Why I Don't Support Medicare For All

I’ve been an advocate for universal healthcare since the ‘70s when I first became aware of such issues. But Medicare for all is a baaaad idea. There are better ways to achieve universal coverage and cost containment. Our federal government cannot be trusted with something as important as healthcare. A perfect example is Trump’s recent unilateral decision to stop paying insurance companies their cost sharing reduction subsidies, causing insurance premiums to soar for millions of people. Just think what he would do to a federally-run single payer system!

Even though there are government run single payer systems in other developed countries, such a system in the US would be a total disaster. Why? Those other systems work in countries where the federal government has the best interest of the people at heart. We have no proof this is the case in the US. Our federal government has the best interest of corporations at heart. (And, even though corporations are people (right?), that’s not going to help you any.)

For example, during the G.W. Bush years, he passed a law prohibiting Medicare from negotiating with drug companies for better prices. That’s pretty blatant. Drugs are so much cheaper in Canada because their medical system negotiates for better prices. (By the way, you can take advantage of that by having the prescriptions you have to pay out of pocket for filled through an on-line, mail-order Canadian pharmacy. Still perfectly legal. Bush tried to make that not so but couldn’t get it through.)

And when have you ever seen a government social program that wasn’t chronically under-funded? With the current conventional medical mindset dominating medicine, there is no way that we would not have rationing of healthcare. And the first to go would be anything conventional medicine considers alternative, the next would be the “less necessary” surgeries, such as those for pain from herniated discs. MRIs and expensive blood work would be regulated and more patients would be harmed and more physicians would get sued for missing diagnoses they couldn’t make because they couldn’t get the tests run.   

How could such a system be protected by the vagaries of whatever administration was in power? What would Regan, the Bushes, and Trump have done to such a system if it were already in place when they took office? What would happen to it if the radical right continues to gain momentum?

A single payer system would stifle medical innovation. If Ma Bell hadn’t gotten broken up, we’d all still be using rotary dialing.

Supporters of Medicare for all are also using funny numbers to support their arguments. They say that Medicare is so much more efficient than private insurances, with a 2-4% overhead compared to the 20-26% overhead for private companies. But that efficiency is achieved because they farm out most of the work to administer their plans to the private companies. And what they pay the private companies for that work is not included in their administrative overhead.

On the possible plus side, with a single payer system, it is easier to see that real wellness and prevention makes sense. It may motivate major societal changes, such as stopping the taxpayer subsidization of junk food, decreasing air and water pollution, outlawing cigarettes, taking real steps to make the workplace less stressful, expand parenting classes, and other such measures. But these advantages can also be gained by other ways to achieve universal coverage and cost containment that are not dependent upon the government. I have blogged previously about such a system.

So, please, give the matter some careful thought. If we adopt Medicare for all, we’d be jumping from the frying pan into the fire. You deserve better.