I happen to believe that, once we actually actively work to save the democracy from collapse by encouraging voters to show up instead of helping the current Republican Party in their mission to encourage them to stay home, that we can start building a progressive country again. And part of that progressive mission will be to create a universal health insurance system, in which anyone who becomes sick or injured can go to the doctor for treatment without having to worry about how they will pay for it. It will happen, and it will happen as soon as we can manage to elect Democrats every election, at least for a while.
That said, I have lived in this country for 60 years now, and I have seen nothing that leads me to believe this country will, or even should, adopt a single-payer healthcare system. I’ll get to that a bit later. This column is about the snake oil being used to sell the latest Unicorn Progressive wish, “Medicare for All.”
You see, the Unicorn Progressive movement has glommed onto the phrase, “Medicare for All” because they have convinced themselves that phrase will sell it to the masses. They are convinced Medicare is so popular, they can piggyback onto it and ride it to single-payer heaven.
In a way, this makes sense. Medicare is easily the most efficient and finest working segment of the current healthcare system. If you’re going to sell snake oil, why not use the Medicare system to peddle it to people? if you’re going to sell air to gullible people, you use an oxygen tank, right? Since that’s the purest air possible, it’s most likely to work. Okay, that’s a stupid analogy, but this is the way unicorn progressives think. They believe their position on every issue is sacred and perfect and they believe everything they propose is, without argument, the finest proposal ever made. Just as snake oil salesmen used to tout their wares as the perfect cure for everything that ails you, unicorn progressives sell single-payer as the cure for all the faults in our current healthcare system.
I would say “fair enough,” except their methods for selling single-payer don’t pass a basic sniff test. They are using bullshit to peddle it. One prime example is this graphic, which I saw on Twitter and which was being retweeted dutifully by unicorn progressives for a couple days.
There are so many problems here, it’s difficult to know where to start. First of all, the title. “Americans” don’t support “Medicare for All.” SOME Americans do support it. According to most polls, half the American people support the principle of single payer. More accurately, they love the idea of “Medicare for All,” since Medicare works pretty well and seems to be flawless in its execution. I mean, who wouldn’t support a more efficient system?
What is missed, however, is the fact that Medicare got to be what it is after more than 50 years of tweaking and adjusting. It also works because it’s so limited; it only pays the bills for people over 65. More accurately, it only pays 80 percent of the medical bills for people over 65. Actual Medicare recipients have to carry private insurance to make up the other 20 percent, with the poorest receiving Medicaid to pick up the slack. What’s funny is, none of that is even mentioned in the graphic above, and that only touches the surface of the bullshit in that thing.
I’m not going to discuss the column on the GOP proposals because they don’t matter, since they can’t pass anything, anyway, but the column about the Affordable Care Act unnecessarily mischaracterizes that program, as well. For instance, their numbers regarding the insured and uninsured are based on Trump’s bastardization of the ACA, and his and the GOP’s purposeful starving of that program/law. If the ACA had been fully implemented, the number of people covered would be much higher than 90 percent by 2026, and the number of bankruptcies due to medical bills would have been much lower than happened under Romneycare in Massachusetts, an incredibly random statistic that seems to still have crap on it from when they pulled it out of their butts.
Going down the column, the item regarding “restrictive networks” is complete horseshit. The restriction largely depends on the level of insurance a family chooses. No, you cannot go to “any doctor you choose,” but you can’t under current Medicare rules, either. Doctors and medical groups choose whether or not they want to take Medicare patients, and many doctors are so popular, they can’t treat all the patients who come through their doors. In other words, it is a fantasy to believe “Medicare for All” will allow everyone to go to any doctor they wish.
Now, let’s talk about the rest of that chart, dealing with the costs. To believe this graphic, “Medicare for All” will cost nothing. No premiums, no deductibles; you just show up at the doctor and you get treated for “free.”
If you believe that, I have this wonderful bridge to sell you. I’ll sell it to you cheap, even though it carries thousands a day to and from Brooklyn.
Right now, we spent upwards of $3 trillion on healthcare in this country. Medicare, as it stands, represents 15 percent of federal spending. In all, Medicare benefits payments totaled $702 billion, with $591 billion of that coming from the Medicare Trust Fund and the other $111 billion coming from private insurance. (Source) Even if we do everything possible to control costs, if we are to turn Medicare into a true “single-payer” system, the amount the Medicare Trust Fund will have to cover will grow more than 500 percent, and contrary to this graphic, that money will come from somewhere. Right now, federal spending is at $4 trillion; that will have to rise to nearly $7 trillion, just to cover “Medicare for All.” Yet, according to the chart above, no one will have to pay anything for that.
This is what I mean when I talk about snake oil.
According to unicorn progressives, we will apparently just expand Medicare to cover everyone, and only the extremely rich will pay for it. The insured will not have to pay for anything. Everything will be “free.” Unfortunately, that’s not how anything works in real life. Nothing is free. And implying to anyone that they will someday have “free healthcare” is the epitome of selling bullshit as fact. We will all pay for this and, especially at first, the costs to us will not drop significantly.
I would also note that the goal is NOT “single payer,” it is universal health insurance. everyone should be covered and healthcare should be treated as a right. However, I would also note that MOST universal healthcare systems are NOT “single payer.” In other words, treating “universal
In fact, imagine you unicorn progressives get your wish. Suppose we implement a “single-payer” system. If you are just as diligent as you have been about keeping Republicans in power, what do you imagine will happen to that government-paid healthcare system? And if it’s paid for entirely by huge taxes on the “one percent,” what would prevent Republicans from “starving the beast”?
The Affordable Care Act was a fitting transition into a universal healthcare system, as originally written. It follows the model of the vast majority of universal healthcare systems in the world. All we have to do is add a public option and this hybrid public-private system will work fine and not be subject to the whims of the current Republican Party. Instead of selling snake oil, how about reforming what we already have? Reform is always more achievable than “revolution.” And more often than not, the results are more favorable.
You think THIS country, in which half of all people can’t be bothered to vote are just going to sit back while we take away their current insurance and replace it with “government insurance? Based on what? The glory of your intellects?
Also published on Medium.