Right On: Medicare for All? They’ve got to be kidding

Composite image, St. George News

OPINION — Bernie Sanders has a catchy title but it only takes a peek under the hood to see that his Medicare for All would be a disaster from the get-go.

Start with your current health insurance; or rather, forget your current insurance. Here’s what his proposed legislation says:

“It shall be unlawful for a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act, or for an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.”

Translation: Single-payer health care for all.

No tax-free, employer-provided health insurance for the 150 million Americans now covered.

No Medicare Supplement or Medicare Advantage plans for those over 65.

If you work for a health insurance company or agency, you’re out of a job. Of course the government will need hundreds of thousands of you to administer the new program: Welcome to civil service.

Support for Sanders’ plan drops when people hear that his plan would dramatically increase taxes and government control. Nearly half of adults surveyed last year falsely assumed they could keep their current insurance under a single-payer plan.

To counter the public’s aversion, Democratic politicians have been warned not to use the phrase “single payer” in their ads or speeches: It doesn’t poll well. Sanders’ home state of Vermont abandoned the idea. Nearly 80 percent of Colorado voters rejected a single-payer referendum.

Matt Bennett, founder of the centrist Democratic think tank Third Way notes: “The notion that Medicare for All is popular is premised upon people knowing almost nothing about it.”

Nonetheless, Democratic politicians have signed on in droves hoping for cynical, short-term political advantage and knowing it will never be enacted in anything like its current form. They believe it’s a political wedge issue for them in next week’s midterm election.

Medicare for All has been endorsed by 16 senators, including 2020 presidential hopefuls Cory Booker, Kamala Harris, Kirsten Gillibrand, and Elizabeth Warren. A companion House bill has more than 120 co-sponsors.

Not one of them is willing to talk about the program’s cost.

Former British Prime Minister Margaret Thatcher famously said, “The problem with socialism is that eventually you run out of other people’s money.”

It’s hard to think of a faster way to run out of other people’s money than Medicare for All.

The first of Bernie’s pipe dreams: government-run health care will lower costs.

Obamacare was sold in part because it was going to “bend the healthcare cost curve downward.” Instead the cost curve has bent upward. People use more stuff when a third party is paying the bill.

Sanders’ Medicare for All will provide a lot more free stuff: dental, vision and hearing will be covered with “no cost-sharing, including deductibles, coinsurance, copayments, or similar charges, imposed on an individual for any benefits.” Drop by the doctor’s office whenever you have the sniffles.

Pipe dream number two: Today’s version of Medicare is sustainable and can be easily extended.

The New York Post reports that Medicare benefits totaled $702 billion last year. But Medicare tax receipts totaled only $286 billion. See a problem here?

So where does the rest of the funding come from? It comes from “general revenues,” or in other words, from your income tax dollars. Congress has hidden the true cost of Medicare, making it look like a bargain. It isn’t.

Even when allowing for inflation and the time value of money, Medicare recipients will receive benefits triple the amount of their Medicare contributions.

Pipe dream number three: Medicare for All will lower the nation’s total spending on health care.

A widely-discussed Mercatus Center study estimates Sanders’ proposal will cost $32 trillion over its first 10 years. Two other independent studies come to the same conclusion when adjusted to include similar benefits and time frames.

Sanders has never offered a cost estimate and for good reason. Doubling personal and corporate income taxes still wouldn’t cover the program’s cost.

The Mercatus study makes a number of Sanders-favorable assumptions by accepting that the program would achieve all its hoped-for objectives. If it doesn’t – and it won’t – costs would be even higher.

For example, Medicare for All expects to cut all health care provider payments to today’s Medicare reimbursement rates, some 40 percent lower than private insurance rates.

Many doctors and hospitals today operate on a combination of these two payment levels. Others won’t accept Medicare patients at all because reimbursement levels don’t cover their costs.

Sanders’ plan would require all providers to accept whatever rate the government chooses. Let the lobbying and political fun-and-games begin.

If you believe Medicare reimbursement rates will hold, I’ve got some beachfront land I’d like to show you at low tide.

Further, the Mercatus study accepts Sanders’ expectation that government administrative costs would be half of today’s private insurance industry. Do you want to bet?

Does anyone believe all this can be done without impacting both the availability and quality of health care?

Actually there are some who do. Those folks point to Canada’s socialized health care as a model for the U.S. Then again, these are the same folks who heaped praise on Veterans Administration hospitals before scandalous conditions resulting in premature veteran deaths came to light.

