Medicare for All is Medicare for None

 

Most seniors like their Medicare. While it is far from free, it does cost less than private health insurance because it is federally subsidized. Since nearly every doctor accepts Medicare, there is rarely any difficulty finding access to healthcare.

Therefore, when people hear progressives like Vermont Senator Bernie Sanders speak about his socialized medicine program called Medicare for All, they believe he simply wants to extend the same healthcare benefits to all Americans. Nothing could be further from the truth.

Recently, I had lunch with an old friend and attorney and we discussed this very issue. His comments about Medicare for All revealed many misconceptions about what that would mean to our healthcare. It occurred to me that if this educated man could be misinformed, many others would be, too. To address this misinformation, I have listed some of his questions and their answers:

If Medicare is good for seniors, won’t Medicare for All be good for everyone?

Although Medicare is mostly funded by taxpayers, it is not strictly a government system. It was formed originally by providing a standard benefit package offered by Blue Cross in 1965. It has always been privately administered, mostly by Blue Cross, which continues to provide private insurance to non-seniors. In recent years, one third of all seniors are enrolled in plans offered by private insurers such as Cigna, Humana, and United Healthcare under a cooperative program called Medicare Advantage. The success of the Medicare Advantage program is mostly due to the competition between these private insurers which lowers costs and improves the quality and range of services provided.

Medicare for All calls for the elimination of all private health insurance. There will be no competition and all healthcare decisions will be made by the government. The lack of competition will lead to lower quality, fewer services, and higher costs. With no competition, providers will be stuck with fixed rates and no means to appeal. As a result, providers will lose incentives to provide more than the minimum care needed. This trend is already prevalent in socialized medicine systems operating today in Canada and Great Britain.

We have the best quality healthcare in the world, though not the cheapest. Won’t we continue to have the best healthcare even with Medicare for All?

My friend and I agree that America leads the world in providing the best possible healthcare. He believes this will continue despite a change to socialized medicine. This is not the pattern we see when studying socialized medicine systems in other countries. Healthcare outcomes are dramatically worse in countries where the government controls all healthcare. We may have the best trained doctors in the world, but those doctors’ hands will be tied by government officials who will determine who gets care and what care they get. This is most dramatically seen in cancer screening and treatment.

Socialized medicine systems such as the United Kingdom and Canada don’t allow for expensive drugs and therefore these countries do not enjoy our cancer survival rates. The U.K.’s National Institute for Health and Care Excellence (a misnomer at best) has rejected immunotherapies because they are too expensive. Better healthcare comes at a price that socialized systems are not willing to pay.

As a result, these systems have lower cancer survival rates. The age-adjusted mortality rate is about 20% higher in the U.K. and 10% higher in Canada and France than in the U.S. Survival rates for hard -to-treat cancers are also higher in the U.S. than in most countries with nationalized health systems. The British medical journal Lancet  published last year that an individual diagnosed with pancreatic cancer between 2010 and 2014 had nearly twice the likelihood of surviving five years in the U.S. than in the U.K.

Here are some five-year survival comparisons:

  • Brain Cancer
    • S. – 36.5%
    • France – 27.2%
    • K. – 26.3%
  • Stomach Cancer
    • S. – 33.1%
    • France – 26.7%
    • K. – 20.7%

 

The availability of expensive drug treatments is only one reason for better survival rates in the U.S. Another reason is better methods of detecting cancer at earlier stages. MRI scanners are more widespread and available for earlier diagnosis. Other diagnostic advances include Google’s artificial intelligence (AI) that can now detect breast and lung cancers with better accuracy – meaning fewer false positives and negatives – than radiologists. AI systems are also enabling researchers to identify more genetic links and to personalize treatments.

With Medicare for All, all physicians will work for the government. Since we’ll have the same great doctors, won’t we still receive the same great healthcare?

Medicare for All will mean the government sets all prices for doctor services and approves or disapproves of all treatment. All doctors will have to accept the fee schedules set by the government or cease to practice medicine. Many older, experienced physicians will see this as an incentive to retire, or at least leave the clinical practice of medicine. This will strip many talented physicians from the work force.

They will be replaced by younger physicians without the experience or work ethic of some of our best physicians. These new physicians will be willing to accept the lower fees mandated by the government, but they will demand reduced hours and will produce less service. Combining these changes, the net result will be severe exacerbation of our physician shortage, which is already alarming.

But the real problem is the government will have to approve all treatment. It doesn’t matter how good your doctor is, he or she will be limited by government approval. Combining this feature of socialized medicine with an increasing doctor shortage leads to a common situation experienced in all socialized medicine systems.

All socialized medicine systems suffer from common ailments:

  • Delays in treatment– longer waiting times to see a physician
  • Rationing of healthcare– delays or denial of specialized care
  • Poorer healthcare outcomes– lower survival and life expectancy rates

 

Joe Biden tries to distance himself from Medicare for All by saying he just wants to “improve ObamaCare.” However, his platform calls for a “public option” to be added to ObamaCare, which simply means a slower timetable until socialized medicine is a reality. The end result is the same – total government control of healthcare.

Now he’s added Senator Kamala Harris to the ticket and she was one of the first presidential candidates to embrace Medicare for All, declaring openly it would mean the elimination of all private health insurance. Later, she tried to walk back her support when she received a backlash, but she will certainly support Biden’s move to socialized medicine over time.

Don’t be fooled. Medicare for All will mean the elimination of all private health insurance – which means Medicare for None.

 

(Note: For more on Medicare for All, use the Search feature on my blog to see earlier posts on this same subject.)

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