Ten years ago, the passage of Obamacare vastly increased the federal government’s role in our health–care system. The health care overhaul was sold to the American people as a solution for skyrocketing costs and high uninsured rates. While some uninsured gained coverage, the law further complicated America’s complex system, which continues to fail so many of our citizens. Despite the glaring shortcomings in our current system, which is riddled with government intervention, many are calling for the next step: a single-payer system. American’s should be skeptical.
Single-payer, Medicare For All, or a universal health–care system are some of the terms commonly used to describe the pie-in-the-sky system proposed as the new fix for American’s health–care problems. Although there are different proposals to thrust the government further into the health–care sector, the most popular plan championed by Sen. Bernie Sanders would grant full control to the government. Fellow Democratic presidential nominees, such as Sens. Elizabeth Warren, Kamala Harris, and Cory Booker, are co-sponsors of the legislation. Not everyone on the Left fully endorses this plan, however.
Sanders’ plan would transition to a single-payer system. A recently released report by the Congressional Budget Office noted a single-payer system has four essential factors. It would rely on the government to operate major functions of the plan such as eligibility, benefits, and payments for services. All eligible enrollees would be required to pay into the system. Receipts and expenditures would be reflected in the government’s budget, and private insurance would be outlawed or play a minor role.
Medicare For All as envisioned by Sanders would eliminate almost all private insurance and provide all Americans with coverage, including primary care, hospital visits, long-term care, vision, dental and prescription drugs in plan administered by the government.
Indeed, most Americans would probably enjoy having such benefits. Polling by the Kaiser Family Foundation finds 71 percent of respondents favored a National Medicare For All plan after hearing it would guarantee health insurance for all. But Americans should be concerned the tremendous costs of such a plan.
The most substantial effect on the economy would be the almost complete removal of the private sector in health care. Sanders’ program would shift more than half the country into a government plan by removing the market for private insurers. Support for the Medicare For All program fell to 37 percent in the KFF poll when respondents heard private insurance would be eliminated. Through competition and innovation, the American health–care system has produced some brilliant modernizations in medicine. Putting control in the hands of the government would likely stifle that innovative drive.
So how would the government, assuming the responsibility for administering the plan, pay for such a large system? Under Sanders’ plan, patients would be subject to no out-of-pocket spending. Instead, taxes would rise, particularly on the wealthy, to pay for the program. KFF poll data shows support for the Medicare For All program falls to 37 percent when respondents are told most Americans would be required to pay more in taxes. Moderate estimates put the price tag at about $30 trillion over the first 10 years. The U.S. government is projected to run an $897 billion budget deficit in 2019, adding to our federal debt of $22 trillion. The federal government will have difficulty paying for its growing obligations to Social Security and entitlement programs, let alone the trillions needed to pay for the massive new program.
Would everyone get the care they need in a single-payer system? Probably not. Reports from other single-payer countries paint sobering picture. For example, patients in the U.K. and Canada can experience significant wait times for certain medically necessary services. Support for Medicare For All in the KFF poll fell to 26 percent when respondents were told the system might lead to delays in people getting some medical tests and treatments. Research has shown that when patients are responsible for less of the bill, health care consumption increases, much of it unnecessary. In a country where upwards of 327 million people would be crammed into one health–care program, it’s not difficult to imagine the effects on wait times.
Conservatives believe public policy is most effective when it’s administered as close to the intended population as possible. I believe the policy distance between patients and Washington D.C., is a critical problem in our health–care system. Health–care reform needs to focus on shifting the balance of power back to the patient, instead of toward the government. Moving to a single-payer system would be the final blow to patient choice in America’s health–care system, not to mention a blow to taxpayers’ already thinning wallets.
Jordan Roberts is the health care policy analyst for the John Locke Foundation.