Like all socialized health care systems, Canada controls costs by restricting health care supply. Wait times to see specialists often run years, not weeks or months. Have a cold? Come on in. Need a knee replacement or breast reconstruction? Get in line.

As a result, Canadians who can afford it journey to the U.S. for treatment. When – not if – reality hits Medicare for All, where will Americans go, Mexico?

My simple, comprehensive Obamacare replacement is looking better and better.

Howard Sierer is an opinion columnist for St. George News. The opinions stated in this article are his own and may not be representative of St. George News.

Email: hsierer@stgeorgeutah.com

Twitter: @STGnews

Copyright St. George News, SaintGeorgeUtah.com LLC, 2018, all rights reserved.

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26 Comments

  • tcrider November 1, 2018 at 3:43 pm

    How- weird,
    You moron, you would prefer to keep the corporate welfare going
    instead of helping people, you belong in a glass case at the dinosaur museum.

    • Blemonds November 1, 2018 at 3:58 pm

      What seems moronic is for people like Bernie Sanders to force people like me pay for others to get healthcare. I worked all my life to earn my health insurance and now he wants me to pay for others as well. People who want others to receive free healthcare should start a crowd funding service and like minded people can donate to their hearts’ content. But it would fail because the idea is to force other people to donate, even if it is against their will.
      That was a tenet of Ted Kennedy’s faith. He believed forcing other people to be ‘altruistic” would earn him a spot in Heaven. Hard to say what Bernie Sanders’ motivation is if not just a lust for power

      • tcrider November 1, 2018 at 4:17 pm

        I would never vote for Bernnie, and unlike most right wing extremists,
        I do not consider everyone that does not support the pospotus a Lib,
        no one is trying to pull a fast one and you really need to see through all the fear
        based BS.

    • 42214 November 1, 2018 at 4:32 pm

      There are 2 kinds of people in this scenario. Those that take the benefits and those who pay for the benefits. Margaret Thatcher said socialism is great until the other guy runs out of money. I think alot of the payers are getting sick of the takers.

      • Henry November 1, 2018 at 10:31 pm

        Actually, Medicare has one kind of people in the scenario; those who pay into the system for many years in order to ensure they have healthcare when they’re older or have been disabled at least two years. Those who pay for the benefits but never reap the reward would in all likelihood be dead before they’re 65, so they would have trouble bing sick of the “takers.” Oh – and in anticipation of your reply about how easy it is to become disabled, I would invite you to try applying for disability… come back in a couple years when you’ve completed the process and we can talk about the “takers.”

    • bikeandfish November 1, 2018 at 6:37 pm

      A bit harsh response for a pretty mainstream opinion by Howard.

    • Craig November 2, 2018 at 9:29 am

      In my opinion name-calling suggests you have nothing useful to add to the discussion.

      I did not see anything suggesting inappropriate corporate welfare is any more useful than inappropriate personal welfare.

      Are you going the pay the bill or do you expect someone else to pay your costs?

  • Blemonds November 1, 2018 at 3:49 pm

    Our liberal friends are trying to pull a fast one on us by conflating Medicare with a single payer system. Medicare only pays a portion of medical expenses. The patient pays the balance. If you can afford the balance, great. If not, you need a supplemental insurance. That makes Medicare a three payer system. Moreover, you pay a Medicare premium as a tax your entire working life even though you are ineligible to use it. The premium is low because of exactly that, you’re paying for something you can’t have. Once you become eligible, you keep paying a premium. If Medicare kicks in for all, that tax you pay will balloon because now you’ll be using the services and the old premium will in no way cover the expenses

  • Henry November 1, 2018 at 5:22 pm

    The Medicare program has so many hands in the pot that it needs an overhaul. As long as private, for-profit companies are allowed to manage parts of Medicare under the guise of providing better care/saving money, there will be issues. One of the most significant problems Medicare has is that medications are paid FULL RETAIL PRICE rather than at a reduced cost that the negotiating power afforded by millions of recipients would allow. Big Pharma, Private Insurers, and “consultants” make a significant amount of their income from Medicare Beneficiaries. Medicare for all would be a great idea if the program cut out the waste. One thing is certain, we need to ensure a healthy population and without the ability to seek care and afford medications, people turn to street drugs such as Heroin to treat their pain. We are spending hundreds of millions on the Opioid Epidemic, why not pay for prevention and healthcare versus crime and addiction. This isn’t a Liberal issue; it’s not a Conservative issue; it’s a HUMAN issue. I read your “comprehensive” plan; please tell me how someone without the ability to pay out of pocket for the 15-20% of their adjusted gross income will access healthcare. If you can’t come up with hundreds of dollars up front, you won’t receive care. Also, the catastrophic coverage you speak of will cost huge amounts to be administrated, including someone to issue the pesky denials that will surely follow.

