Medicare-for-All: Resurrection of a Terrible Idea

Progressive Democrats are trying to reintroduce their Medicare-for-All plan, a bait-&-switch scheme to impose single payer surreptitiously. It is national financial suicide, medical death-by-queue, and end of American medical freedom called medical autonomy. 

That is not hyperbole – it is simple fact. 

Avowed socialist Bernie Sanders along with Representatives Pramila Jayapal (D-Washington) and Debbie Dingell (D-Michigan), as well as 14 senators and 110 members of the House of Representatives are seeking to resurrect H.R. 1384, the disastrous Medicare for All National Health Insurance Bill. They claim CoViD deaths showed the need to bring it back. Further, they assert 15 million Americans otherwise will lose Medicare coverage, that the bill would save $650 billion, lower drug costs, reduce administrative cost and hassle, and improve access to care. 

Every claim is false. 

It is now clear the number of deaths directly attributable to CoViD was greatly inflated, but whatever the number, lack of insurance coverage played no role. National health insurance, viz., H.R. 1384, would thus have no impact.

There is absolutely no basis for the claim that 15 million will lose Medicare coverage. If not, why would patients need H.R. 1384?

The claim that Medicare-for-All will save money is falsehood, propaganda, or to use favored progressive phraseology, disinformation. Senator Sanders himself admitted the bill would cost $30 trillion to $40 trillion over ten years. An independent, objective financial analysis by Mercatus Institute projected a cost of $32.6 trillion over ten years.  For perspective, that means each year American taxpayers would pay an amount similar to the entire GDP of Japan ($4 trillion) just to fund these new expenses. 

Last year the U.S. spent $4.3 trillion on healthcare. Half went to pay for bureaucracy, i.e., two trillion “healthcare” dollars produced no care

There is no evidence for the assertion that H.R. 1384 would reduce administrative costs and hassle. To suggest that government bureaucracy is low cost, efficient, and user-friendly would be laughable if it weren’t so painful. The original application for Obamacare insurance was 21 pages long. Eventually, Washington proudly achieved a reduction to only 11 pages. The claim that Medicare-for-All would lessen physicians’ regulatory burden is easily refuted by citing the administrative nightmare doctors currently face when trying to get paid by a federal insurance program, Medicaid. 

The most egregious assertion about Medicare-for-All is that it would improve patients’ access to medical care. Nearly one third of U.S. physicians do not accept new patients with Medicaid insurance; in Texas, less than half do. After Obamacare was fully implemented, the average maximum wait time to see a primary care physician was 122 days. That’s four months to diagnose belly pain: gas, ulcer, or cancer. This author’s wife waited six months to discover her abdominal pain had progressed to inoperable pancreatic cancer.

Imagine how long a patient would wait to get in to see their Medicare-for-All supplied physician with a panel (list) of 1000 patients or more. However bad our physician shortage is today, consider how much worse it will be and how much longer patients will wait, when the few doctors that remain in practice are being paid Medicaid “allowable reimbursements” and must deal with the Byzantine Medicaid bureaucracy. 

Sanders et al want to use Medicare-for-All as a “springboard” to a single payer system. Their H.R. 1384 eliminates private insurance and gives total medical as well as financial control to Washington. H.R. 1384 creates several new federal healthcare agencies including the Office of National Health Budget (Section 601 of the bill), that will dictate payments to all those who work in healthcare, both providers such as doctors and nurses, and suppliers like pharmaceuticals.

With Medicare-for-All, patients must choose a physician from a small government-approved list and then wait forever to get care. In Canada’s single payer system, cancer patients cross over to the U.S. to get care before they die. In our homegrown single payer, the VA system, “47,000 veterans may have died” waiting in line for care. Similar death-by-queue of government insured patients has been reported in Illinois Medicaid.

As harmful as Medicare-for-All is to Americans’ health and the financial stats of the nation, it will be fatal to liberty. With total federal control, patients will no longer make their own medical choices–Washington bureaucrats will. Medical autonomy will cease to exist. Physicians will no longer practice personal, one-patient-at-a-time medicine. They will be forced to follow Washington’s one-size-fits-all clinical algorithms, obey pharmacy benefits managers, work within “guidelines” that produce cookbook medicine, and triage critically ill patients applying woke rather than strictly medical criteria. Physicians will have to follow government orders as to what, where, when, by whom, and even if patients get care.

Leon Trotsky wrote of Communism, "In a country where the sole employer is the State, opposition means death by slow starvation ... who does not obey shall not eat."

In a country where the sole provider of medical care is the State, as with Medicare-for-All, who does not obey shall die-by-queue: waiting in line for care that never comes. 

Deane Waldman, M.D., MBA is Professor Emeritus of Pediatrics, Pathology, and Decision Science; former Director of the Center for Healthcare Policy at Texas Public Policy Foundation; and author of the multi-award-winning book Curing the Cancer in U.S. HealthcareStatesCare and Market-Based Medicine.

Photo credit: Molly Adams CC BY 2.0 license

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