Medicare for All: Headache for All?

Published in Economic Liberty .

No matter who wins in 2020, calls for Medicare for All will simply not go away.

The program, which Vermont Senator Bernie Sanders is promoting in his 2020 presidential campaign, would have the state take on a greater role in America’s economy. According to his campaign website, Medicare for All would establish a single-payer, national health insurance program that would allow all Americans to receive “comprehensive health care coverage, free at the point of service.” It’s no exaggeration to say that the U.S. healthcare system is a mess. According to Julian Adorney in an article for the Mises Institute, healthcare costs skyrocketed by 118 percent from 1992 to 2012.

But will Medicare for All be the silver bullet healthcare reform plan that advocates are making it out to be?

For starters, the costs of Sanders’ pet program are steep. Certain estimates have Medicare for All adding $32 trillion to federal budget commitments during its first ten years. Keep in mind that Medicare is already incurring massive losses of upwards of $130 billion since 2008, along with unfunded liabilities that sum up to $30 trillion.

Advocates argue that the legislation will achieve the goals of reducing drug prices and administrative costs. Sanders’ Medicare for All plan will allow patients to hold off payments when they receive treatment. All of this would be thanks to people having to pay taxes to fund the system, regardless of their overall usage. Patients would be incentivized to make more frequent visits to the doctor’s office and the emergency room, even for the most trivial of treatments, because there wouldn’t be any cost associated with doing so.

Some of these unnecessary visits will put a tremendous strain on the healthcare system. The American Association of Medical Colleges already expects a shortage of 120,000 doctors by 2030, largely due to the nation’s aging population. To make matters worse, the 2016 Physicians Foundation survey revealed that 48 percent of physicians have plans of cutting hours, retiring, or taking other steps that reduce patient access to their practices.  Additionally, a 2018 Physicians Foundation survey demonstrated that 80 percent of physicians claim to be “at capacity or overextended.”

One can only imagine how much worse this situation could be under a Medicare for All system where doctor visits are further encouraged. Given that there will be greater demand for healthcare services with taxpayers footing the bill, real constraints will emerge. Not to mention there is an already decreasing supply of doctors. This will inevitably lead to much longer waiting periods.

A major problem with the overall healthcare debate is how much the role of government intervention in the economy is overlooked by critiques of the industry. Yes, medical care cost concerns have their place and should be taken into account, however, it would be unwise to ignore the root cause of this mess — state intervention. From stiff occupational licensing standards that the state imposes, to the FDA’s lengthy approval process, healthcare in America has more than enough regulation as it is.

The talk about healthcare policy is all too reminiscent of education debates. Like education, healthcare is somehow viewed as a service that must be provided by the state. At least, that’s the narrative that opinion-makers have impressed upon us for decades. However, the history of education and healthcare in America shows that free market and civil society institutions are more than capable of providing quality services in these areas.

For the devoted statist, these scenarios seem almost unthinkable. But dusting off the history books will show that anything is ultimately possible when people are allowed to voluntarily interact in the marketplace.

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