    • Happy Commenter November 1, 2018 at 6:24 pm

      Henry, I see you’ve been reading the latest liberal false talking points again..

      • Henry November 1, 2018 at 10:22 pm

        Well, there’s that theory – and it’s certainly a good one. Another theory – just putting this out there as a possibility – would be that I have extensive experience with Medicare, insurance and associated senior care issues. I mean, I could be reading Faux News for my information, and blaming the Liberals for all that’s wrong with the world… but that wouldn’t make me an expert (aka professional), now would it? And, Blemons, Medicare is a single payer system with co-pays & deductibles: Part A is covered by all those pesky premiums that you paid for over at least 10 years so it’s “free” to most people; if not you’ll pay $422/mo; Part B has a premium of about $135/month, substantially cheaper than many healthcare plans. Part D plans have their own costs, depending upon the plan. Medicare pays 80/20, so there are indeed out of pocket costs that are cost-controlled so it’s certainly not gonna break the bank. There are supplements that can be purchased, altho many people make payments. Medicare Advantage plans cover more while limiting your choices (and care). A Republican President came up with the idea to expand Medicare Advantage, which is a HUGE bonus for the health plans like Humana, United, etc. I mean – you could actually google all this info, instead of trying to offend me by implying I don’t know my stuff. Your turn.

        • Rice November 2, 2018 at 9:39 am

          You get out of here with your civil logic!

        • bikeandfish November 2, 2018 at 10:08 am

          Well played Henry.

          80/20 isn’t bad given what most of us experience with private insurance.

          I just wish more states would implement such systems. Our country seems torn about federal level programs right now.

  • Happy Commenter November 1, 2018 at 6:22 pm

    You believe you have a right to healthcare? Well, like most of us, you also have a right to pay for it yourself!

    • bikeandfish November 1, 2018 at 6:40 pm

      We would in such a program through a tax. Really no different than most insurance as the healthy offset cost the of those who need service.

      That said, I don’t believe a single payer at the national level is a likely or wise decision.

    • No Filter November 2, 2018 at 10:08 am

      So you say we don’t have a right to healthcare, well I say you don’t have the right to claim social security benefits at a rate 13% higher than you paid into it.
      From Howard’s link in this article, “The typical couple retiring today will receive Social Security benefits 13 percent higher than their lifetime contributions, and Medicare benefits that are triple their lifetime contributions into the system, even after adjusting for inflation and net present values.” So who is paying for this increase? The tax payers. When you get your disability check John, you better thank all those underpaid workers for footing your bill.

      • Happy Commenter November 2, 2018 at 5:02 pm

        No one said you don’t have a right to healthcare libby!. You have to pay for it like you do everything else. No Freeloaders..

  • KR567 November 1, 2018 at 7:41 pm

    Woooooohooooooo free medical care for everybody !!! LOL !

    • Henry November 1, 2018 at 10:34 pm

      Please look at the Medicare deductions in your paycheck, then explain to me the “free” part. Unless you’re not working, in which case you’ll probably qualify for Medicaid to pay for your Medicare premiums. Then I’ll be paying for you – but I’m not bitter.

  • utahdiablo November 1, 2018 at 8:49 pm

    Oh hell, if Bernie gets his way, then he’ll just mandate a $5 dollar per gallon tax to pay for it all…problem solved “According to the U.S. Energy Information Administration (EIA), Americans consumed 140.43 billion gallons of gasoline in 2015, or about 384.74 million gallons each day.”

  • jaltair November 1, 2018 at 9:53 pm

    Laws can be redone. I’m conservative, but I see a place for a single-payer system with the Feds to act in that capacity. Something Medicare-like, but take out insurance as the payor and much would be saved. People still pay into their own health-care even through the employer or privately. Much like a tax is taken from income. Everyone could be covered and Medicaid could help those who would qualify so the burden is down for them.

