Democrats’ Plan B For Medicare: Medicare For All

Last month, ObamaCare was dealt another huge blow. On August 12, the U.S. Court of Appeals for the 11th Circuit in Atlanta ruled that the law’s requirement that all adults purchase health insurance was unconstitutional. The court determined that the government isn’t empowered to force private citizens to buy a particular product, be it a car, broccoli, or a health plan.

The Atlanta decision is the highest profile rejection of the individual mandate to date. Lower courts in Florida and Virginia have ruled similarly. In Florida, Judge Roger Vinson found not just the mandate but the entire law unconstitutional. The 11th Circuit scaled his ruling back, however.

It is likely that one of the legal challenges will make its way to the Supreme Court — where a majority of justices might well strike the mandate down. But President Obama may want to slow down the march to the high court. He may not want a decision before the 2012 election.

A defeat at the Supreme Court would spell disaster for the signature legislative accomplishment of the Obama Administration. The individual mandate is the linchpin for ObamaCare — without it, the rest of the law won’t operate as intended.

Democrats know the individual mandate might go up in smoke. So they’ve started strategizing a constitutionally sound means of achieving the ever-elusive goal of “universal coverage.”

Their preferred remedy? “Medicare-for-All,” a term popularized by the late Senator Edward Kennedy (D-Mass.) who supported a single-payer, government run healthcare system.

Former Clinton labor secretary Robert Reich laid out the basic idea in a recent op-ed for the San Francisco Chronicle. “So what do Obama and the Democrats do if the individual mandate in the new health care law gets struck down by the Supreme Court?” Reich asked. “Immediately propose what they should have proposed right from the start — universal health care based on Medicare-for-All, financed by payroll taxes.”

This notion has been floated in progressive policy circles in the past. It’s a pure distillation of their government-heavy approach to health care reform. Typically, though, the idea’s been shelved out of fears of political blowback.

Today, when the government extracts Medicare taxes from people’s paychecks, it’s forcing them to assent to this deal: Hand over a slice of your paycheck now, and get government-sponsored health insurance in old age.

Of course, Americans are not allowed to opt out of that deal — just like they won’t be able to opt out of the individual mandate. But unlike the mandate, the taxes that finance Medicare are not in danger of being deemed unconstitutional.

Reich wants to increase Medicare payroll taxes and then steadily expand the program’s enrollment to the point that the vast majority of Americans, if not all of them, get their health coverage from the government. The end result would be a Canadian-style system where government is the only provider, and private insurance is outlawed.

Never mind that the program as currently structured is already headed for bankruptcy. Decades of mismanagement and the inevitable inefficiencies of a huge government program have left Medicare with huge and still mounting debt.

In fact, according to a nonpartisan Medicare Trustees report released earlier this year, the program faces an astonishing $36 trillion in unfunded liabilities over the next 75 years.

And that’s actually an optimistic assessment. As researchers wrote in the report, “the actual future costs for Medicare are likely to exceed those shown by the current-law projections.”

If the country can’t afford to pay for the care of those currently in Medicare, how could we possibly afford to add several hundred million more people to the program? The tax hikes needed to support such an expansion would have to be so astronomical that they’d effectively strangle the economy.

The national debt is already threatening the long-term financial health of this country. Expanding Medicare — on the back of new, job-killing taxes — would severely worsen our fiscal woes.

Reich and the Medicare-for-All crowd also never mention that Medicare’s current crop of patients already have a difficult time finding a doctor.

Officials have steadily ratcheted down Medicare reimbursements for doctors to the point that they’re well below rates for the privately insured. Many physicians actually lose money when they treat Medicare enrollees. Some have stopped accepting beneficiaries altogether.

In Texas, for example, more than 300 physicians dropped out of Medicare between 2008 and 2010. Exoduses like this are happening all across the country.

Enrollees, in turn, face longer wait times and less access to care. And their situation is only going to get worse. ObamaCare actually requires additional deep cuts in Medicare’s rates over the next couple years. To paraphrase former British Prime Minister Sir Winston Churchill, “this is something up with which we shall not put.” The American people will not put up with rationed care and long waiting lists to get appointments with doctors and tests.

If the individual mandate is actually struck down, Medicare-for-All may become the new rallying cry for progressive luminaries. And if President Obama wins a second term, he may look to heed that cry.

Voters can’t let that happen. Medicare-for-All would be disastrous for both the American economy and patients’ well-being.

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.

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