Why Sanders’ Medicare-For-All Will Fail

Bernie Sanders is promising a single payer healthcare system he calls Medicare-for-All. Some people are falling for this false promise. We must avoid ending up like the Greek sailors in mythology who listened to the Sirens’ song, crashed on the rocks and died.
Democratic presidential candidate Sen. Bernie Sanders, I-Vt., speaks during a rally  Sunday, Feb. 21, 2016, in Greenville, S.C. (AP Photo/John Bazemore)
Democratic presidential candidate Sen. Bernie Sanders, I-Vt., speaks during a rally Sunday, Feb. 21, 2016, in Greenville, S.C. (AP Photo/John Bazemore)

Sanders’ Idea of Medicare-for-All

Sanders would create his Medicare-for-All by first dumping all 70 million “free coverage” Medicaid recipients into the Medicare program that covers 49 million seniors who paid into the Medicare Trust for 40 working years.

How is that fair?

Then, Sanders would add the remaining 200 million Americans, including millions of illegals … I think. He isn’t clear on this. His plan won’t work for a number of reasons.

Medicare Is Quickly Going Broke

The Medicare Trust is a huge health savings account into which working Americans were required to pay during their employment. The Trust is supposed to pay all medical expenses of the 49 million enrollees. The Obama administration admits that the Trust will be insolvent within 10 years.

Why would Sanders want to hasten the collapse of Medicare by adding 270 million other Americans to the rolls?

Want Your Tax Bill to Go Up, Even Higher?

Sanders’ answer is simple: he will raise taxes on everyone. What will this do to our sluggish economy? How will an already strapped, barely-making-ends-meet over-taxed, over-regulated, middle class respond to more money taken by the government?

What Sanders' Medicare-for-All looks like (Dr. Deane Waldman, MD MBA)
What Sanders’ Medicare-for-All looks like (Dr. Deane Waldman, MD MBA)

At least Sanders is honest — he says our tax bills will go up. President Barack Obama outright lied. He called his healthcare reform “affordable,” and promised we would save $2,500 per family, per year. What we got from Obamacare was sticker shock, with family health insurance premiums rising to $20,000 per year or more.

Cost of Medicare-for-All

What about the cost of Sander’s Medicare-for-All? And where does all that money go?

Adding 70 million Medicaid recipients plus 200 million other Americans to 49 million Medicare enrollees will require several trillion (yes, with a “T”) dollars in bureaucratic costs. Just think of the new eligibility requirements, authorization codes, verification standards, billing processes, etc. And I haven’t mentioned the tens of thousands of new accountants, administrators, billers and coders, bureaucrats, consultants (always remember the contemptuous and contemptible Jonathan Gruber), and of course, lawyers to defend the new rules, regulations and executive orders against the inevitable challenges.

Lest you think I exaggerate, Obamacare spent $2.6 trillion in bureaucratic costs just to expand Medicaid by 10 million and create 17 Healthcare Exchanges plus healthcare.gov.

Sanders’ expansion of Medicare by 270 million Americans would assuredly sink an already unsupportable federal deficit.

Money For Bureaucracy, Not For Care

Sanders boasts about all the costs we wouldn’t have to pay when Medicare-for-All eliminates health insurance. Apparently, he doesn’t understand that Medicare works through insurance companies. So, there will be no savings there.

There will, however, be new costs related to additional BARRC: bureaucracy, administration, rules, regulations, and compliance necessary to implement his Medicare-for-All. This “mandatory” spending on bureaucracy will leave less and less money for your care. More dollars to bureaucrats means fewer dollars for nurses, doctors, and hospitals.

When the government controls your healthcare spending, they allocate first to themselves. We the Patients get what is left over.

Do You Want “Doctor” Sanders?

The most unacceptable aspect of Medicare-for-All is this: like all government-controlled healthcare systems, the central government takes over as your medical decision maker.

Washington, D.C. decides what care you get or don’t get, and when you might get it. In Medicare-for-All, the doctor is a government employee. He or she works for Washington; not you. In Medicare-for-All, neither you nor your doctor has any real say in your care.

Just ask a veteran, one who hasn’t died on a waiting list. Our veterans have the Department of Veterans Affairs system, a form of Sanders’ Medicare-for-All. As a result of the government allocation process that diverts care dollars to healthcare bureaucracy, “307,000 veterans may have died waiting for their medical care.” That is a direct quote from an Inspector General’s 2015 Report on the VA healthcare system.

Access to timely care and the good health of all Americans are what really matter, or what should matter, in healthcare. Even so, we seem focused almost exclusively on the money.

So, let me end quoting a world-renowned economist.

Friedrich Hayek won both the Nobel Prize in Economics in 1974 and the Presidential Medal of Freedom in 1991.

He wrote it is, “An optimistic delusion that [central; government] planners can manage economic growth by substituting their expertise for the information generated by the billions of daily interactions of a complex market society.”

A fitting epitaph for Medicare-for-All would be a paraphrase of Hayek: It is conceit FATAL to patients when government thinks it can make better life-and-death decisions for us than we can make for ourselves.

“Dr. Deane” Waldman MD MBA is the author of the FREE Healthcare Decoder; The Cancer in the American Healthcare System; and the new e-book series, Restoring Care to American Healthcare. Dr. Deane is host ofwww.wecanfixhealthcare.info; Professor Emeritus of Pediatrics, Pathology and Decision Science; and Adjunct Scholar (Healthcare) for the Rio Grande Foundation, a public policy think tank. Dr. Deane serves as “Consumer Advocate” Director on the Board of the New Mexico Health Insurance Exchange. Opinions expressed here are solely his own and do not necessarily reflect those of the Board.

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