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Bruce Bialosky

What Really Happens if We Get Medicare for All

A huge issue in the coming national election, Medicare for All, has been pitched as the next step by Leftists who want to nationalize our health care system. Yet it seems very little introspection has been done on the subject as to what really will happen. It is time we take a look.

First and most importantly, all private insurance will go bye-bye. From the polls taken, most people do not understand that. There are an estimated 180 million Americans who have private insurance. Most like their private insurance even though they are bothered by it at times. If you cannot get someone on the phone to resolve your issue, typically your insurance agent can, or your doctor can. Compare that to your experience with the government.

I work with tax agencies all the time. These are the revenue producing and collecting entities. They are impossible to deal with. When you are spending the government’s money, do you think it will be better or worse? The elected officials who want to put this medical system in place have their own preferred system. Do you think they wait in line? Do you think they stay on the phone for hours trying to get approval for a procedure?

A material argument made is there is less paperwork with Medicare. Two things to consider. First, how much of that is their lack of responsiveness? Second, most paperwork currently sent by insurance companies is due to government mandate. They cause a problem and then their advocates complain about the problem. My experience with the federal government, particularly the IRS, is they are a huge waster of paper. And their technology is terrible. Why do we think it will be better at a cost center than their revenue-producing division?

What will happen to your hospital? Since the only payer for services to them will be the federal government, who do they really work for — you or the government? What will be the incentive for the hospitals to provide better care or buy the newest equipment or have a division dedicated to working on a new procedure or developing that new procedure? Currently if you go to a hospital, they are tacitly responsible to you (and your insurance company). If you are told you cannot have something at the hospital, do you complain to the nurse, doctor or hospital administrator?
Or would you want to complain to some government employee somewhere in an unknown locale who only works 8 a.m. to 5 p.m. and promises to get back to you in 24-48 hours?

Then there is the fact Medicare and Medicaid under pay for services now to hospitals paying only 80% of the hospitals hard costs. Private insurance makes up the difference now. What happens when the government is the only payor? Bankruptcy for hospitals and then the government takes over?

What will happen to your doctor? They will not work for you any longer as they will have to answer to the government to get paid. Already the doctors are subsidized by the private insurance companies. Medicare pays about 80% of their costs also so the private insurance companies make it up. It is a cost transfer to private industry now. Medicaid pays even less.

One of the big pitches of Medicare for All is that they will cut expenses (I will believe it when I see it), if we ever get to see it. Just an example of their lies on this. When Obama took over student loans in 2010 they told us they would spend $800 million on administrative costs. This year they will spend $2.9 billion. Why would we believe the administrative costs for government run health insurance would be any different?

They also are going to cut reimbursement rates. That is what happens when you have a monopoly; you can dictate prices.
Or will doctors just become employees of the national government plan? Either way, your doctor will not be responsible to you.

The biggest question is what will be the quality of people becoming doctors in the future? They will have less chance to make a fine living, so will the best and brightest become doctors or hedge fund operators? Either way, how many people will want to endure the rigors of becoming a doctor for the joy of becoming a government employee.
n addition, will doctors be compensated like school teachers where the most skilled and capable make the same amount as the dud who should be a washout, but is hung on to?

Last the drug companies. They have been attacked relentlessly, but they are a godsend. They have developed many medicines that are life-savers. I know many people who would already be dead and would have been years ago without little pills. These are not 80-year-olds. These are people in the 40’s or 50’s who popped a pill and have a functioning thyroid or normal blood pressure.

The government gives the drug companies enough angst now on new product developments. What will happen when the government is the only payor?

I can go on with device manufacturers, nurses, etc., but you get the idea. We have laws against monopolies in our country. Why would we turn our health care system into a monopoly?

Don’t be fooled by the public option. Whether it is the short course that Senator Sanders favors or the ten-year phase-in from Senator Harris, it is all the same. It is a way to degrade private insurance companies by taxpayer underwritten healthcare which buffers the true cost to the policy holder.

One of the hallmark arguments for Medicare for All is that “health care is a right.” Yet no one seems to ask these simple questions:
1. When exactly did it become a right?
2. If it is a right, then those who have chosen to become health care providers must provide a person health care even if the patient has no ability or will to compensate them? What about the economic harm to the provider?
3. What exactly needs to be provided? Since vision care is included in the latest plan, what are the restrictions on how many pairs of glasses or contacts are provided for as one example?
4. We have many advanced surgeries today. For example, knee replacements, stents, hip replacements and on and on and on. Are all those considered part of that right?

You get the point. Someone has to make all those decisions and it will not be you or me.

We are told that other countries like England and Canada delight in their health care system which is single-payer. Part of it is they don’t realize how bad it is because it is the only system they have. Somehow, they think it is “free” despite coming at a high cost. We know many Canadians cross our border to pay out-of-pocket for procedures they either cannot obtain or would have to wait a lifetime to obtain.

We have two functioning health care systems already in the U.S. run by our federal government. Those are the VA and the Indian reservation health care. You must consider whether that is really what you want for you and your family. You are dreaming if you think it will be any better.