Medicare for All – Sooner or Later


Vermont Senator Bernie Sanders ran for president in 2020 on a platform pushing Medicare for All. During the presidential campaign, I wrote extensively on the evils of Medicare for All. These posts can be viewed by simply searching on the blog site under “Medicare for All.” You might have thought this information was irrelevant now that Joe Biden was elected president – but you would be wrong.

Even The Wall Street Journal editorial board believes Bernie Sanders is calling the shots in this White House. Therefore, Medicare for All is far from dead. The next step in implementation of this radical rewriting of Medicare is the so-called $3.5 Trillion budget bill that most now concede is more like $5.5 Trillion.

The newest push by Democrats is to expand Medicare coverage to include dental, hearing, and vision benefits. This despite the recent report that the Medicare Trust Fund is due to run dry in 2026 (Medicare Going Broke). The WSJ editors say Democrats claim that half of Medicare recipients have no dental insurance, but this is not accurate. Nearly 9 in 10 low-income seniors have access to dental coverage through Medicaid. AARP sponsors dental plans with low premiums, and many graduate dental schools offer charity care for low-income seniors.

Seniors can also get dental, vision, and hearing benefits through privately managed Medicare Advantage plans. Bill Clinton and Republicans in Congress established Medicare Advantage in 1997 to reduce wasteful spending under the program’s traditional fee-for-service payment model and increase competition with the goal of improving care. This program has been widely embraced and now covers 24.1 million seniors, or about 40% of the Medicare population. Competition has also lowered average premiums by 34% since 2017 even as most added benefits. About 74% of Medicare Advantage enrollees have access to dental benefits and 79% to vision care including eye exams and glasses. Some 72% get help paying for hearing aids.

You would think this tremendous success would be welcomed by both Republicans and Democrats – but not so. Democrats dislike Medicare Advantage because it reduces government control over healthcare. Instead, they want to require traditional Medicare plans to cover benefits that seniors are already getting elsewhere – because traditional Medicare is government controlled. No need to worry about wasteful spending.

This will not only raise the cost of Medicare for taxpayers at a time when Medicare is already on the way to bankruptcy, it will also impact the cost of private healthcare. Because Medicare reimburses hospitals below the cost of care, privately insured patients get charged much more to compensate. The expansion of Medicare could result in privately insured Americans paying more for their contact lenses and dental work.

The estimated cost of this expansion of Medicare is $81 billion a year when fully phased in, or more than $800 billion over ten years. To disguise the real cost, Democrats plan to delay phasing in the dental plan until 2028. That saves $60 billion a year and helps squeeze the expansion into their 10-year budget window.

Naturally, Democrats cite polls showing the popularity of this expansion of Medicare benefits. Who wouldn’t agree to “more free stuff” when asked that simple question? But few voters know any of these fiscal or other facts because the press doesn’t report them, apart from WSJ. The same folks don’t know the Medicare Board of Trustees recently reported the fund faces a $578 billion shortfall over the next decade.

The WSJ editors sum up the situation: “All of which proves that when it comes to entitlements, looming bankruptcy is no barrier to expansion. Bernie Sanders wants Medicare for All on the installment plan, and the reconciliation bill is one giant step. The surprise medical bill will come later in rationed care and higher taxes for the middle class.”

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