“Medicare for All” is Bad Law, Bad Philosophy, and Bad News
Humanity much prefers good news to bad. That is why national politicians – hoping to get credit for largesse – embroider legislation with happy-sounding names. Often, ugly realities hide within. “Medicare for all” is one such example.
The very idea of giving away quality care for nothing and paid by nobody, puts one in mind of Alexander de Tocqueville. “The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money.” That day may have come.
As of mid-2019, Congress has introduced 6,035 bills, of which five percent may become law. Given divisions between House Democrats and Trump’s White House, likely fewer.
Nevertheless, half a dozen Democratic presidential candidates are pushing “Medicare for all” – a giant hoodwink. If any supporter became president and had a pliable Congress, “Medicare for all” would change America – and usher in the largest loss of individual freedom since depression-era rationing.
The two “Medicare for All” bills, S. 1129 introduced by Sen. Bernie Sanders (I-VT), and H.R. 1384, introduced by Rep. Jayapal Pramila (D-WA), are an affront to individual choice and promise to grossly undermine access to timely, quality medical care – if you read the text.
While these bills sound like the magic elixir, ending worry forever, they are the exact reverse. In the Senate, vote-hunting presidential candidates, including Cory Booker (D-NJ), Kirsten Gillibrand (D-NY), Kamala Harris (D-CA) and Elizabeth Warren (D-MA) have signed on. As one promises the moon, the next ups the ante.
In the House, less interested in bipartisan legislation than New Green socialism, the bill has been joined by 106 co-sponsors, including the 12 most left-leaning members, of whom Pramila is one.
The other 11 – who got a perfect 100 “progressive” report card – are Jahana Hayes (D-CT), Andy Levin (D-MI), Joe Neguse (D-CO), Alexandria Ocasio-Cortez (D-NY), Ayanna Pressley (D-MA), Donna Shalala (D-FL), Jamie Raskin (D-MD), Mark Pocan (D-WI), Mark DeSaulnier (D-CA), Adriano Espaillat (D-NY), and Ro Khanna (D-CA).
What would these two bills do? Well, here you go – right from the text:
Title 1 establishes a “universal Medicare program,” mandating one-size-fits-all, wait-your-turn, get-what-we-give health care for all. Federally approved providers will dole care, with all others outlawed.
Under this title, no person will be allowed to travel to the US for care. New anti-discrimination laws invite unlimited damages – presumably against doctors and hospitals. Everyone will be required to register (from birth) and carry a universal medical card or else, no care.
Stunningly, “it shall be unlawful for … a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or …an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee …” So, overnight, 180 million Americans lose private health care plans, using their own private doctors, offices, hospitals, nurses, and in-home care. Gone.
Under title 2, in an act of sublime faith in government fairness and efficiency, payments are approved as “medically necessary or appropriate.” Can you imagine anything going wrong? Left unapproved? Any late payments for critical health care? Any bottlenecks? Perish the thought.
“Comprehensive reproductive” care will be provided – at taxpayer expense – which we may assume means unlimited, federally-approved abortions, no limits in the law. Terms like “community services” and “self-directed personal assistance services” are open.
“Cost-sharing” – added costs – will continue for prescription drugs, except for those in poverty. The federal government will determine when to cut off access to experimental drugs; individuals can be institutionalized over 21 for certain conditions.
Under title 3, doctors are again forbidden from providing private medical care, barred from using unapproved providers, and must submit receipts in 30 days – or they are left out to dry.
Doctors are then ominously encouraged to testify against each other if they see any violations. At about this point, similarities to the worst aspects of Soviet socialism begin creeping into the analysis.
In rare situations where a non-reimbursed private contract is permitted, it is illegal if signed when “facing an emergency health care situation” – which not only reveals utter distrust of doctors but seems to defeat the provision itself. Put differently, if national health care fails and you need help, that is exactly when you are not allowed to get it. Clever.
Doctors are also penalized for providing private care by having to sign an affidavit – which forfeits their chances of filing claims for one year pursuant to any government-covered services. Too cut by half – they lose their living trying to help people stay alive, if the systems fails.
Under title 4, administration is a nightmare, effectively combining in the HHS Secretary responsibility for every aspect of the most burdensome federal program likely on record, with dozens of new reporting requirements and a new bureaucracy to process millions of filings and “grievances.”
Now, add weak fraud and abuse provisions, mass tracking of patterns of practice, pie-in-the-sky quality assessment by statisticians, amateur provisions against bribing reviewers, and you have a royal federal mess.
In more happy talk, “cost containment” actually contains no cost containment, but coverage for health education and unemployment benefits for five years. Later provisions promise federal “valuation” of services, which is code for taking expensive procedures, undervaluing them to save money, and leaving hospitals and doctors with the bag.
Perhaps the biggest myth in this whole labyrinth – a fictional world where private health care vanishes, replaced by Soviet-era “bread lines for medical assistance” – is the absence of any credible way to cover costs.
Professionals share a consensus that the plan – even if it never works, imposes interminable delays, kills private innovation, research and personalized care, lowers quality and rations what is left – will cost $32 trillion dollars in ten years.
That is 32 thousand times a billion. Or more than one and a half times America’s gross domestic product. Or two-thirds of all the money in the world’s central banks. Or a fifth again more than the combined value of all the Fortune 500 companies. Or more than ten times the cost of the Iraq and Afghan wars. Do you see the point? Inconceivably expensive.
So, perhaps we end where we began – with a hard-headed quote from de Tocqueville: “Democracy extends the sphere of individual freedom, socialism restricts it. Democracy attaches all possible value to each man; socialism makes each man a mere agent, a mere number. Democracy and socialism have nothing in common but one word: equality. But notice the difference: while democracy seeks equality in liberty, socialism seeks equality in restraint and servitude.”
Humanity prefers good news to bad, but let’s not kid ourselves. “Medicare for All” is a crock, an immoral political gambit, socialist slight-of-hand dressed up as joy. Presidential candidates calling us like carnival barkers are hoping to get credit for largesse and take us for fools. Don’t buy it.