Bernie Sanders’ ‘Medicare-for-all’ means worse health insurance at higher cost for most Americans

Bernie Sanders’ ‘Medicare-for-all’ means worse health insurance at higher cost for most Americans

Unions shouldn’t let Sanders’ political maneuvering fool them. His brand of “Medicare-for-all” would cripple union health plans and leave workers with something far worse.

Union health plans are generally more generous and extensive than non-union benefits.

In 2018, three-quarters of union members had access to dental benefits, compared to half of non-union workers.

That same year, employers covered 86 percent of individual union workers’ health insurance premiums, compared to 79 percent for non-union employees. Non-union families had to pick up 36 percent of their health insurance premiums – nearly double the share that union families were responsible for.

Sanders’ bid for “Medicare-for-all” would eliminate private insurance plans for everyone – union and non-union workers alike.

The senator and his allies promise their government-run health plan would offer benefits on par with union benefits. But organized labor is skeptical.

After all, how can Sanders possibly deliver on his promise to cut health costs if every American has a plan that’s as comprehensive as a typical union plan?

Desperate to keep organized labor on his side, Sanders last month released “The Workplace Democracy Plan,” which includes several provisions aimed at making “Medicare-for-all” more appealing to unions.

None of these changes will actually protect union benefits.

Consider the senator’s claim that unions will be able to negotiate coverage for things not covered by “Medicare-for-all.” His plan would cover just about every type of health service. The only things left for unions to negotiate over would be elective procedures, such as Lasik and cosmetic surgery. And it would be virtually impossible to write insurance policies for such procedures.

Sanders’ promise to “integrate” union-sponsored clinics into his proposed health care system also falls short. By harnessing cutting-edge technology and innovative approaches to care, union clinics have found ways to cut costs, improve outcomes and reduce wait times.

Sanders’ plan states that these clinics will be “kept available for members.” But it’s unclear whether that means union clinics will be open to everyone under “Medicare-for-all” – or only to union members.

If the former, union members can kiss their high-quality care goodbye.

These clinics are successful precisely because they have the resources to provide top-notch care. They won’t be able to maintain those standards if they’re expected to treat an unlimited number of patients under “Medicare-for-all’s” payment rates, projected to be about 40 percent below those for private insurance.

Union members might fare better if Sanders intends for these clinics to remain private. But if that’s the case, then he’s conceding that some people should have access to better health care than others.

Then there’s the final piece of The Workplace Democracy Plan, which would require “companies with union-negotiated health care plans . . . to enter into new contract negotiations overseen by the National Labor Relations Board.”

The idea is to pass any savings employers realize from the switch to “Medicare-for-all” back to union members “in the form of increased wages or other benefits.” This provision is meant to ensure that members’ total compensation isn’t cut by “Medicare-for-all.”

That’s great for the 10 percent of American workers who are union members. But what about the rest of the country?

About 180 million Americans get health coverage through their employer. Knowingly or not, each of these workers has sacrificed higher salaries in exchange for health insurance. Most of them are not going to get government-ordered pay increases under “Medicare-for-all.”

AFL-CIO President Richard Trumka said this week that union workers would have a “hard time” supporting a “Medicare-for-all” plan, unless it carved out space for union-negotiated health plans.

Trumka’s comments come just weeks after Democratic presidential contender Sen. Bernie Sanders, I-Vt, announced a change to his “Medicare-for-all plan” designed to mollify union leaders and win their support.

Unions shouldn’t let Sanders’ political maneuvering fool them. His brand of “Medicare-for-all” would cripple union health plans and leave workers with something far worse.

Union health plans are generally more generous and extensive than non-union benefits.

In 2018, three-quarters of union members had access to dental benefits, compared to half of non-union workers.

That same year, employers covered 86 percent of individual union workers’ health insurance premiums, compared to 79 percent for non-union employees. Non-union families had to pick up 36 percent of their health insurance premiums – nearly double the share that union families were responsible for.

Sanders’ bid for “Medicare-for-all” would eliminate private insurance plans for everyone – union and non-union workers alike.

The senator and his allies promise their government-run health plan would offer benefits on par with union benefits. But organized labor is skeptical.

After all, how can Sanders possibly deliver on his promise to cut health costs if every American has a plan that’s as comprehensive as a typical union plan?

Desperate to keep organized labor on his side, Sanders last month released The Workplace Democracy Plan, which includes several provisions aimed at making “Medicare-for-all” more appealing to unions.

None of these changes will actually protect union benefits.

Consider the senator’s claim that unions will be able to negotiate coverage for things not covered by “Medicare-for-all.” His plan would cover just about every type of health service. The only things left for unions to negotiate over would be elective procedures, such as Lasik and cosmetic surgery. And it would be virtually impossible to write insurance policies for such procedures.

Sanders’ promise to “integrate” union-sponsored clinics into his proposed health care system also falls short. By harnessing cutting-edge technology and innovative approaches to care, union clinics have found ways to cut costs, improve outcomes and reduce wait times.

Sanders’ plan states that these clinics will be “kept available for members.” But it’s unclear whether that means union clinics will be open to everyone under “Medicare-for-all” – or only to union members.

If the former, union members can kiss their high-quality care goodbye.

These clinics are successful precisely because they have the resources to provide top-notch care. They won’t be able to maintain those standards if they’re expected to treat an unlimited number of patients under “Medicare-for-all’s” payment rates, projected to be about 40 percent below those for private insurance.

Union members might fare better if Sanders intends for these clinics to remain private. But if that’s the case, then he’s conceding that some people should have access to better health care than others.

Sanders has revealed that he’s willing to jettison his supposed commitment to health care equity in order to pander to union members.

In so doing, he’s also admitted that “Medicare-for-all” will yield worse coverage at higher cost for most Americans.

Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is “The False Promise of Single-Payer Health Care” (Encounter 2018). Follow her on Twitter @sallypipes.

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Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.