    I believe health care is so important that it takes priority. As I said, take out the insurance middle-man (except for those who would like to pay privately to cover the 20% not covered by the plan), and a lot of money would be saved. Have the federal government also pay drug companies for researching new drugs and after on market to sell, the feds buy the patent. The problem, “big pharma” owns the government.

    I really think costs could be kept lower all the way around. Don’t sound very conservative, do I?

  • No Filter November 2, 2018 at 9:49 am

    Come on Howard, using the wait time scare tactic is getting old. Wait times will be longer for elective procedures not emergency procedures. Elective procedures have longer wait times already in the US. As for everyone complaining about paying for others medical care, what do you think your taxes and premiums go towards. We pay for medicaid even if we don’t use it, we pay our insurance premiums to cover the cost of everyone covered by the insurance company. Do you really think the insurance company covers the cost of large medical expenses that are more than a patients premium? No it is covered by the premiums of the all people who are covered by the company. Those who are healthy have always paid for those who are sick, it’s the right thing to do, when you are sick and aging the younger peoples premiums will pay for your healthcare, it’s a give and take system that benefits everyone. Seems like we already have a single payer-like program, but instead of all the money in one pot, multiple companies are getting rich off the people who pay ever raising cost for healthcare. I would rather pay what I do to my healthcare premiums to a single payer knowing I can get medical care no matter what rather than pay a private company who can at anytime change the rules and say “no we don’t cover that, you have to pay it by yourself, please read our fine print”

    • Happy Commenter November 2, 2018 at 6:24 pm

      Just like that recreational weed you get in Mesquite. You have to pay for it youself!

  • Kilroywashere November 3, 2018 at 2:29 pm

    Oh, you are all wrong. AMA, Pharma, and Health insurance companies put together are the largest lobby in this country next to the defense industry. They have a virtual monopoly on our health as well as the associated designated costs. Health costs rise every year at exhorbanent rates without any justification, often 10x+ against inflation. Try to get a price ahead of time. One hospital will charge 18k for the same hip surgery that another charges 70k. Bottomline the American public is being extorted and politicians get their donations and kickbacks. Both my parents died from medical malpractice so even if you do have health insurance you may not get what you pay for. The change has to come from regulating corporate greed. Then maybe your $250 EpiPen that costs $5 in materials will be $20. Visibility of cost would be a great start so Americans can shop around. Otherwise it is all about maximizing shareholders wealth and most Doctors have surrendered to the system as they are prey to malpractice lawyers. Bernie’s plan would be a disaster, and until you fix the root cause of monopolistic greed, well l, better hope you die with your boots on.

    • bikeandfish November 3, 2018 at 5:30 pm

      Alot of truth there. But how do you address the roor cause (or one of them) given tge current political climate? Neither side actually holds major corporation’s feet to the fire. Few politicians seems willing to take on that Herculean task as it would be political suicide come the next election.

      Once we start pulling away the layers of the onion you get to see how many more there are. And so many of the potential solutions fly in the face of dominant political ideologies. I think most of us miss the pre-Clinton years when both parties cared enough to bring real solutions to the table. More and more we are seeing radical partisans more interested in ideological purity instead of solving our nation’s problems.

      • Kilroywashere November 4, 2018 at 4:00 pm

        Wash your hands religiously. Dont get sick. I wish there was an answer other then that. Or… Keep income to a bare minimum, to qualify for Medicaid, which for many folks is impossible , especially if you have kids and require a job to put food on the table. On Medicaid you have no $2K + ambulance cost, and as an example, if you have hepatitis C (say from your heroin habit) you wont have to pay $90,000 for Harvoni meds – it’s almost absolutely free. Wish I had a real answer other than it has to start with Doctors. But they have sold out and the hippocratic oath is a distant memory now. My mother was a nurse for over 40 years and in the early 90s she had to quit due to administrative cost cutting that was putting her in a position of making triage decisions as a part of her job, while high paid Administrators cutting expenses brought in temp nurses that sat on their thumbs trying to figure out where the hospital kept the aspirin and paper cups. All I can say, her words of wisdom, in every hospital… EVERY HOSPITAL… there is at least one doctor that you dont want even operating on your cat. 3 opinions always!!!! Doctors are peer reviewed and should never feel slighted if you get other opinions. It just might save you from getting your gall bladder removed for nothing. You have to see doctors like car mechanics even though they are trained to put themselves on a pedestal. If they wanted too, the doctors could fix the problem with medical care in this country. They know this is the case.

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