Medicare for all is much easier said than done.
Maggie Mahar (via Ezra Klein) points to some real reasons why expanding Medicare will be difficult, and filled with unknowns. As Ezra puts it, “when you take a program with 44 million beneficiaries, all of whom are in the same age range, and scale it to 300 million beneficiaries across all age demographics, a lot of uncertainty is introduced Medicare.”
The administrative savings from such a system are grossly overstated, and the necessary tax hikes to the middle class will be significant.
Countries with a mostly publicly-funded health system, like Germany and Switzerland, have families contribute about $9,000 annually in health premiums. The majority in the United States, who cost-share premiums with their employers, pay far less than that. In these difficult economic times, it is unlikely that voters will want to pay more in terms of health premiums if Medicare for all was enacted. And that’s on top of marked tax increases.
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?
A single-payer system is a political non-starter in the United States. Those who spend significant time and energy supporting such a cause would be better served putting their weight behind a more realistic scenario.
To do otherwise will only make them irrelevant in the upcoming health reform debate.
