Medicare for All moves from Congress to States
For now, Congress has rejected “Medicare for All.” But lawmakers in several states are now taking office.
In California, Democrats are calling for “a universal, single-payer health care system” as part of their party platform. An offer to install this system failed in the California Assembly in late January, but Golden State leaders have pledged to run another race.
At least a dozen more states are considering bills that would ban private health insurance and establish single-payer health care. This is bad news for Americans. It doesn’t make much sense to force nine out of 10 Americans to abandon their current health plans as part of a push for universal coverage.
About two-thirds of insured Americans currently depend on private health insurance plans. Some 177 million people receive coverage through an employer and about 34 million people get private coverage directly.
A single payer system could end all these plans.
In addition, Americans like their private plans. In a recent study of people with employer-sponsored coverage, more than two-thirds said they were satisfied with their insurance. More than three-quarters felt confident that he would protect them during a medical emergency.
The Kaiser Family Foundation‘s research found that support for a single payer diminishes when people consider its consequences, such as higher taxes and delays in treatment.
Analyzes of specific single-payment state plans suggest that the disadvantages would be serious.
The New York Health Act, for example, would reduce employment in the Empire State by 315,000, according to a study published last year by the Foundation for Research on Equal Opportunity. Another report found that if the bill became law, New York residents would have to pay about $ 250 billion in new taxes.
In addition, a single payer will result in lower quality care. This is because government payers rely on lower payments to hospitals and doctors to control costs. Look no further than Medicare. The American Hospital Association says hospitals receive only 87 cents for every dollar they spend treating Medicare beneficiaries.
This is obviously not sustainable. If a single payment system were widely adopted, and its low pay rates, doctors and hospitals would respond by reducing the supply of care they are willing to offer.
This decline in supply, combined with unlimited demand fueled by free health care at the service point, could lead to long waits.
Just ask the Congressional Budget Office. According to a recent CBO analysis, a single payer system would result in more “unsatisfied demand” for health services, “more congestion in the health system” and “lower payment rates.”
Lawmakers in several states have responded to concerns like these by advocating a supposedly more moderate public option: a government-administered insurance plan that would supposedly compete with private options.
But any public option would also reimburse providers at lower rates than private plans. The public plan would use this pricing power to set premiums and deductibles below those of private insurers. As people gravitated toward the cheaper public option, private insurers would gradually leave the market, until only the public plan remained.
A public option is just a slower way to introduce single payment. And single-payer health care is a worse cure than illness.