Medicare For All - A Major Step Toward Socialist Twin Tower Goals Of Government Dependence

This post shows how the Medicare for All legislative bills introduced in both the House & Senate by Democrats is a major step toward the socialist twin tower goals of making people totally dependent on government from cradle to grave: Tower #1 - financially through taxes & Tower #2 - physically through universal single payer healthcare.

 

On April 30 the House Rules Committee held a hearing on HR 1384, the Medicare for All Act of 2019, introduced on 2/27/19 by Congresswoman Pramila Jayapal (D-WA-7).  The bill currently has 108 co-sponsors including the Chairman of the Rules Committee James McGovern (D-MA-2) & Congressman Ed Perlmutter (D-CO-7) – both of whom participated in the hearing.

 

The aforementioned House bill is essentially a companion bill to the Senate Medicare for All Act of 2017, Senate bill 1804, originally introduced on September 13, 2017 & then updated on April 10, 2019, by Democrat Socialist candidate for president Vermont Senator Bernie Sanders.  The 2019 version has 14 Senate cosponsors including four other Democrat presidential candidates – Booker, Gillibrand, Harris, & Warren.

 

In addition, the 2019 Senate bill has been endorsed by 63 national organizations and unions including:  American Federation of Teachers, Democratic Socialists of America, National Education Association, National Nurses United, National Organization for Women, New York Nurses Association, Service Employees International Union, United Electrical Radio and Machine Workers, United Mine Workers of America, & Utility Workers Union of America.

 

Twenty-eight percent of Republicans support Medicare for All.  See graphic below.

 

click on graphic to enlarge.

 

The problem with Medicare for All is that none of the various bills have anything to do with Medicare other than using the name & reimbursing medical providers @ Medicare rates – in fact the bills eliminate Medicare including Medicare Advantage.  They also eliminate employer coverage, most private insurance, & Medicaid.  The bills more closely resemble Medicaid for All but with no state component or function like current Medicaid. 

 

Medicare for All is a universal single payer healthcare system totally controlled by the federal government. 

 

The initial cost estimate of Medicare for All indicated a $2 trillion savings over current healthcare expenditures the first ten years of the program's full implementation even while adding almost $6 trillion in added demand & expansion coverage to include dental, vision, hearing, & long term care.  The problem is that this calculation pointlessly assumed that hospitals & doctors would be willing to accept 40% reductions in their compensations under Medicare for All.  Redo the calculation using actual prevailing rates & the initial $2 trillion program savings turns into a $3.253 trillion increase over the first ten years of the program.  Source:  "The Costs Of A National Single Payer Healthcare System."  Mercatus Working Paper by Charles Blahous July 2018.

 

Dr. Blahous, public trustee for Social Security & Medicare from 2010 to 2015, calculated that Medicare for All would increase federal government spending by $37.950 trillion in the first decade of the program's full implementation (2022 – 2031 assuming the program started in 2018) using prevailing compensation rates for hospitals & doctors. 

 

The added federal costs of the program would require more than doubling the currently projected individual & corporate income tax revenues – to include a combination of such things as mandatory taxes on employers' gross receipts & payrolls, a national sales tax on nonnecessities, a wealth tax, & taxing long term capital gains @ ordinary income tax rates.  During the first ten years of the program the total amount of tax revenue collected & spent by the federal government on Medicare for All is calculated, using the questionable assumptions of savings in the bill, to approximate the currently projected personal healthcare spending for the same period meaning that the calculated cost of a government program is one thing, even if such costs historically have always exceeded their initial estimate by billions of dollars.  Another thing is - do people like & want the federal government's increased involvement in their healthcare? 

 

The additional $37.950 trillion federal government spending over ten years amounts to 12.3% of GDP in the first year of the program growing to 14.8% in the tenth year (& further thereafter) thereby bringing the total federal government spending on healthcare to 22.9% of GDP in the tenth year (sum of current projected federal government spending on healthcare plus the increased calculated spending).  See Table 4 of above referenced Blahous working paper.

 

Similar calculations regarding the enormity of the Medicare for All costs have been made by the Urban Institute, the Center for Health & Economy, & Emory scholar Kenneth Thorpe. 

It is telling that Bernie has not done a cost analysis of either the 2017 or 2019 Senate Medicare for All bills that he introduced.  See graphic below.

 

 

 

But Bernie & AOC are not the least bit concerned about the enormity of these costs or the impractical & destructive basis for implementing the program, i.e., 40% cuts in compensation for hospitals & doctors.

 

A study by the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary determined that 80% of hospitals will lose money treating Medicare patients in 2019.  This is the future for hospitals treating all patients @ Medicare rates under Medicare for All.  Bernie & AOC will not relent from their position that hospitals & doctors will be willing to remain in the medical system with 40% cuts in compensation from the current private-public blended rates to Medicare reimbursement rates. 

 

These cuts in compensation would undoubtedly reduce the supply of healthcare services (see graphic below) while Bernie & AOC acknowledge that Medicare for All will increase healthcare demand.  Less doctors & hospitals with greater demand for services will inevitably result in rationing, waiting lines, & lower quality of care with the most vulnerable hurt the most – this is the real cost of Medicare for All.

 

click on graphic to enlarge

 

When Bernie introduced the Medicare for All Act of 2019 he said it was to guarantee healthcare to every American as a right, not a privilege.  Well healthcare is not a right or a privilege – it is a good to be purchased like food, shelter, or clothing.  A right is a gift from God that extends from our humanity – natural rights are anterior to government & therefore preexisted any government claim on them.  If healthcare is a right why do we need someone to provide it to us?  It is obvious from this post that it won't be hospitals or doctors under Medicare for All.  Click here to hear the great libertarian Judge Andrew Napolitano explain the difference between a right & a good.

 

Thomas Sowell asks "why would you expect someone else to provide for you what you do not provide for yourself?"  The significance of the answer to Dr. Sowell's question applies to much more than healthcare.  I use it every day.  It is a pillar to live by.

 

But a large mindset change is needed to return healthcare in America to its place in our foundation of limited government, free enterprise, & personal responsibility.

 

A frequent healthcare insurance complaint is "my premiums are high & I have a $5,000 deductible" implying that the owner of the policy is looking to be reimbursed for items like having their teeth cleaned or their eyes examined when they know they need glasses.  Such a complainer is confusing real insurance with a prepaid healthcare plan – which is what most of us have today.

 

The vast majority of what we call healthcare insurance today is really not insurance but rather prepaid healthcare plans where policy holders do not proceed with treatment until their insurance company agrees to pay for the treatment that the policy holder really has already paid for in advance plus a profit for the insurance company.  People have been brainwashed to accept the dominance of their healthcare quality by a far off insurance company, & now with Medicare for All an even more distant & impersonal federal government calling the shots, never thinking that they could pay for much of the routine care like teeth cleaning themselves, have lower premiums & a deductible that they agree with & can afford thereby gaining better control of their own healthcare to boot.  

 

If insurance companies can make money reimbursing policy holders after paying for all the routine items they approve why don't people think they could make a better deal for themselves by getting inexpensive catastrophic insurance & paying directly for the items on the list of prepaid healthcare expenses that they already really have paid for in advance through higher premiums?

 

Putting people in direct contact with their doctors without interference or involvement by insurance companies or the federal government starts to clear up the picture that we need to focus on.

 

And, after all of the above comes into clear focus we will see that the federal government providing a universal single payer healthcare system, in point of fact, has nothing @ all to do with the enumerated powers specified in our glorious & magnificent Constitution.

 

Reference Post:  The Solution To America's Healthcare Problems