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Oct
8

Are claims that “Medicare for All” will hurt Medicare accurate?

CMS Administrator Seema Verma said last week that “Medicare for All would become Medicare for None.”

Verna said – and I quote:

A) “By choosing a socialized system, you are giving the government complete control over the decisions pertaining to your care, or whether you receive care at all.”

Uh, Medicare’s recipients are pretty damn happy with Medicare’s “government run healthcare” today – much happier than those of us insured thru employers

Verna fails to explain how MFA is fundamentally different from Medicare as it exists today – and therefore would somehow become this “government-controlled healthcare” monster.

Her claim appears to be based on unfounded assumptions, namely MFA would be fundamentally and in some ways diametrically different from Medicare. Yet she provides no credible rationale for this assertion, instead using code words such as “socialized medicine” to grossly mis-characterize the proposals for MFA (note I’m not advocating for MFA, as I’ve said before, however I do believe something like it is in our future because the current system is unsustainable)

In fact, the MFA proposals consistently support keeping the core of Medicare the same, just expanding it to include the rest of us.

B) “Rather than straining Medicare, we are working to strengthen Medicare.”

I call Bullshit.

Recall that her boss, President Trump, and the Republicans in Congress proposed a budget that would cut $537 BILLION from Medicare over the next decade. I’m hard-pressed to figure out how cutting over a half-trillion dollars from Medicare will “strengthen” it.

Finally, she says C) “Let’s learn from the mistakes made in Medicaid when the Affordable Act pushed millions of able-bodied Americans into a program designed for pregnant women, children, aged and those with disabilities, only to then incentivize states to serve the able-bodied before protecting Americas most in need.

The ACA did not “push” millions of able-bodied Americans” anywhere. The reality is those “able-bodied Americans” could not afford or get health insurance – it was too expensive, wouldn’t cover their pre-existing conditions, or just wasn’t offered, period. The “free market” failed them – and Verna et al have yet to offer any plans that would help millions of working-classAmericans get affordable health insurance

It also didn’t favor those new Medicaid members over current ones – that’s just not true and is a blatant mis-characterization of the law.

What does this mean for you?

I’ve been waiting for the current Administration’s national strategy/plan to fix healthcare. If this is symbolic of their thinking, we’re going to get MFA sooner than I thought.


9 thoughts on “Are claims that “Medicare for All” will hurt Medicare accurate?”

  1. I too believe the medical system will HAVE to change, to a one payer system, and socialize medicine is inevitable. My daughter has lived most of her life here in TX, and she has now ben I France married to a French man for three, years, she raves about their socialized medicine, and how it works for all…. I have worked in the HC industry now for 30 years , and I am appalled, at what “insurance” has become with their high deductibles and high premiums, not to mention all the exclusions towards the deductible.
    We have the luxury of being able to move and retire early, and will probably move to France, as my daughter would be able to claim us, and we would be able to receive social medicine for free. Its a no brainer….
    Sad commentary on our current social system… I can afford Insurance, but many will be forced to drop insurance, as they simply cant afford it with the lack of a” living wage” in this country….. Just enough money not to qualify for Medicaid…..
    I see Insurance as a necessity for catastrophic coverage, It certainly does not cover half of the expenses use to …. I read your Colum, and realize this country is in a bubble and the next generation, of the few which will be considered middle class will have their serious struggles to just survive cost of insurance, and not only HC, but home and auto too…
    With the tragedy which occurred last week confirming Kavanagh to the supreme court, we will all be at the mercy… of the supreme right

    1. I also know someone who moved to France to marry her boyfriend.
      She raves about France’s healthcare system.
      It is truly “patient-centered.”
      I asked her why it is so different from our system, and
      she replied: “The French believe that nothing is too good for another Frenchmen. In the U.S., we do not feel that way about each other.”
      This is why the French are willing to pay such high taxes to fund universal care: inanced by employer and employee payroll taxes (50% of income); a national earmarked income tax (35% of income); taxes levied on tobacco and alcohol, the inanced by employer and employee payroll taxes (50%);income tax (35%); plus taxes levied on tobacco and alcohol.
      And in France, specialists are paid far less than in the U.S. (even after adjusting for differences in the cost of living in France) and hospitals are paid far less for tests and procedures than our “brand-name” private hospitals.
      As a result, if we had universal healthcare in the U.S., we would have to pay significantly more in taxes to finance it.
      Unless we regulated how much doctors and hospitals could charge for surgeries, tests, office visits, and a night in a hospital. Most Americans are not willing to do that. They would happily regulate how much drug-makers charge. But they don’t want caps on how much doctors and hospitals are paid. They truly bellieve that because we pay providers more, our care is better. (In fact, if you look at the research, outcomes are better in France.)

