The Banner (Bonita Springs, FL) By Sally C.
Pipes April 24, 2019
Many Democratic
politicians believe bigger government will solve America's healthcare woes. But
some centrist Democrats worry full-fledged "Medicare for All" will
spook independents.
So they've unveiled
seemingly moderate plans that would allow people to buy into Medicare before
they turn 65. Lawmakers insist these proposals wouldn't abolish private
insurance or force everyone into a federal health plan. They'd simply offer
another option.
Voters shouldn't
buy this. Medicare buy-ins would eventually lead to single-payer. Government
rationing and long waits for care would follow.
Last month, Sens.
Tammy Baldwin, Debbie Stabenow, and Sherrod Brown introduced the Medicare at 50
Act, which would let Americans 50 or older buy a privately administered
Medicare plan through Obamacare's exchanges.
They claim
"Medicare at 50" is more feasible than Medicare for All because it
would be less expensive and wouldn't force anyone to switch plans.
That's true in the
short term. But in the long run, the proposal would lead to Medicare -- and
only Medicare -- for everyone.
Medicare's
reimbursement rates are lower than those for private insurance. That's part of
the appeal of expanding government-run coverage. Proponents argue that
Medicare's massive customer base gives the program negotiating leverage to
extract better prices from healthcare providers.
But Medicare's
payments don't cover the cost of treating its beneficiaries. For every dollar
hospitals spent treating Medicare patients in 2017, they received 87 cents in
reimbursement. Hospitals balance their books by charging private insurers more.
Supporters of
Medicare for More also boast that Medicare doesn't need to turn a profit.
Medicare spent more than $700 billion on reimbursements and administrative
expenses in fiscal year 2018 but collected $123 billion in premiums, copays,
coinsurance, and rebates.
Because Medicare
can swallow huge losses and make providers accept cut-rate reimbursements, it
could market plans at lower prices than private insurers. As people migrated to
cheaper Medicare plans, providers would shift additional costs onto private
insurers. That would drive premiums up further.
Medicare plans
would become even more appealing. The cycle would repeat until everyone over
the age of 50 had opted for Medicare. Exchange customers under the age of 50
would find themselves paying ever more for coverage. Eventually, Congress would
sweep the wreckage of the private insurance market into the ballooning Medicare
system.
Some House members
have proposed an even more ambitious buy-in scheme. The "Medicare for
America Act" would automatically enroll the uninsured and those who
currently buy coverage in the individual market in Medicare. It would also make
Medicare more generous by slashing deductibles and capping out-of-pocket
spending, among other things.
Large employers
would have to provide benefits comparable to the new plan or contribute 8
percent of their annual payroll to a new Medicare trust fund. Employers
typically spend more than 8 percent of payroll on health benefits. Many would
choose to cut costs by dumping employees onto the government plan.
Consequently,
Medicare for America would lead to de facto single-payer, if not de jure.
Doctor shortages,
long waits for treatments, and low-quality care would follow. In the United
Kingdom's single-payer system, one-quarter of residents are waiting for some
sort of medical appointment or treatment. Under single-payer in Canada,
patients waited a median of 19.8 weeks for specialist treatment after being
referred by a general practitioner last year.
Medicare buy-ins
sound harmless. But these plans would inevitably lead to single-payer -- and
the rationing that accompanies it.
Sally C. Pipes is
President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific
Research Institute. Her latest book is The False Promise of Single-Payer Health
Care (Encounter 2018). Follow her on Twitter @sallypipes.
No comments:
Post a Comment