The 27 Million Problem

“Medicare for All” has materialized again from the mists as Democrats begin maneuvering  to become the party’s 2020 presidential candidate.  It is easy to find out who is a Democrat–they are the motley crew running to become President.  If they are a motley crew running from the President , they are Republicans. Generally, motley crews are politicians running to or from something.

When I first made some observations about Medicare for All a few months ago, I actually took the proponents at face value.  I wrote how expensive Medicare actually is with its various premiums, the payment of which is necessary if you want reasonably full coverage.

One respected observer took me to task by replying that the slogan was really aimed at a comprehensive approach for coverage for all.  He was, it turns out, right in one sense and wrong in another.

It is now clear, based upon all the Democrats who plan on being elected President, that Medicare for All means a single payor system for healthcare, i.e., the Feds.  These would be the same folks who have made a mess out of both Medicare and Medicaid.

Several polls indicate that there is support for Medicare for All but the supporters do not want to pay for it.  They want something for nothing.  So do I but that is a path to economic ruin.  Support evaporates if taxes have to be increased.

Support further decreases if people are told that they can no longer have private insurance in a single payor system.  Medicare beneficiaries worry that their coverage, for which they spent their working life being taxed, will be adversely affected.

Most people have health insurance.  It comes from their employer, from Obamacare state exchanges for working individuals not covered by their employer, Medicare and Medicaid (MediCal to Californians).  Obamacare has problems and the price is yet to be fully paid for it but one very positive thing it did accomplish was to encourage the growth of Medicaid.  Medicaid expansion accounts for most of the newly insured folks.

According to the Kaiser Family Foundation, about 27 million people had no health insurance in 2017, the latest year where there is available data.  The nation’s population in 2017 was 326 million.  Is it really necessary to upend the current system in order to deal with the less than 10% who have no coverage?

For politicians of all stripes. the easiest thing to do is to propose solutions before adequately defining the problem to be addressed.  That gets headlines.

It would be far better to spend more time defining the problem and then look for solutions which are not rooted in ideology but offer a practical approach to solving a problem.  Right now, everyone is backed up, if I may so, to a wall and not interested in solving a solvable health care problem.

As long as the motley crews feel health care coverage is worth more as a campaign issue, the 27 million will go wanting.