“Medicare for All” sounds good, but it’s a phony name. Beware of the bait and switch. The “Medicare for All” legislation, introduced by Sen. Bernie Sanders (I-Vt.) and cosponsored by many high-profile Democrats, keeps the name “Medicare” but nothing else.
The legislation actually abolishes Medicare and Medicare Advantage, and outlaws employer-provided coverage and the private insurance people buy for themselves. Everyone automatically will be enrolled in the same one-size-fits-all public coverage, whether they work or not. Children will be signed up at birth.
Once the government is paying for the entire nation’s health care, watch your tax bill soar. A single middle-class guy currently paying a 24 percent marginal tax rate will get clobbered with a life-changing 60 percent rate instead. Say goodbye to your standard of living.
Worse, say farewell to the standard of medical care you’ve come to expect. “Medicare for All” will pay doctors and hospitals at reduced rates, forcing them to operate under conditions of austerity. Hospitals will have to jam more beds in a room and spread nursing care thinner.
No wonder presidential contenders such as Sens. Elizabeth Warren (D-Mass.) and Cory Booker (D-N.J.) give us a lot of double-talk about their support, even though they’ve put their names on the legislation. Is it possible they didn’t read it?
On paper, “Medicare for All” guarantees hospital care, doctors’ visits, even dental, vision and long-term care, all paid for by Uncle Sam (Sec. 201). The hitch is that hospitals will have too little revenue and more patients than ever.
Here’s why: Currently, Medicare shortchanges hospitals, paying them less than the full cost of caring for seniors, as the American Hospital Association reports. Hospitals accept the low payments because they can shift the unmet costs onto their younger, privately insured patients.
Under “Medicare for All,” no cost-shifting is possible. Private insurance is outlawed (Secs. 107 and 801) and everyone is in the government system. Hospitals get shortchanged on all of their patients. The rates will be 40 percent less than what they could get from private plans, calculates economist and former Social Security trustee Charles Blahous.
The Sanders bill imposes hard-and-fast dollar caps on how much health care the country can consume yearly. Regional health authorities will curb “overutilization.” (Sec. 403) To see how it’s done, look at the British National Health Service, which is denying women breast reconstruction after cancer and delaying hip replacement surgeries when a region’s cap is reached. At least in Britain, people are free to buy private coverage and get the care. But not under the Medicare-for-all bill. Those alternatives are outlawed. You’d be trapped.
Seniors, ‘baby boomers’ at risk
Under Medicare-for-all, doctors will be paid 30 percent less than private insurance would pay them, according to Blahous. To keep their doors open, they’ll have to see more patients per hour. Since seniors have more complex medical problems and require more time, doctors will avoid them like the plague.
Whenever over-65ers have to vie with younger people for health resources, they get pushed to the back of the line.
There’s no disputing what Medicare-for-all would cost. The left-leaning Urban Institute and the right-leaning Mercatus Center at George Mason University estimate $32 trillion over 10 years. Rep. Alexandria Ocasio-Cortez (D-N.Y.) wants to hike the marginal rate on the uber-rich to 70 percent. That would raise less than $1 trillion dollars in a decade, a mere fraction of the cost of Medicare-for-all.
Sanders himself offered several tax-hike proposals, including a job-killing hike in the capital gains rate to as much as 64.2 percent, but all of his tax-hike proposals together would bring in less than half the revenue needed.
Here’s the bitter truth: According to Congressional Budget Office data, raising $32 trillion in tax revenue would require adding 36 percentage points to the marginal tax rate of every federal income taxpayer in the United States. Not just the rich — everyone. The single woman earning $82,500 and the couple earning $165,000 would see their rates soar from 24 percent to 60 percent. Ouch.
Covering the uninsured is an important national goal. But a close look at the Medicare-for-all legislation shows that it would plunge hospitals into scarcity, lower quality of care, and deprive 185 million Americans of the choice to keep the plans they have now. Paying for it would require hiking income tax rates to intolerable heights. The human and financial costs of “Medicare for All” are simply too high.
Betsy McCaughey is the former lieutenant governor of New York. Her work on patient advocacy and health care policy issues since leaving office includes founding the Committee to Reduce Infection Deaths in 2004. She has been a fellow at the Manhattan Institute and Hudson Institute and has written numerous articles on health care reform. She is the author of the New York Times bestseller “Beating Obamacare.”