(FINAL of a seven-part series: Medicare for All – Quality and Accessible Care for None)
The core belief of the Medicare for All advocates is that only a government-run, bureaucratic “Deep State” can solve the problems with medical care in America.
These socialists (after all, they are advocating adoption of one of the most socialized systems in the world) can’t even fathom that it is the unelected, unaccountable bureaucracy, and more recently the unaffordable Affordable Care Act, that have further damaged an already flawed medical payment system.
One only has to look at the Veterans Affairs (VA) system to get a glimpse of how national, government-run health care would (not) function. This authentic single-payer system has let our veterans down for years. A VA investigation in 2016 found that over 100 vets died just in Los Angeles County alone over a 9-month period while awaiting treatment. And this despite a $15 billion reform package that passed in 2014 supposedly to clean things up.
It is essential to recognized that even with all of our payment or insurance issues, actual medical care in America is second to none.
Many critics of our health care will cite Organization for Economic Cooperation and Development (OECD) or World Health Organization (WHO) statistics that appear to show the U.S. well behind other countries on health measures such as infant mortality. But these organizations use decidedly different ways to measure infant deaths than we do here. In many places babies born alive but who die shortly after birth are considered stillbirths and not even included in their country’s infant mortality statistics. Additionally, babies born before 26 weeks’ gestation or less than 12″ long are not even counted as babies in many cases.
For major medical treatment, the world’s elite vote with their feet. In 2010, Saudi Arabia’s King Abdullah could have gone anywhere in the world to have surgery on his back for a painful slipped disk. He could have gone to Michael Moore’s beloved Cuba or nearby Europe. After all, the biased WHO ranks nearby Morocco, Oman or Cyprus higher than the United States in terms of medical care. The king avoided Andorra or the United Arab Emirates. He could have gone anywhere but he came to the United States where he knew he would have the best chance for a successful outcome. And he did.
When considering our long-term survival rates for serious illnesses, the skill of our medical experts, the availability of quality and timely care, and technological medical innovations, the first choice destination for the world’s kings, elite and super-rich is the United States.
“Health care” was considered the major political issue in the recent mid-term elections. The politically popular term, “Medicare for All,” has resonated with many because it is virtually the only plan being touted that addresses the great concern of many voters — being denied insurance coverage with “pre-existing conditions.” It means that this entire issue is mostly economic and not medical.
Most responsible adults aren’t sure if they are more frightened of a serious future illness — or ultimately being cured and then being faced with crushing medical debt. Some would say that tapping into this voter fear is smart politics but in reality, and given what’s at stake, it is the essence of political demagoguery.
The key assumption for many voters is that such a socialized plan would harm neither medical quality nor accessibility; treatment would always be excellent and available. This belief is delusional. As the previous sections of this seven-part series have shown, there is nowhere in the world where socialized medicine is both good and readily obtainable.
It is unconscionable to use history’s greatest medical system as a political carrot to entice a less-than-well-informed voting public that the only option to protect them from potential financial ruin is a socialized system like Medicare for All.
The sixth section in this series, “Health care options for America,” illustrated that there are minimally intrusive ways to insure medically high-risk patients and still move much closer to a consumer-based, value-oriented, free market system.
Health care isn’t a human right, it’s a political pick-up line intended to seduce a constituency fearful of both a health and wealth catastrophe. It’s immoral to declare someone has a right to a skilled service that indentures another. The human right is the freedom to purchase the service, not the power to compel someone to give it or someone else to pay for it.
The federal government doesn’t control costs nor does it negotiate prices, it fixes them. If a hospital or physician’s office can’t financially survive with the amount Washington (Medicare or Medicaid) decides to pays it for services rendered, it will close its doors and its patients will have a more difficult time finding care elsewhere.
We are told repeatedly that a Medicare for All plan would lower costs while maintaining quality and access. This is like the deceitful statement from 2009, “If you like your plan you can keep your plan,” on steroids. If the government totally controls the most advanced medical care in the world, we will have to live with rationing, less technological advancement and fewer breakthrough drugs. Patients will lose the freedom to chose their own doctor – if they can find one. [In Quebec, Canadians looking for a family doctor not only have virtually no chance of choosing the one they want, they are placed on a waiting list for an indeterminate time period before being assigned one.]
The proposed “Medicare for All” bill is actually far closer to “Medicaid for All” but that doesn’t have the same political ring to it. Medicare sounds better. The perception is Medicare’s strong and functions well. But in reality, it’s not free for those on it, it doesn’t cover the actual cost of treatment from medical providers, and it will run out of money in 8 years.
The only reason Medicare appears to function reasonably well today is because a semi-free-market health care system exists with it side-by-side. Elderly patients today have access to medicines, skilled surgeons and MRIs because these are substantially subsidized by the private system. Without this now teetering private structure, there would be little incentive to upgrade, innovate or improve.
If Medicare for everyone became law and private insurance was outlawed, the entire system would begin to internally rot. And the elderly, clearly the most expendable as we’ve already seen in England, would pay the highest life-altering cost.
