"Medicare for All” sounds good until you see its high price tag and consider the implications it would have on the quality and access to health care. The House Rules Committee held its first ever hearing Tuesday on the Democrats’ Medicare for All bill introduced by Rep. Pramila Jayapal (D-WA). A similar bill was recently reintroduced by Sen. Bernie Sanders (I-VT) in the Senate.
While Medicare for All has little chance of becoming law with Republicans in control of the Senate and the White House, the proposal is quickly gaining traction among 2020 Democratic presidential candidates, earning support from at least seven to date.
As described during the hearing, Medicare for All would implement a government takeover of health care coverage, where all medically necessary services would be paid for by the federal government and all private insurance that duplicates government coverage would be prohibited. Enrollment in the government-provided coverage would be universal and automatic, and patients would no longer pay any out-of-pocket costs for health care services.
The first of the witnesses to testify in favor of the House bill was patient advocate Ady Barkan, a 32-year-old diagnosed with ALS who contended that Medicare for All would provide high quality health care to all, cut down on administrative waste, and save Americans money.
Grace-Marie Turner, President of the Galen Institute and a witness testifying against the bill, countered that the opponents of Medicare for All have many of these same end goals for our health care system. “Everyone should be able to get health coverage to access the health care they need, coverage and care should be affordable, we must guard the quality of care . . . and we must work to protect the most vulnerable,” said Turner.
The problem is that a single-payer health care system would move our country away—not toward—these shared goals. Turner argued that it’s hard to see how patients would be more empowered when dealing with a single government payer for health care: “In a country that values diversity, will one program with one list of benefits and set of rules work for everyone?”
Polls show that while the phrase “Medicare for All” is initially popular, once Americans are told that such a proposal could lead to delays in getting medical treatment, abolish employer-sponsored insurance, eliminate the current Medicare program as we know it, and raise taxes, support drops precipitously.
Dr. Charles Blahous of the Mercatus Center, the second witness testifying against the bill, projects that the net cost of the proposal would reach at least $32.6 trillion in the first ten years. Another study predicts that 71% of families will pay more under one version of the Senate bill than they would under the status quo.
In addition to the high cost of the program, Medicare for All could also be detrimental to the quality and timeliness of health care that patients receive. The House bill contains a provision that prevents the federal government from paying providers based on quality, which means that poorly-performing doctors get paid the same as doctors who produce good outcomes for their patients. Additionally, we have seen how patients in Canada and Great Britain suffer long wait times for care under their single-payer systems.
It is evident that many millions of Americans are frustrated with the current health care system. Indeed, health care costs and availability continue to poll at the top of voter concerns. However, we must look for ways to expand access to affordable health coverage that provide more, not fewer choices, to patients.