{"articles":[{"reaction_config":[{"text":"Support","color":"#2ca788","stance":"support"},{"text":"Oppose","color":"#ef3e42","stance":"oppose"}],"id":42344,"title":"‘This Is About Freedom’: The Argument Against Medicare for All","html_content":"

by If You Can Keep It | 2.20.20

This is our second piece in a series on Medicare For All, explaining the cons of the proposal. Our piece on the Pro arguments can be found here.

What is Medicare For All?

Also known as “single-payer,” Medicare For All would do away with private insurers and put everyone in America on a government-run insurance program. As the name implies, think Medicare—for everyone.

There are multiple proposals out there, but we’re going to focus on the most far-reaching proposals, which are outlined in bills sponsored by Sen. Bernie Sanders (I-VT) and Rep. Pramila Jayapal (D-WA).

“This Is the Strongest Argument Against Medicare for All”

This was the headline in a recent New York Times op-ed, subheaded:

“A deep-blue state’s failure to enact a single-payer system shows why a national version is unlikely to succeed.”

Following the passage of the Affordable Care Act (aka Obamacare) in 2010, Vermont Gov. Pete Shumlin (D) worked to create Green Mountain Care, a single-payer plan to cover all its citizens.

It’s failure, the Times writes, “demonstrates why any similar project undertaken at a national scale is unlikely to succeed as well. In fact, it is the strongest argument against Mr. Sanders’s single-payer plan.”

What were the problems?

Political support

“The first problem for any single-payer push would be political support: Mr. Shumlin campaigned on a promise to build a single-payer system in Vermont, but the public never quite bought in.”

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One reason for the lack of public support: funding. Estimates from the governor’s office “found that employers would have to pay taxes equal to about 11.5 percent of payroll, while families would have to pay as much as 9.5 percent of their annual income to make the financing work.”

Public outreach

In a 2017 post-mortem on Green Mountain Care, the Cornell Policy Review found that the the higher-than-expected costs and administrative problems “fostered an atmosphere of uncertainty and distrust in the state government, turning a politically steep climb into a politically insurmountable one.”

“Medicare for All” Support Drops When Possible Side-Effects Discussed

A poll from the Kaiser Family Foundation found that the American public likes the concept of a ‘Medicare for All’ national health plan―but that support plummets to strong disapproval when possible side-effects of such a healthcare system are mentioned. (For our full coverage of this story, click here.)

Overall, the poll found that 56% of respondents favored a Medicare for All national health plan. However, Americans opposed a national Medicare for All healthcare system under the following circumstances:

70% opposed a healthcare system that would lead to delays in people getting some medical tests and treatments.
60% opposed a plan that would threaten the current Medicare system.
60% opposed a plan that would require most Americans to pay more in taxes.
58% opposed eliminating private health insurance companies.

Based on these findings, the Medicare for All bills offered by Sanders and Jayapal would face stiff opposition for a few reasons:

Their bills would eliminate the current structure of Medicare. The only federal healthcare programs that would be unchanged under their proposals would be those offered through the Indian Health Service and the Dept. of Veterans Affairs (VA).
While their proposals don’t include any funding mechanism, both plans are contingent on a combination of new and increased taxes that would require separate legislation.
Both bills would prohibit private health insurance companies from offering plans that rival the benefits covered by Medicare for All. Private insurers would only be allowed to offer plans for extraneous benefits, such as plastic surgery.

What are critics saying?

In an analysis by the Mercatus Center, a free market-oriented think tank, Charles Blahous condemned the cost of the program:

“A doubling of all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan… M4A would markedly increase the demand for healthcare services while simultaneously cutting payments to providers by more than 40 percent relative to private insurance rates, reducing payments to levels that are lower on average than providers’ current costs of providing care. It cannot be known how much providers will react to these losses by reducing the availability of existing health services, the quality of such services, or both.”

And Ashley Kirzinger, associate director for the Kaiser Family Foundation’s public opinion and survey research team (see above), said:

“The problem is: What is Medicare-for-all? It’s not Medicare and lots of times it’s not for all, so it’s a little bit of a misnomer.”

John McDonough, a professor at Harvard’s T.H. Chan School of Public Health - who was instrumental in creating Obamacare - made a similar argument:

Medicare For All is “an advertising slogan; it’s not a scientific concept.”

He told Pro Publica that core dimensions of health policy — cost, access, quality and equity — vary wildly depending on factors such as income, geography, race, gender, ethnicity, and job type.

Kentucky Senator Rand Paul, one of the most vociferous free-market Republicans in Congress, has continued to rail against any government-funded healthcare program, be it Obamacare or Medicare For All. In 2011, he delivered what may be his most oft-requoted diatribes:

\"With regard to the idea whether or not you have a right to health care ... It means you believe in slavery. You are going to enslave not only me but the janitor at my hospital, the person who cleans my office, the assistants, the nurses. … You are basically saying you believe in slavery.\"

Paul made a similar argument when attempting to repeal the ACA in 2017:

“They think this is about actuarial tables and insurance, and all this stuff. No, this is about freedom. This is about whether we as Americans should be free to buy what kind of insurance we want. What's best for us and our families. And it's about whether the individual knows best or government knows best. Are we too stupid that President Obama has to tell us what kind of insurance? Does he think Americans are too dumb to make their own decisions?\"

What do you think?

Are you opposed to Medicare For All? Are you against any government-sponsored healthcare? Should Republicans attempt to repeal Obamacare again after the election? Take action above, then join the conversation below.

–Josh Herman

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