Medicare for All

Richard Quinn

I CAN’T TAKE IT ANY more: I need to rant about health care.

There’s absolutely no reason to continue the current health-care payment system, none, not one. Where’s the rationale for having private insurance, Obamacare, Medicare, Medicaid, TRICARE and the Children’s Health Insurance Program (CHIP)? Each was developed to deal with the same issue—paying for health care.

Some form of Medicare for all, or M4A as it’s sometimes known, is the only system that makes sense. Before I hear it one more time, I am not talking about socialized medicine or a care system like the U.K.’s National Health Service.

Instead, I’m talking about a universal payment system funded through employer and worker taxes, premiums and out-of-pocket cost sharing—all calibrated relative to the individual’s ability to pay. There’s no such thing as free health care, so let’s not even use the “f” word.

The popular arguments against a universal billing plan are largely false and misleading. Wait times, third-party involvement between patients and providers, denied care and health-care rationing are already part of our current systems in some form or another. Even for people with insurance, thousands of dollars in deductibles and coinsurance can be devastating to their budget.

And please don’t talk about instilling competition in providing health care—that’s nonsense. The system is nothing but incentives to provide more care—often unnecessarily—either for profit or to protect the medical provider from lawsuits. If you invest in a multi-million-dollar piece of equipment, the only way to make it pay is to use it. It’s well documented that a great deal of health care is unnecessary. If you think more care is always better care, think again.

For Americans who insist on private insurance, maintaining a form of Medicare Advantage is possible. Sixty-five million Americans are enrolled in Medicare. As of January 2023, another 93 million people were enrolled in Medicaid and CHIP, about 17 million more in Obamacare and 9.6 million in TRICARE, the health-care system for military personnel and their families.

Altogether, then, about 184 million Americans use some form of government-run health insurance system, often operated in coordination with private insurers and with care provided by the private sector. Yet, according to some, Medicare for all is not acceptable. That’s laughable.

I know all the arguments against M4A. I know there are consequences and I know the projected cost savings are imaginary. I know many health-care providers won’t be paid at their current rates, but they’ll have reduced administrative hassles as well. During the transition, there may be shortages.

Still, everyone will have health-care coverage, and there will be a fairer distribution of costs and tremendous opportunity for better coordination of care no matter where you are in the U.S. Isn’t it absurd that, in this era of technology, you can’t walk into any doctor’s office or health-care facility and have them instantly access all your medical records before they start tests or provide care? Don’t like that idea of health record coordination? Fine, you could opt out and end up having more tests.

Any transition will take years, resistance from self-interested parties will be tremendous and Twitter will be overwhelmed by raucous debates. But who has a better idea for how to achieve universal coverage that offers a fair distribution of costs and the opportunity for better coordination of health care for individuals?

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