COUNTERPOINT: Should America enact a Medicare for All program?

No. Improving current system would preserve choices, save money in long run

By LAUREN CRAWFORD SHAVER
    As the debate over America’s health-care future continues to develop, we have heard an increasing amount about so-called “Medicare for all” proposals. The fact is, while “Medicare for all” may make for a nice slogan, the negative impacts of such a plan on families in Illinois and throughout the nation would be significant.
    Rather than eliminating our entire health-care system and starting from scratch with a costly, one-size-fits all government-run program – which is what Medicare for all would do – our elected leaders should protect and build upon what is working within American health care, while coming together to fix what isn’t.
    Today, with the free market and public programs working together, more Americans have access to quality health coverage than ever before. Americans benefit from choice, competition and control over their coverage and care, and more than 180 million receive health coverage through their employers, while millions more use the marketplaces to select coverage that works for them.
    Not only are more than 90 percent of Americans now covered, patients – including those with pre-existing conditions – are better protected than ever before and young adults are able to stay on their parents’ plans until they are 26 years old. Polls show a majority are satisfied with their current health care.
    At the same time, we can all agree that our current system isn’t perfect and more should be done to extend quality coverage to millions more Americans. But, we can achieve this goal by using the tools available within our current system – such as expanding Medicaid in states that have yet to expand the program, extending federal subsidies to allow Americans at all income levels to choose market-based coverage to fit their needs and by using tools like reinsurance to stabilize premiums – all while preserving the patient choice, competition and quality of care Medicare for all would put at risk.
    In contrast, instead of building on this success, Medicare for all would abolish the coverage millions depend on, cause massive disruptions to Americans’ care, and force each and every American into a one-size-fits-all program run by politicians and bureaucrats in Washington. This massive, government-run system would leave Americans with fewer choices and less control over their coverage and treatments, as well as a lower quality of care and longer wait times for patients.
    Because they often rely upon drastic cuts to physicians and hospitals, a recent study by Navigant found that Medicare for all-style proposals – including “Medicare buy-in” or so-called “public option” proposals – could force hospitals to limit the care they provide, produce significant “layoffs” and “potentially force the closure of essential hospitals.”
    In fact, while some claim that a “buy-in” or “public option” approach is a “moderate” alternative to what Senator Bernie Sanders, I-Vt., has proposed, another recent study, prepared by KNG Health Consulting for the American Hospital Association and the Federation of American Hospitals, found that in Illinois alone, such a plan would slam hospitals with $26.5 billion in cuts that “would compound financial stresses they are already facing, potentially impacting access to care and provider quality.”
    Not only does Medicare for all put Americans’ care at risk, it comes with a massive price tag that would be passed on to working families through significantly higher taxes. Two independent studies – one by the liberal leaning Urban Institute and another by the libertarian-leaning Mercatus Center at George Mason University – have estimated the cost of a Sanders-style Medicare for all proposal would be more than $32 trillion over 10 years, the equivalent of nearly 1.5 times our total current national debt of $22 trillion.
    This, of course, means Americans would be forced to pay more through higher taxes. The Mercatus Center calculated that “doubling all federal individual and corporate income taxes going forward would be insufficient to fully finance the plan,” while the centrist Committee for a Responsible Federal Budget (CRFB) finds that it “would mean increasing federal spending by about 60 percent (excluding interest)” and “require the equivalent of tripling payroll taxes or more than doubling all other taxes.”
    “There’s no possible way to finance [Medicare for all] without big middle class tax increases,” CRFB explained to The Washington Post recently, but a national poll taken earlier this year by the Kaiser Family Foundation found that support for Medicare for all plummets when respondents are informed it would force most Americans to pay higher taxes.
    And tax increases are far from the only negative economic consequences families and job-creators would feel under Medicare for all. A report issued last fall by professors at the University of Massachusetts-Amherst acknowledges that it would “produce significant job losses” potentially impacting millions of Americans, while delivering “a significant negative shock to the U.S. economy.”
    On top of all this, important questions remain unanswered when it comes to how Medicare for all would affect our nation’s seniors and children. Supporters of Medicare for all have yet to explain how moving every American into Medicare, a program designed for seniors and which already faces serious financial stresses, would affect seniors’ access and quality of care. And as the president of First Focus on Children noted recently, Medicare for all-style proposals “raise very different challenges for children,” as they force “millions of children out of Medicaid and CHIP into the Medicare program.”
    Every single American deserves access to high-quality, affordable health care, and this is exactly why Medicare for all is the wrong approach. Instead, our elected officials should focus on realistic, constructive solutions that build upon our current system’s successes and address its weaknesses in order to extend coverage to millions more Americans without saddling families with unaffordable tax increases or sacrificing the choice, control and quality of care so many enjoy today.
    Lauren Crawford Shaver, the executive director of the Partnership for America’s Health Care Future, was previously the deputy assistant secretary for public affairs in health care at the U.S. Department of Health and Human Services and has worked on numerous Democratic political campaigns over the last decade. She wrote this column at the request of the Illinois Business Journal.