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The home of the loudest cheerleader for Medicare for All, Sen. Bernie Sanders, is of course the state of Vermont. Just a year after the Affordable Care Act was signed into law, his state tried to go one better than the ACA with its own version of a single-payer system, constructed by the same people who designed the federal Obamacare (ACA) law. In 2011 Democratic Governor Peter Shumlin signed this government-run health care and insurance program into law.
Vermont was undeniably the best testing ground for this effort. The state has a small population, just 14 total hospitals, and super Democratic majorities in both houses of the legislature. So it was easy to both pass into law and test its efficacy in this, the perfect “socialist laboratory” state.
The plan never really got off the ground. And it wasn’t because it was some hasty, quickly thrown together bill. It was a highly coordinated federal-state effort. The federal Department of Health and Human Services (HHS) along with the Treasury Department and White House budget office worked closely with the governor’s planning team. Vermont even hired the original Obamacare gurus, William Hsiao of Harvard and Jonathan Gruber of MIT, as its architects.
HHS provided a $45 million grant to the state for planning. All 625,000 residents were to be automatically enrolled in the state plan. At the time, the budget of the state would have had to roughly double, adding $2.6 billion in new state spending. Keep in mind that Vermont already has the nation’s seventh highest top income tax rate at 8.95% – to go along with a 6% sales tax and a 8.5% corporate tax rate.
Unfortunately it became obvious shortly thereafter that the “Green Mountain Socialist Republic” had bought into a delusional dream and hadn’t listened to objective financial projections. The governor’s financial advisors had originally told him it wouldn’t work, that Hsiao’s and Gruber’s projected savings were “not practical to achieve.” He didn’t care, the money would work out somehow.
By 2014, the state abandoned the program. Financial realities forced Gov. Shumlin to concede that the plan would have required a new 11.5% payroll tax and a 9.5% income tax that would have done great harm to the state’s economy.
What’s truly ironic is that the University of Vermont Medical Center advertises to Canadians who often choose to escape their socialist-system’s long wait times by crossing the border into the United States to get immediate, high quality care just 45 minutes from the border.
America’s first real attempt at a Medicare for All, government-operated, single-payer system proved a failure just a few years after its inception and even with the assistance of academic experts, federal guidance and financial support.
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Economics (and common sense) says that there are only two ways to allocate scarce resources: price as found in the free market, or government dictate which is bureaucratic rationing to deal with the guaranteed shortages.
There has never been a time in modern history when those with greater wealth could not find a place and/or a source to meet a specific need. If the United States is ignorantly led down this dark path and chooses socialized medicine, two things are guaranteed to occur:
(1) Someone or some nation will use the destruction of this (reasonably) free market of magnificent medical care to launch their own fee-for-service international medical haven. Our misfortune would create a windfall for enterprising investors, physicians and forwarding-thinking politicians on foreign soil.
(2) We will begin to lose our best and brightest physicians. Where would any world-class surgeon choose to practice? How would he or she choose to be compensated? Based on neither skill nor merit – perhaps on purely seniority as most teachers in the country are? Or based on expertise, competence and results like most professionals are? The answer is clearly the latter.
The United States has been attracting physicians from Asia and the Middle East for a number of generations but the flow of these highly educated, nationally beneficial immigrants will promptly cease if Medicare for All becomes a reality.
Do Americans really want their health care system to become the most socialized system in the world? Socialist nation icons like Sweden and Denmark have patients pay about 15% of their medical care on their own. The U.K. is a mess and Canadians have private insurance that pays for 13% of the nation’s medical costs. Even communist China’s citizens pay about a third of costs out-of-pocket. And Cuba has two systems: a miserable one for its citizens and a considerably better one for tourists and, of course, Communist Party members.
How many Americans have actually read this Medicare for All bill? Do they know what it says or are do they have blind trust in these politicians?
Do Americans really want to be guaranteed to lose their private insurance, be placed on a wait list to be assigned a primary care physician that the government chooses, wait for months to see a specialist like they do in Canada? Do they really want the size of the federal government to double — at a minimum?
I think not. The more people learn about the details of this unimaginably destructive concept, the fewer will want any part of it. Here is is for all to enjoy.
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So for those of you who remain Medicare for All advocates, let me make one final appeal: Make it work first in Vermont or Massachusetts or even giant California. Before we risk the entire country’s medical system, why not a test run? Make it just like the Sanders’ plan and commit to it 100%. Then give it enough time for an objective assessment to be made as to how well it worked. Vermont would likely work best since it’s less densely populated than even the two-county Lehigh Valley in Pennsylvania where the hospital I served was located.
At the same time, let’s give the free market a chance as well, say in neighboring New Hampshire (make it literally live up to its motto: Live Free or Die). Make medical providers compete in terms of both quality and price, i.e, value like everyone else. Let hospitals advertise their prices and allow the patient to be a real consumer like he or she is with any other product or service.
Please Senator Sanders, try out your idea at home. Give the Green Mountain State another shot to be the country’s first real test case.
But I know you won’t do that. You’re so politically poisoned that in your biased ideological testing laboratory, you’ll have no qualms about treating America’s great medical system as your lab rat.