Why we should say no to Medicare for All – Pacific Research Institute

Why we should say no to Medicare for All

This month Sen. Bernie Sanders was released from the hospital after suffering a heart attack. The Vermont senator, a Democratic presidential candidate, used his health scare to renew his call for “Medicare for All,” which he claims will ensure everyone has access to the kind of “great health care” he does.

But Sen. Sanders gets it wrong. Medicare for All wouldn’t provide “great” health care to anyone. Instead, it would subject everyone to lengthy waits for low-quality care.

Sen. Sanders and his allies promise the most generous healthcare system on the planet. Medicare for All would provide soup-to-nuts coverage of everything from checkups and surgeries to prescription drugs and long-term care. Private coverage for anything deemed medically necessary would be banned. Patients could walk into any doctor’s office or hospital and receive care without co-pays or deductibles. Out-of-pocket prescription drug costs would be capped at $200 a year. No referrals would be required for specialist care.

Of course, Medicare for All wouldn’t actually be free. It’s expected to cost between $32 trillion and $38 trillion over 10 years, according to Mercatus Center scholar Charles Blahous. Sanders himself says that his plan could cost up to $40 trillion over a decade.

To pay for this program, Sanders has proposed a host of new taxes, among them a new 4 percent income tax on every American household.

But patients wouldn’t perceive these new taxes as barriers to care. Because care would be free at the point of service, patients are likely to respond by demanding unlimited quantities of it.

That’s a problem, given that health care is already in short supply. The United States is projected to be short close to 122,000 physicians by 2032.

Medicare for All could also deprive hospitals of as much as $151 billion a year in revenue, according to research from Dr. Kevin Schulman of Stanford University. Many hospitals would respond to such revenue losses by trimming services or even closing.

A spike in demand for care paired with a decline in supply would result in waits.

For evidence, look at the experiences of other countries with Medicare for All-style health care, like Canada and the United Kingdom.

Last year, Canadian patients faced a median wait of close to 20 weeks for treatment from a specialist following referral by a general practitioner. All told, Canadians were waiting for 1.1 million procedures in 2018. Assuming one patient per procedure, nearly 3 percent of the population was on a waiting list. Apply that same rate to the United States, and more than 9.8 million Americans would be waiting for care.

Even worse, the care patients receive after escaping those wait lists is of poor quality. Consider what happens to patients who suffer heart attacks.

For every 100 patients admitted to the hospital with a heart attack in the United Kingdom, around eight die. In Canada, it’s around seven patients for every 100 admitted. In the United States, just under six patients die. All told, the United States has a lower 30-day mortality rate for patients over the age of 45 admitted to the hospital with a heart attack, compared to its peer countries.

It’s no wonder patients in Canada and the United Kingdom come to America in search of the same high-quality care Sen. Sanders received.

In 2010, Newfoundland’s then-Premier Danny Williams traveled to Mount Sinai Hospital in Florida for heart surgery, even though he could have gotten the same procedure in Canada. Earlier this year, Rolling Stones front man Mick Jagger underwent emergency heart surgery in New York. While the singer was recovering, his brother Chris said, “at least [Mick] has not got to wait in line for the NHS,” Great Britain’s National Health Service.

Fortunately, we have a long way to go before Medicare for All takes root in the United States. Similar plans have failed to launch in the states that have considered them. In 2014, Vermont’s Democratic Gov. Peter Shumlin scrapped a state-level single-payer health care plan he had previously supported because it would have required economically crippling new taxes and nearly doubled the state budget.

Sen. Sanders is right about one thing — he has access to great health care in the United States. Medicare for All would destroy that system of great care — and saddle everyone with mediocrity.

Sally 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.

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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