Medicare for all is a socialist’s dream — and an American nightmare

From The Hill, By Dr. Deane Waldman, 07/28/2018

Medicare for all is a socialist’s dream — and an American nightmare
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After Alexandria Ocasio-Cortez’s victory over a top House Democrat in a New York City primary, the left was elated.

“Ocasio-Cortez’s Socialism Can Work in the Midwest — with a Rebrand,” declared New York Magazine (a somewhat dubious authority on what can work in the Midwest). Its reasoning? Ocasio-Cortez’s “Medicare for All” plan polls well.

“Both Medicare for All and single-payer health care enjoy majority support in recent polling from the Kaiser Family Foundation,” the magazine points out. But it acknowledges that when more facts are presented to those being polled, support drops. And the fact is, we know exactly what Medicare for All would look like.

First, it would be unfair. Forty-four million Americans paid for their Medicare benefits by contributing for 40 years or more into the Medicare Trust. The rest of the American public did not contribute their fair share, so why should they be given for free what others paid dearly for?

Second, even in its present form, Medicare isn’t sustainable. The Congressional Research Service reports the Medicare Trust Fund will be insolvent in less than 10 years. When that happens, Medicare will be broke and seniors will not get the care they need. Why would anyone want to extend the problem of no-care to everyone?

Maybe when candidates such as Ocasio-Cortez promote Medicare-for-All, they’re looking for a system where the government provides health insurance to all for no charge. But wait! We already have such a system. It’s called Medicaid. Maybe supporters of Medicare-for-All are really advocating Medicaid-for-All.

Medicaid is a failure. Because mandates from Washington dictate how the states spend their money, states are not in control of the largest single item in their budgets. And because Medicaid spending comes first, other state priorities must accept the leftovers. Worst of all, Medicaid provides inadequate access to care and instead of making people healthy, Medicaid has caused unnecessary suffering and even death.

Let’s face it, Medicare-for-All is really code for government controlled, single-payer healthcare. After all, England and Canada appear to have successful single-payer systems. Why shouldn’t it work here?

It all depends on how you define success. The British and the Canadians pay a very high cost for their systems, and not only in monetary terms. Single-payer health care systems take away individual choice, they discourage life-saving research and innovations, and they exchange quality of care for a balanced budget

And there are heart-breaking cases such as Alfie Evans and Charlie Gard — babies in Great Britain who were left to die at the behest of the government. In the National Health Service, the government has the final say in all medical decisions — not patients or their families.

Americans, even those who respond favorably to polls about a vague Medicare-for-All system, would never stand for that.

There is death-by-queueing in single payer systems, where sick persons die from treatable conditions because they could not get care in time and succumb “waiting in line” for care. You don’t even have to go outside the U.S. to see these avoidable deaths. In our own single payer or Medicare-for-All system, the VA, “307,000 veterans may have died waiting for medical care.”

Medicare-for-All, aka government-controlled healthcare, is precisely what we don’t want. It will either deny us the care we need or land our nation in bankruptcy court. Most people thought the cost of Obamacare, $1.34 trillion, was excessive, but that’s peanuts compared to the $18 trillion price tag for Bernie Sanders’ — and Alexandria Ocasio-Cortez’s — Medicare-for-All.

Instead of government-controlled, insurance-dominated healthcare, we need to return to our roots, to what made our country great: the free market. In 2017, the U.S. spent $3.4 trillion on healthcare for 323 million Americans, or $10,526 for every man, woman and child. Imagine if every family of four put $42,105 in an HSA every year! and simply shopped for and paid for their health care. No government stealing our money to pay its bureaucracy. No insurance company delaying or denying care. Just the old but right doctor-patient relationship with no one and nothing in between.

The answer isn’t Alexandria Ocasio-Cortez’s rebranded socialism. The answer is for us to turn away from government dependence and rely on ourselves.

Dr. Deane Waldman (@SystemMD), MD, MBA, is a retired pediatric cardiologist and director of the Center for Health Care Policy at the nonprofit Texas Public Policy Foundation.

 

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