Why Medicare for all won’t work

“Finally, 30 percent of doctors already refuse to accept Medicare. If the program were expanded, it will only hasten the physician exodus to cash-only models. Who will patients turn for care then?”

Who do they turn to now? I am very well insured, I don’t need a referral for my insurance company so no paperwork for PCP. I don’t feel cared for now. I can’t get appointments when needed, my care is rushed and often a waste of time. I feel the only option I have now is to forgo medical care or find a concierge practice.

Medicare for all would not leave people unable to find a doctor for very few doctors could afford to opt out. What it would do is leave them unable to get anything but rushed third rate care from that doctor.

A two tier system would immediately establish itself–but few would be in the higher tier.

Medicare doesn’t cover the cost of decent care now. Where decent care is given to Medicare beneficiaries, it is being subsidized by other payers. Eliminating those other payers would eliminate the subsidy, and what the government pays for is all recipients would get.

It is also noteworthy that the “crises” that gave us Medicare was that senior citizens were paying 21% of their income on medical care. With Medicare, they still pay 20%.

Ultimately, it would solve nothing and create many new problems. In the future things would bet even worse as medical schools would find the applicant pool circling the drain.

I think it’s a little presumptuous to equate “medicare for all” with any sort of “single-payer system”. Clearly any such workable system would have to alter reimbursements so that doctors do not lose money by seeing patients (as many do now with Medicare and Medicaid), and would be massively reworked to cover necessary care for all age groups. Really the only similarity between Medicare and this kind of new hypothetical system would be the concept of a single entity negotiating for and distributing payments. I think such a system has the potential to be self-correcting in terms of fair reimbursements; i.e., if doctors are not paid enough to make a decent living, the entire thing will quickly implode, and someone needs to come up with a solution quickly.

And, as already pointed out by another reader, the $9K contributed by the citizens of publicly-funded health systems most likely is actually less than the premiums that an employee and his/her employer pay in total now. Moreover, I believe that $9K covers a significantly greater proportion of basic services (lab work, prescriptions, screening exams, etc) without the need for a copay by the patient, which should also be figured into how much the average person in the U.S. actually pays for health care here.

We already know that we pay more per-capita for health care here than almost any other industrialized country, and although you may argue that the government and large companies shield the consumer from much of that cost burden now, the fact that such a system is clearly non-sustainable is the very reason that we are having these conversations now.

You forgot 7) Medicare has a scheduled bankruptcy date which would only been rapidly advanced by increasing the number of beneficiaries. It’s a BROKEN SYSTEM.

Suggesting extending it to all is quite honestly one of the stupidest things I’ve ever heard. It’s like looking at Social Security going broke and saying, wow, let’s enroll more people in it!

I’m reluctant to to respond to any Anonymous posts, but I’ll make it a quick one.

Medicare is not bankrupt. I’ll repeat, Medicare is not bankrupt. In fact, it’s not even close. Social Security, on the other hand, does have a scheduled date where its benefit payout will exceed its estimated income… but– and this is important to understand– it’s because the SS income from payroll taxes has been put into the general revenue fund. Remember Gore’s much maligned lockbox argument? Never hear that anymore, but that doesn’t mean it’s not pertinent.

As far as comparisons to the NHS, they’re fallacious. In Britain everyone contributes to health insurance and it’s their choice if they want to go outside NHS. In the US 1/5 contribute nothing to their health insurance but do pay taxes to Medicare to cover elderly beneficiaries who sometimes have a lot of money. This makes no sense.

But the most annoying thing about people who do not see that universal care coverage is important is that they never have any better suggestions. The status quo is not workable as health care costs take up 15% of our GDP, businesses go bankrupt because health care is inexplicably tied to jobs, and quality of care deteriorates.

Including everyone in Medicare would actually increase revenue for docs who take Medicare patients. One reason I went into Ob/Gyn way back when was because the reimbursement was better than other specialties that took more Medicare and the problems with Medicare were manifest even back in the late 80′s when I made that decision.