The solution that rolls off the tongue of all my Progressive acquaintances – Are You Sure You Want Medicare for All? – Reason.com
Senator Bernie Sanders (I-Vt.) plans to unveil his long-awaited “Medicare for all” proposal for government-controlled, single-payer health care. His colleague, Sen. Elizabeth Warren (D-Mass.), is all-in on the scheme. “Medicare for All is one way that we can give every single person in the country access to high quality health care,” she writes. “Everyone is covered. Nobody goes broke paying a medical bill. Families don’t have to bear the costs of heartbreaking medical disasters on their own.”
Sounds like fantasy land. And it is.
“Notwithstanding recent favorable developments,” the Medicare Trustees conceded in their report this year, “current-law projections indicate that Medicare still faces a substantial financial shortfall that will need to be addressed with further legislation.” The report foresees that “the trust fund becomes depleted in 2029.”
Yikes, I still plan to be alive then. And how bad is the shortfall?
In actual dollar amounts, says Michael D. Tanner of the Cato Institute, “Medicare faces unfunded liabilities approaching $48 trillion. And, if we return to double digit health care inflation, we could see Medicare’s liabilities swell to more than $88 trillion.”
This is the government funded health insurance plan that ONLY provides coverage for seniors age 65 and over, those on Social Security Disability (after 2 years) and people who have end state renal disease. It doesn’t take too much common sense to see the financial train wreck coming down the pike if Medicare for all is the single payer system of choice.
And what about the doctors? They face, you guessed it, RED TAPE and sub par reimbursement (just like Obamacare except apparently worse).
Red tape is also a huge burden for medical providers who accept Medicare. “A random survey of 1,000 practices found physicians and staff spend 15.1 hours engaged in quality measure reporting each week, at a cost of more than $40,000 per year for each doctor,” according to FierceHealthCare.
Jumping through bureaucratic hurdles for the privilege of accepting substandard compensation isn’t as attractive as it might seem. That may be why a growing number of physicians refuse to see Medicare patients, others limit the number they’ll accept, and more balk all the time.
Sub par reimbursement also implies that under 65 private insurance is subsidizing the Medicare system. This could lead to upheaval if the system was implemented.
Under a single-payer system, options for medical providers may be more limited than they are now—there probably wouldn’t be any better-paying private insurers to take by preference to the government system. But there also wouldn’t be any private insurers to effectively subsidize Medicare patients. (emphasis added) In the case of a single-payer transition, doctors who find the terms of Medicare for All unacceptable may switch entirely to private-pay (if that’s still permitted), while some percentage will leave medicine entirely. Considering the potential for switching over to single-payer in The Atlantic, Olga Khazan predicts “Hospitals would shut down, and waits for major procedures would extend from a few weeks to several months.”
So expect pushback from doctors. Assuming it remains legal, I expect private pay to expand. It’s already happening with Direct Primary Care practices and the Surgery Center of Oklahoma. Also, if any form of single payer is implemented, it would not surprise me to see hospital/medical ships 13.8 miles off the coast, just outside United States territorial waters.
The article continues, discussing Medicaid for all as an alternative option. Medicaid is a State/Federal partnership and is varies from state to state. Reason goes on to state:
And, yes, Medicaid is rule-bound too, governed by most of the same red tape that ensnares Medicare.
Again, switching to Medicaid for All would limit providers’ choices. They could take the plan, switch to private pay (if allowed) or leave medicine. But if each patient seen represents an actual loss, few providers would have the ability, let alone incentive, to knuckle-under and accept the new order. (emphasis added) Many would be out of business—or politicians would be scrambling to find yet more money to make sure that the country maintained some sort of health care industry.
And in Colorado, there are very serious provider payment problems: This business owner billed Colorado thousands in Medicaid payments and received only $288. She isn’t the only one. His the story on Jill Tullman’s speech therapy center…
Since March 1, the state has paid her just $288, despite that she bills from $8,000 to $12,000 per week for clients who have Medicaid government insurance. Tullman didn’t pay her last mortgage payment and borrowed money through her credit card so she could pay her staff.
And ever the opportunist, former State Treasurer, Cary Kennedy, who is running for Governor is proposing Medicaid for all. How timely. Democratic candidate for governor proposes Medicaid-for-all health care plan in Colorado
She’s right about one thing, a 27% increase announced for 2018, which the Division of Insurance and Connect for Health Colorado seem to be quite proud of, is “simply too much.” But Medicaid-for-all is most definitely NOT the answer.
The only thing Medicaid for all would accomplish is to put Connect for Health Colorado out of it’s misery.
