• Dr. Bob

"Medicare for All" May Mean Healthcare for None

When Joe Crowley was upset by Alexandria Ocasio-Cortez in a congressional race in New York, it is unlikely that we down here in Griffin knew it or even cared. She was one of four radical socialist elected as Democrats that have virtually taken control of the direction of that party. The issue that propelled her to her current position was her advocacy for single-payer healthcare, or “Medicare for all.”

Now virtually one third of Congress is running for the presidency in 2020 from the Democrat party. The socialist/progressive agenda has not just gained traction in that party. Anyone in that party who opposes the socialist agenda will be ostracized, ridiculed, and punished. There is no conceivable pathway by which a moderate candidate who did not support Medicare for all (including illegal immigrants) could be nominated by the Democratic Party.

Let’s analyze for a minute what “Medicare for all” really means. It is important that we all understand the implications of what is being said here. There is more than meets the eye.

Medicare was begun in 1965 by an act of Congress. It was designed to be expanded when it was conceived. Originally designed for people over 65 years of age, people who were disabled were covered after 1972. There was even a Medikids program on the drawing board back then. Taxpayers have fed their money into the Medicare system all their lives.

Sen. Bernie Sanders introduced the Medicare For All Act of 2017. If this bill passed, according to the New York Times, 156 million people who now have insurance through their workplace would pay considerably higher taxes and lose their current plans. 80% of those like their current insurance, so they will not be happy when this comes to their attention. 28 million people who were not insured now we get insurance. This figure, however, would likely more than double or triple because Democrat candidates insist that all illegal aliens should be covered at taxpayer expense. The implication of this is that the price tag is open – but open only to increases.

Under this bill, private healthcare insurance would be eliminated. The party that once lied to all of us with “If you like your insurance, you can keep your insurance,” will now tell us, “if you like your insurance, we’re going to eliminate it completely and replace it with something more expensive with fewer options.” Sounds like a real deal.

Physicians and other healthcare providers would face pay cuts, and reimbursement to hospitals would be slashed. Proponents say that this would be partly compensated by the possibility that there would be no unpaid bills. The assumption here, of course, is that the government would, or even could, pay its bills.

Here are a couple of points that I have never heard anyone address. First, consider the rural hospitals. People who live in rural areas are more likely to eat poorly, to be indigent, to be obese, and to suffer from heart disease, hypertension, diabetes, and cancer. They are more likely to be underinsured, with 15% of adults patients being completely uninsured. Medicare is reimbursing these hospitals serving such a high risk population at about 101% of operating costs. Most business cannot operate on that margin.

Accordingly, at least six Georgia hospitals have closed their doors since 2013. When hospitals close, communities tend to die off. The pharmacy, the bank, and other parts of the community will close their doors soon afterward. Hospitals tend to be among the largest employers in small communities, so jobs will be lost. Mortgages will not be paid. Cars will not be bought. Restaurants will suffer. Under a Medicare for all scheme, expect an acceleration of the demise of rural hospitals. You can kiss your hospital goodbye. They will not make it financially.

A second point is this: I speak from personal experience here. If we filled our clinic with Medicare patients, we would close quickly. Medicare reimbursement is a tiny fraction of reimbursement from virtually any other source. Your doctor’s office will not survive. Doctors will not be able to pay their overhead, such as utilities and labor. More jobs will be lost. Many doctors will opt to change careers altogether. So, you could kiss your doctor goodbye under a Medicare for all reimbursement scheme.

You will hear candidates falling all over themselves to convince you that where this has been done, it has benefited everyone. In Great Britain, 20% of all patients diagnosed with cancer will wait two months on average after referral from a general practitioner before they begin treatment. You can kiss them goodbye, too, if they have aggressive cancers.

The Canadian system is cited by many “progresses” as the shining example of efficiency. On average, if a general practitioner refers a patient to a specialist under the Canadian system, the waiting time is 19.8 weeks – 138.6 days. Waiting time for CT scan? 4.3 weeks. Waiting time for MRI? 10.6 weeks. Waiting time for an ultrasound? 3.9 weeks.

It is difficult for healthcare providers to even address this topic because it may sound self-serving. But these are the facts.

There are a lot of problems in the American healthcare system. It is bloated, inefficient, expensive, and worse, it fails to produce the outcomes we expect. However, socialism has never worked anywhere at any time on this planet. There is no reason to think that socialism will improve healthcare.

Instead of empowering government to control all your health care decisions, it seems there could be better solutions in front of us if they empower patients to make their own informed decisions about healthcare. Ronald Reagan said that government is never the answer, it is the problem. That is certainly true in healthcare.

So, as we watch the 2020 political races and the debate stages that look a little bit like Romper Room, keep all of this in mind as you hear healthcare plans presented and launched like ping-pong balls to be batted about. Understand that your health care insurance, your doctor, your hospital, and your community are at stake.

It is terrifying to think that an entire political party advocates for all of this.