential fortunes of Senator Bernie Sanders hasn’t extinguished interest in his signature legislative proposal, Medicare for All. Kaiser Family Foundation (KFF) polling published as recently as May 27[i], showed overall favorability of the plan at 56 percent, matching its popularity in January[ii] when Sanders was in strong contention for the Democratic nomination.
If History is a teacher, be aware that universal health care is not an idea that originated with Sanders, nor President Barack Obama, nor First Lady Hillary Clinton during her husband’s presidency. It was injected American political debate by President Harry Truman in 1945[iii], who saw it as an extension of the President Franklin D. Roosevelt’s New Deal. But Congress never even put the idea to a vote – at least not for 20 years.
When Medicare was signed into law July 30, 1965[iv], President Lyndon Johnson arranged for Truman to become its first enrollee in ceremonies at the Truman Library in Missouri. Medicare, of course, is essentially universal health care upon your 65th birthday.
Still An Issue
While current political winds may not be blowing in the direction of eliminating private insurance, arming yourself with arguments on its behalf may help you demonstrate an expertise that wins more business. After all, life would be simpler for company executives if government handled employee health insurance.
Fortunately for your business, a survey of 147 companies employing a combined 15.6 million people by the National Business Group on Health (NBGH)[v] showed that more than half believe Medicare for All will reduce health care quality while increasing costs, and two-thirds suggest it would stifle health care innovation.
In a press briefing posted on the group’s website in January, Ellen Kelsay, chief strategy officer of NBGH, pointed out that “many proposals are lacking detail” and reminded the press gathering that “the private employer-sponsored market does quite a bit to provide subsidization to public or government-funded health care programs. The private market also drives a lot of innovation within the health care delivery system at large.”
Private insurers pay hospitals 241-293% higher rates than Medicare, according to a 2019 Rand report.[vi]
“Hospitals will readily tell you revenue from commercial payers helps cover the shortfall in their costs when they treat Medicare or Medicaid patients,” explained NBGH’s Steve Wojcik, vice president of public policy.
“It’s true that employer coverage benefits from tax advantages,” Wojcik added, “but Medicare beneficiaries only pay for a small portion of the costs of their care and coverage. The rest is funded by the taxpayer and through the Medicare payroll tax, which is shared by employers and employees. So while employer coverage benefits from tax advantages, people who are covered through Medicare benefit from taxes from employees and employers to help pay for their coverage.”
Would Medicare for All provide basic Medicare only, or a level of supplementation such as Part F, in which the individual is responsible for no medical charges?
NBGH President and CEO Brian Marcott also questioned the impact on providers.
“Private insurance pays providers anywhere from 150% to 300% of what Medicare pays, depending on the market. If we move to Medicare for All, what will be the provider payment? How will that payment affect access? There are a lot of questions around Medicare for All. It’s not so much an issue of employers dismissing it outright but there are too many issues on the table for it to be a reasonable consideration at this point.
“There’s the whole question of the financial solvency of Medicare currently,” added Marcott, “let alone expanding Medicare to cover everybody, and then the impact on taxes, which you can see here is a significant concern (among survey respondents).”
The Congressional Research Service reports that Medicare’s Hospital Insurance Trust Fund “will become insolvent in 2026.”[vii]
Perils of Carefree Care
A policy researcher for Reason Foundation, Nicholas DeSimone, fears catastrophic consequences if patients are relieved of all financial burden – and thus cost-saving incentives. Posting on the website of the Foundation for Economic Education,[viii] DeSimone wrote:
“If Medicare for All covered all 325 million Americans—which include the nearly 30 million uninsured Americans and the 41 million more with inadequate health insurance—it would be the most disastrous third-party payer ever, once cost was not a primary factor.”
Canada’s single-payer system, according to DeSimone, causes an average wait of more than 21 weeks to see a specialist and its cancer mortality rate is higher than the US, although deaths from heart disease are slightly lower.
A post in November 2018 at FEE[ix] also projected doom should Medicare for All materialize.
“In health care,” wrote Warren C. Gibson, “increasingly providers respond to bureaucratic diktats rather than consumer preferences. Patients’ remaining market power would vanish under ‘Medicare for All.’ We would be left to the tender mercies of faceless bureaucrats—infantilized, if you will.”
A professor of engineering at one university and economics at another, Gibson also wrote:
“Private insurers, who must answer to market forces, worry a lot about maintaining adequate reserves. The looming Medicare and Social Security crises have been widely publicized, even on government websites, yet politicians continue to ignore them.
“Medicare has to go,” Gibson opined. “The government must ultimately be gotten out of health care entirely, but getting there from here will not be easy.”
History of Cost Projections
When Medicare was launched in 1965, it was projected to cost $12 billion (inflation adjusted) by 1990. Its actual cost was 9 times greater than projected – $107 billion.[x]
If DeSimone and Gibson haven’t pummeled Medicare for All into oblivion, there are numerous other posts on FEE.org[xi] that attack from all angles.
But how does it become a leading cause of death? You’ll have to accept DeSimone’s logic.
Following heart disease and cancer, the third leading cause of death in the US currently is “seeking medical treatment,” he claimed, citing a 2016 Johns Hopkins study[xii] indicating medical errors contribute to a quarter-million deaths annually.
DeSimone believes fee-for-service pricing prompts unnecessary treatments; claiming, essentially, that seemingly free healthcare will generate more treatment thus proportionately more fatal errors to the point of overtaking heart disease as America’s leading killer.
Such rationale is perhaps a stretch, less plausible than DeSimone’s assertion that Medicare for All is “more a political talking point than a medical solution to improve the overall health outcomes of Americans.”