  2. Free market capitalism has, with some exceptions, provided many with the goods and services this society produces, especially after it has failed miserably during the early 20th century with the Great Depression, and later with the Great Society programs of the 1960s that attempted to resolve the lingering problem of poverty among the forgotten poor who did not benefit from the New Deal. But capitalism has failed miserably in providing health care to all, so now this Administration, a defender of the free market, is doubling down on such an approach, while at the same time trying to discredit a popular idea…Medicare for All. As you pointed out so well, Joe, she could not cite any evidence to support her wild accusations, which is not unexpected, as they have run out of ideas and are once again scaring people with the “Socialized medicine” bugaboo. Reagan tried that in the early 60s to scare people against Medicare, but as you indicated, people are very happy with their government-run socialized medicine. You still have not answered the question raised about Medicaid for All which you advocated some time ago. If Medicare for All is an extension of Medicare to all Americans as it works now, then by that analogy, Medicaid for All would work the same. In that case, access to Medicaid would be on an income basis, with individuals required to have less than $2,000 in the bank. Is that so?

      1. That’s good, because high wage earners won’t stand for giving up their income and assets to qualify.

    1. Well said Richard. Reminds me of many arguments, each having their own version, with the most accurate likely lying someplace in the middle. Rhetoric by either side only serves to further muddle the issues, leaving the vast majority of our population further confused, following the ideology of the “:side” they most align with, yet still no closer to the truth or viable solution. While passion and vigilance is important, it is even more important for all to come to the table with an open and unbiased mind, willing to consider all possibilities as opposed to simply perpetuating the agenda of the “side” they most align with;, something I think we can all agree will likely not happen any time soon.

  3. France does have a far better public health system, but they have national sales tax plus a payroll tax for benefits that is almost 40%. Our own Medicare plan is great, but it requires about $11,000 per person.
    I just cannot picture how America could collect the necessary taxes. A national sales tax would be fought vigorously, as would higher payroll taxes. Plenty of marginal businesses cannot pay the existing payroll taxes.

    I am all for expanding Medicare, but only if we pay for it like grown ups.

  4. Joe-
    As usual, a provocative and timely post.
    Just one caveat:
    Americans don’t love Medicare;
    a growing number love “Medicare Advantage”,
    which is a version of Medicare offered by a private
    insurer.
    One in three seniors are now enrolled in Medicare
    Advantage, and their numbers are growing sharply
    (https://www.kff.org/medicare/issue-brief/medicare-advantage-2017-spotlight-enrollment-market-update/
    They like Medicare Advantage even though most of these private insurers’ plans limit there choice of doctors and hospitals to providers in the insurers’
    “network.”
    This is because Medicare Advantage plans, unlike the
    government’s traditional Medicare, don’t let doctors &
    hospitals charge whatever they choose.
    Medicare Advantage does not include docs & hospitals that over-charge.
    As a result, Medicare Advantage plans can afford to offer
    more services and charge only a modest premium.
    Some offer plans with a Zero deductible.

    A few offer home visits for seniors who are house-bound. (In NYC, the insurer “Health First” offers home
    visits from doctors at no extra charge.

    These are zero deductible plans with low co-pays for drugs.
    This all suggests that the best private insurers can add
    value to govt-run Medicare.
    The biggest problem with traditional govt Medicare is that Congress serves as its board of directors.
    And, as we all know, many of our reps in Congress are
    controlled by lobbyists who make huge contributions to their campaigns.
    Lobbyists representing the AMA, the American Hospital Association, many specialists, drug-makers and
    device-makes would not let Congress regulate or cap
    what prices these groups can charge.
    As a result, in the U.S., Medicare-for-all would require a huge increase in taxes.
    By contrast, the private insurers who offer Medicare
    Advantage are not beholden to lobbyists. This is why
    they can offer seniors more services. The trade-off is that they refuse to include specialists who charge far more than their peers–and hospitals that charge more than others in the same city–in their networks.
    A growing number of seniors are more than happy with the trade-off.
    If we are going to have healthcare for all in this. country
    (and I certainly hope we do)
    I don’t think our government will be able to make it
    affordable. Lobbyists have too much control over our govt
    But the best private insurers could help make it affordable.
    Finally, many people suggest that private insurers insist on profits that greatly add to the cost of healthcare in the U.S.
    The truth is that private insurers involved in Medicare
    Advantage enjoy just a 5% profit margin.
    This is much lower than many American corporations
    And it seems that a great many seniors feel that they are
    getting good value for their money.

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Joe Paduda is the principal of Health Strategy Associates

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