BernieCare for All Means Medicare for None
Senator Bernie Sanders, in keeping with his socialist proclivities, wants single-payer government run healthcare for everyone. As he describes it on his website,
Health care must be recognized as a right, not a privilege. Every man, woman and child in our country should be able to access the health care they need regardless of their income. The only long-term solution to America's health care crisis is a single-payer national health care program.
It all sounds great. Everyone should also live in a nice house, drive a late model car with all of the recent safety features, and receive an Ivy League education.
Unfortunately, economics gets in the way through cost and the relentless operation of the law of supply and demand.
Since Senate Minority Leader Chuck Schumer claimed that that healthcare would “define” next month’s midterms, it’s worth revisiting the Democrats’ plan.
Bernie’s plan is not new. It was first introduced into Congress in 2003 by former Democrat Congressman John Conyers, who resigned in disgrace last year over multiple sexual harassment allegations. Since then Medicare-for-all has been sitting in a desk drawer waiting for the optimal political opportunity to be resurrected.
It’s been proposed or threatened in the intervening years but never seriously on a national level. Several states have tried this type of plan, appropriately, under the concept of states being laboratories of democracy. Prove that it works at a state level before foisting it on an entire country -- but even that has proved to be a challenge.
Vermont passed a single-payer plan only to have the governor decline to implement it since it would cost more than the entire state budget and would drive businesses to neighboring states due to the new taxes necessary to fund the monstrosity.
Colorado tried its hand at a mile-high version of single-payer via ballot referendum in 2016. Voters noted the cost, doubling the state budget, and the taxes needed to fund the plan and rejected ColoradoCare by a four to one margin, despite Hillary Clinton winning the state on Election Day.
Theoretically, Democrats could have passed Conyers’ plan into law in 2009 when they had veto-proof majorities in both houses of Congress and control of the White House. Go big or go home. The Democrats settled for Obamacare instead and are now in no position to legislate anything.
Starting with cost, BernieCare will bust the federal budget. According to the Mercatus Center, a George Mason University research institute, this scheme will cost $32.6 trillion over the first ten years. Or about $3.3 trillion per year. The entire federal budget is $4.1 trillion per year, meaning that this plan will consume over three quarters of the federal budget, leaving little money for anything else.
This also assumes that these projections will stand the test of time. Medicare, when created in 1965, was projected to cost $12 billion per year by 1990, but in actuality cost $90 billion that year. No doubt the projections about BernieCare similarly far underestimate the actual costs.
What happens if BernieCare underestimates cost by a factor of two or four? What happens then? Bernie has not addressed this likelihood.
Such a plan would eliminate private insurance, and premiums would be replaced by taxes. As Mercatus observed, “Even doubling all federal individual and corporate income tax collections would fall short of fully funding the plan.” Yes, a doubling of taxes and still not fully funded.
How will they make up the shortfall? Cut payments to providers. Physicians will be paid 40 percent less. With many specialty practices already running at over 50 percent or higher overhead, expect these practices to close. Working at a loss won’t appeal to many physicians or clinics.
Enter supply and demand. Give everyone in America access to unlimited free healthcare, including all of the illegal immigrants welcomed by open-borders Democrats, and expect demand to surge. Combine that with fewer physicians willing to work at half their previous payment rates, and supply dwindles.
The only solution when demand exceeds supply is, “An artificial control on the distribution of scarce resources”, which is the definition of rationing. Democrats consider this a dirty word and accuse Republicans of fear-mongering when using the dreaded R-word.
In healthcare, rationing translates to wait lists for elective surgery, imaging tests, and specialist appointments, just as is commonplace in countries with single-payer schemes such as Canada, New Zealand, and the UK.
In Canada, the average wait time from referral from a general practitioner to a specialist for treatment is 21 weeks or over 5 months. Great news for those waiting for a specialist to evaluate their failing kidneys, shortness of breath, or diminishing eyesight.
The latest and greatest medicines would not be covered under BernieCare. Medical innovation would grind to a halt. Why would companies research and develop new drugs if they aren’t on the BernieCare formulary and the company can’t recoup the billion dollar-plus investment in bringing a new drug to market?
Medicare patients will be hit particularly hard. Medicare is not an entitlement like Medicaid or food stamps. Seniors have been paying into Medicare their entire working lives, in the form of a Medicare tax, as have all working Americans, of any age. With BernieCare they will be in the same category as those who have paid nothing into Medicare. This is hardly fair to those forced to pay into a system via taxes with future expected benefits.
Democrats are welcome to run on Medicare for all, and Republicans will point out the consequences as President Trump did in a recent editorial. It won’t be Paul Ryan pushing granny off the cliff but instead Bernie and his fellow “democratic socialists” trying to turn America into Venezuela, one doctor visit at a time.
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Brian C Joondeph, MD, MPS, a Denver based physician and writer. Follow him on Facebook, LinkedIn and Twitter.