“Medicare-for-all” is like a cold sore. It appears randomly, lasts for a week or so, then disappears until next time. This week, it’s back, and it’s on Sen. Bernie Sanders’ lip.
This plan is not new, first appearing in 2003, courtesy of former Congressman John “Underwear in the Office” Conyers. He called it the United National Health Care Act, or HR 676, and had 25 co-sponsors. It went nowhere, but instead remained dormant, like a cold sore, ready to reappear in the future. And it has every few years.
Most recently, after Representative Conyers joined the crowd of abrupt #MeToo retirees, Senator Bernie Sanders is now running with the 15-year-old bill. His web page states adamantly, “The only long-term solution to America’s health care crisis is a single-payer national health care program.”
Bernie has company with his heir apparent, and latest shiny object capturing the attention of Democrats, Congressional candidate Alexandria Ocasio-Cortez pushing single-payer health care.
Despite her economics degree from Boston University, she came up short with a method to fund her spending spree other than rolling back everything President Trump did to jumpstart the American economy out of the Obama doldrums.
Tax revenues are breaking records after Republican tax cuts. Yet somehow reversing course and raising taxes will provide the government with sufficient money to pay for Medicare-for-all? Ms. Ocasio-Cortez either slept through her economics classes or a Boston University economics degree isn’t worth the paper it’s printed on.
Fortunately, a group that does understand economics, has weighed in. The Mercatus Center, a research institute at George Mason University, calculated that Medicare-for-all will cost, “approximately $32.6 trillion during its first 10 years of full implementation.” Meaning $3.3 trillion per year compared to a current federal budget of $4.1 trillion.
Suddenly healthcare spending by the federal government would go from a quarter of the budget to more than three-quarters. Leaving little for social security, defense, unemployment, food stamps, and the myriad other categories of government spending. The math doesn’t work.
We already know how the numbers settled out based on recent state attempts at single-payer health care, the “laboratories of democracy”. Vermont tried and failed, passing a single-payer plan which was never implemented as the cost was more than the entire state budget.
Colorado also gave it a shot, via a ballot initiative and a projected cost equal to the entire current state budget. Coloradoans wisely voted this down by a four to one margin. The federal cost projections of Bernie’s plan are in line with the state experiences.
So how would Alexandria and Bernie finance their grand scheme? Raising taxes of course. From the Mercatus report, “Doubling all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan.”
Did you get that? Doubling taxes still wouldn’t cover the cost.
What effect would a doubling of taxes have on the Trump recovery? Think of a large bucket of water on a roaring campfire. Suppress the economy and what happens to all of these future projected tax revenues to fund Medicare-for-all? Gone, adding to the budget shortfall.
Don’t forget Alexandria and Bernie’s other giveaways, including a guaranteed income, free education, and other universal benefits. Those costs and promises haven’t even been factored into the Mercatus report.
Option B will be to cut payments to physicians, as the report predicts, doctors “will be reimbursed at rates more than 40 percent lower than those currently paid by private health insurance.”
Physician burnout and morale are already a big problem. Cut reimbursement in half and good luck finding a doctor still willing to practice medicine. Everyone will have insurance but what good is insurance if you can’t find a doctor who accepts it?
Expect a two-tiered system to evolve, as it has in most other countries. Cash payment at market rates for those with the means to pay. They will see a quality doctor in a timely manner and receive top rate medical care. Alexandria, Bernie, and every other legislator will be in this category.
For those without the means to pay for private care, expect long waits and care delivered by nurses, physician assistants, and foreign-trained imported doctors. The government will ration care based on the judgment not of physicians but of bureaucrats tasked with balancing the healthcare budget. This is the tier for the rest of America.
Sure, the care will be free, but you will ultimately get what you pay for. Democrats are lurching further left as the midterms approach, eager to spend money they don’t have. From “Making America Great Again” to “Making America into Venezuela”.
Brian C Joondeph, MD, MPS, a Denver based physician and writer. Follow him on Facebook, LinkedIn and Twitter.
The views and opinions expressed in this commentary are those of the author and do not reflect the official position of The Daily Caller.
