Should the U.S. adopt Medicare for All? | The Tylt

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Should the U.S. adopt Medicare for All?

Vox provides a brief explainer on the form Medicare for All could take in the United States:

A single-payer health care system is one where the government operates a tax-funded health insurance plan for all residents.
In a way, the name "single payer" pretty much says it all: Just one, single entity pays doctors’ and hospitals’ bills. That one party is, in all international examples available today, the government.
This is very different than the current American health care system, where thousands of different parties — some private, some public and some individuals — all chip in a bit.
...Single-payer systems tend to have lower administrative costs than those with many private insurance companies, where doctors and hospitals devote lots of time to figuring out who is supposed to pay them what amount. One 2011 study in the journal Health Affairs estimated that American doctors spend four times as much money interacting with healthcare payers than their Canadian counterparts.
Single-payer systems also have an advantage when it comes to bargaining down prices.

Although some feel hopeful that a single-payer system could drastically improve access to healthcare in the U.S., others maintain concern about long-term consequences.  


According to Vox, some of those concerns relate to innovation in health care. Many make the argument that a single-payer system stifles innovation as lower rates for health care providers leaves "less space to experiment with new treatment." Vox's Sarah Kliff writes: 

The United States has long been a leader in biomedical research, and some attribute that to the fact that we spend a lot of money on health care. We pay more for nearly all medical treatments than publicly financed systems do. According this theory, the extra money allows pharmaceutical companies, device manufacturers, and other developers to experiment with new, potentially groundbreaking experiments. In that view, the United States' higher healthcare costs are subsidizing medical innovations that then proliferate across the globe.

Others feel a single-payer system simply gives the government too much control.


Senator Bernie Sanders has sponsored a bill that would create "Medicare for All." The bill is co-sponsored by 100 Democratic representatives and 16 Democratic senators. Sanders wrote in support of Medicare for All in a 2017 op-ed for the New York Times:

We remain the only major country on earth that allows chief executives and stockholders in the health care industry to get incredibly rich, while tens of millions of people suffer because they can’t get the health care they need. This is not what the United States should be about.
...The reason that our health care system is so outrageously expensive is that it is not designed to provide quality care to all in a cost-effective way, but to provide huge profits to the medical-industrial complex. Layers of bureaucracy associated with the administration of hundreds of individual and complicated insurance plans is stunningly wasteful, costing us hundreds of billions of dollars a year. As the only major country not to negotiate drug prices with the pharmaceutical industry, we spend tens of billions more than we should.

A Koch Brothers-funded study of the bill showed it would cost $32.6 trillion over 10 years. Sanders claimed this was actually $2 trillion less than current plans and cited the study in some of his promotional materials. Politifact says this estimate is technically accurate, but the numbers could vary dramatically.

In cheekily thanking the Koch brothers, Sanders said a study they indirectly sponsored "shows that Medicare for All would save the American people $2 trillion over a 10-year period."
The $2 trillion figure can be traced back to the Mercatus report. But it is one of two scenarios the report offers, so Sanders’ use of the term "would" is too strong. The alternative figure, which assumes that a Medicare for All plan isn’t as successful in controlling costs as its sponsors hope it will be, would lead to an increase of almost $3.3 trillion in national health care expenditures, not a decline. Independent experts say the alternative scenario of weaker cost control is at least as plausible.
We rate the statement Half True.

President Trump, in a vitriolic USA Today op-ed, claims Medicare for All will actually leave many Americans without health insurance.

As a candidate, I promised that we would protect coverage for patients with pre-existing conditions and create new health care insurance options that would lower premiums. I have kept that promise, and we are now seeing health insurance premiums coming down.
I also made a solemn promise to our great seniors to protect Medicare. That is why I am fighting so hard against the Democrats' plan that would eviscerate Medicare. Democrats have already harmed seniors by slashing Medicare by more than $800 billion over 10 years to pay for Obamacare. Likewise, Democrats would gut Medicare with their planned government takeover of American health care.

Liberal Think Progress claims Trump's assertions in his op-ed are wildly misleading and that expanding Medicare would actually protect it for years to come.

“Democrats have already harmed seniors by slashing Medicare by more than $800 billion over 10 years to pay for Obamacare”
This is a favorite talking point of Republicans that dates back to the 2012 presidential campaign. Trump revives it by citing a 2015 Congressional Budget Office report that found that repealing the ACA would add $802 billion to Medicare spending. But, according to Families USA, the increase in Medicare spending would “likely lead to higher premiums, deductibles, and cost sharing for beneficiaries, and would accelerate the projected insolvency date of the Medicare Hospital Insurance trust fund.”
The ACA has, in fact, extended Medicare solvency, ensuring older Americans have key health protections. As the National Association of Area Agencies on Aging found, “Repealing the ACA would eliminate efforts to close the Medicare prescription drug coverage gap for up to nine million Medicare beneficiaries, exacerbating already difficult economic decisions for many vulnerable seniors.”
Trump also argues that the Democratic plan would “end choice for seniors” by getting rid of “other private health plans.” As already mentioned, these claims are misleading, as they fail to mention that Medicare for All proponents aim to expand Medicare as a replacement for existing private health plans.

For the last several years, Republicans have worked to get rid of Medicare and other government-provided social services. They have recently changed tactics, supporting plans that keep Medicare as is, while working against plans that would extend the service. Per the Washington Post:

But over eight years, Republicans have completely given up on the idea of cutting Social Security or Medicare to reduce the deficit. In 2010, through the budget negotiations of 2011, they argued that cuts had to be on the table to get the country's budget under control. This year, in campaign after campaign, Republicans have abandoned that rhetoric. Like the president, they argue that Medicare and Social Security are sacrosanct and that a growing economy will take care of any shortfall.
Should the U.S. adopt Medicare for All?
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