With so much having been written, declared and argued over when it comes to the viability of a Medicare For All system in America, it is virtually impossible for anyone who does not dedicate their life to the study of healthcare policy to determine what is accurate information and what is not.
Is Medicare For All the magic bullet that will allow all Americans to access healthcare by having federally provided insurance coverage? Is it a socialist program that will result in government taking over your healthcare and determining who may live and who must die? Even if it is a good idea, can we afford it or, conversely, can we afford not to have it?
The answer is simpler than you might think-
Not the satisfying and informative answer you were hoping for, right?
Like it or not, it is the truth.
By legislating membership in the Medicare program (or something resembling the same) as a birthright granted to every American now alive or joining us in the future, we would accomplish, at least, a basic level of healthcare for all Americans.
Setting other considerations aside for just a moment, I’m not sure who would find this to be a bad thing. America should be able to institute a system that insures that each and every one of us has access to basic healthcare.
Of course, many of you are thinking, “That’s great…now, how are we going to pay for it?”
According to a recent Mercatus Center study, the additional cost to the government to institute a Medicare For All program would run at about $32.5 trillion over a ten-year period, or, on average, $3.2 trillion a year. For those who view Mercatus with suspicion, given their libertarian/conservative leanings and the financial support they receive from the Koch Brothers, you should know that the left-leaning Urban Institute did a similar study and came up with pretty much the same numbers.
Interestingly, this annual cost estimate is virtually identical to the amount the American people spent on healthcare in 2017.
When we take what is currently being spent by the government paying for citizen healthcare costs and add the $3.2 trillion a year, we can say, with some measure of confidence, that we have a reasonable understanding of the costs of a Medicare For All program.
What we don’t know is where this all goes when we look to how we pay for this large, additional expenditure.
Yes, we can anticipate that both American citizens and businesses would be taxed to pay for the program.
But we don’t know if this will leave our citizens and businesses better off or worse off when we compare what they pay in these additional taxes to what they previous paid in private market health insurance premiums which, if they could afford it, was their coverage before a government single-payer program.
Let’s begin with business.
I have asked many a business executive why they wouldn’t prefer to pay a defined tax to the government to cover the healthcare of their employees versus the headache and costs of the current system which is largely dependent upon employer provided healthcare.
Almost every one of them answered with the same response-if the tax were reasonable, we would like to be able to turn this headache over to the government. But…how do we know that, even if the tax begins as a reasonable one, it won’t climb well into the realm of unreasonable as the years go by?
They’ve got a point.
Thus, given that most Americans still get their healthcare coverage through their job, we can’t get very far with a reasonable debate on Medicare For All until we understand what the ‘reasonable’ tax rate to businesses might be. Until that time, we cannot expect to enlist the interest and willingness on the part of business to switch to a Medicare For All system, relieving them of the tradition-established during WWII- of providing healthcare benefits to employees.
That takes research, negotiation and an understanding as to how long the government can freeze an agreed upon health tax rate to bring business along.
And make no mistake.
Business has been our chief provider of healthcare premium payments for many years and no deal is going to happen without the agreement of business.
Next up is the average American who manages to insure the health of their family, often at great sacrifice to other basic needs in life.
Whatever tax citizens would be required to pay must be measured against what they are already paying in health insurance premiums along with deductibles and co-pays.
If it turns out that the cost to working Americans is less if their coverage comes via a Medicare For All plan, they are probably going to like it. If it costs them more…not so much.
Then there are critical question of how the quality of coverage will compare to what we’ve experienced in the past? Even if I am paying less for single-payer coverage when compared to what I paid to my insurance company, am I getting less coverage, the same coverage or more coverage?
Without the answers to these questions, how can we possibly make a reasonable judgment on what is being proposed?
Note that there is some data from a Rand study looking into the viability of a single-payer program under consideration by the State of New York. The study found that, were New York to institute such a system, taxes would go up dramatically- but premiums, deductibles, and co-pays would be zeroed out, leaving most people with more money on net.
That is promising-but hardly definitive to the point where Americans are going to be willing to experience a massive change in how their healthcare is provided based on a Rand study of New York.
The bottom line here is that, after all these years of fighting over the way to solve our healthcare crisis, we don’t have the basic data we need to form a smart opinion.
But, hey, why would we want to take the trouble to learn the details and realities when it comes to one-sixth of our total economy?
I’ll tell you why we haven’t done the necessary legwork to get to the necessary answers-
It works far better for politicians if they don’t have the data as to know the facts might destroy a viable political pitch that works nicely wherever they have to run for election.
So, when Howard Schultz or Mayor Bloomberg states that Medicare For All is impractical and can never work, these gentlemen don’t know what they are talking about because they don’t have the necessary data to make that determination.
When Senator Bernie Sanders and Senator Kamala Harris tell us that Medicare For All is “the answer” and we no longer need the private insurance policies, they too don’t know what they are talking about because they don’t have the necessary data to make that determination.
And when various conservative politicians rail about a Medicare For All program serving as proof of America’s descent into socialism, take that for what it is- an admission that the “socialism screamer” doesn’t understand the first thing about how such as system would work; lack the data to do a real analysis; and probably wouldn’t care if they were to be given the data.
There are a number of possible solutions to improve the ability of all Americans to gain access to the healthcare system.
But we are never going to get a real understanding of what is, and is not, possible and preferable until Congress-and I mean Democrats and Republicans- quits using the health of every American as a useful political talking point and gets down to the business of modeling and testing the different systems to see what actually works.
Until then, don’t believe anyone who tells you that Medicare-For-All is the answer to our problems and don’t believe anyone who tells you it is not.
Give us the research and the data and then tell us why you do-or do not-support this approach.
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