Do We Really Need Medicare for All?
By Raheem Williams
Medicare-for-all is a common rallying cry for some of the more radical healthcare reform advocates. Proponents for the bureaucratic takeover of healthcare present a fairly rosy picture of questionable savings estimates and longer average life expectancy. However, the devil is in the details, and there’s a lot of unanswered questions.
Contrary to popular belief, the slight decrease in U.S. life expectancy can easily be attributed to our subpar lifestyle choices, not healthcare access. Although this is a public health issue, it’s unclear how medicare-for-all would convince people to give up illicit drugs, alcohol, tobacco or McDonalds. Simply billing the taxpayers all healthcare expenditures wouldn’t solve this problem.
Furthermore, our healthcare system isn’t anything remotely close to a free market. Health insurance and delivery are regulated on almost every level of government. Most Americans have no idea how much they will pay for health services until well after they incur the cost. Hidden prices paid by third-party intermediaries make it nearly impossible to shop around for care. These covert processes benefit industry insiders but harm the public and restrain competitive market forces that would otherwise lower prices over time.
Claims that medicare-for-all would produce massive savings in the long run are fairly dubious as well. Undoubtedly, centralizing administrative costs could produce savings through efficiency gains. However, it’s unclear how much of this would be offset by a lack of cost controls and the addition of 30 million people to a relatively fixed supply of healthcare resources. Countries with universal healthcare produce savings similar to how private insurers produce profit — by rationing care.
Proponents of fully nationalized healthcare are purposefully vague. Medicare-for-all wouldn’t guarantee access to healthcare but it would guarantee consideration for care. To achieve real savings cost controls are unavoidable. There has to be some basis for denying care. So what will this new national healthcare system cover: unlimited taxpayer-funded abortion, gender reassignment surgery and hormones (perhaps even for minors), maybe even breast augmentation? Will we deny right-to-try expenses for experimental treatments for cancers and other terminal illnesses? What will be acceptable wait times for urgent and non-urgent procedures? Likewise, How will we define urgent and non-urgent?
Proponents argue this bureaucratic lottery system is far more just and fair than our quasi-private system. However, this just isn’t true. Our current healthcare system gives priority to productive American workers and their families through employer-based group coverage. Then, there is a second tier of coverage to the poor, elderly and/or disabled through social systems like Medicare and Medicaid. This workers-first approach emphasizes those who currently contribute the most to society.
Likewise, over 50 percent of uninsured Americans are eligible for federal healthcare subsidy programs but are largely unaware they qualify. Another 20 percent refuse to buy it or freely opt out of employer programs. If the goal is to arbitrary declare that everyone must have healthcare, then we can easily accomplish this through any ill-designed legislative decree. However, If the goal is to actually lower costs, improve patient access and outcomes, the problems that plague our current system aren’t likely to fade away by simply changing the billing method. Our system is in desperate need of reform but not total abolition. It may be wise to reject healthcare nihilism.
