The law of unintended consequences rears its ugly head once again
Medicare for All! says Elizabeth Warren and de Blasio. End private medical insurance!
So, how might this work in the real world? Take a look:
More often than not, when a politician declares that the only thing preventing some particular plan from going into place is political will, it’s a sign that there are uncomfortable practical questions they would like to paper over. So it was when Warren explained her support for a single-payer health care in which the government takes over nearly all of the country’s health care financing…
As former Maryland Rep. John Delaney pointed out just a few moments later, Warren’s plan—which is to say Bernie Sanders’ plan—would probably result in a sharp contraction in the number of hospitals.
“If you go to every hospital in this country and you ask them one question,” Delaney said, “which is how would it have been for you last year if every one of your bills were paid at the Medicare rate? Every single hospital administrator said they would close. And the Medicare for All bill requires payments to stay at current Medicare rates. So to some extent, we’re supporting a bill that will have every hospital closing.”
It’s probably an overstatement to say that every single hospital would close. But Delaney is right that under a single-payer plan paying current Medicare rates, some, and perhaps lots, almost certainly would. And many of the hospitals that stayed open would likely shed staff and services.
Medicare pays far, far less than private rates, and the higher rates from private payers is part of what keeps hospitals afloat financially.
Of course, you can raise Medicare reimbursement rates. But then Medicare would become far far more expensive than projected. Politicians like to sweep math under the rug and pretend it’s all just a matter of do-goody willpower or the lack thereof. But in the real world, math dictates what services can be provided for a given amount of money.
It will never happen for the same reason Obamacare did not force employee health plan members into the exchanges. It would be a bloodbath next election. Unions would abandon the Democrats and they know it.
Kodos: Medicare for all!
Crowd: Boo!
Kodos: No Medicare for anybody!
Crowd: Boo!
Kodos: (pause for thought) Medicare for some… tiny American flags for others!
Crowd: Yay!
“Politicians like to sweep math under the rug and pretend it’s all just a matter of do-goody willpower or the lack thereof.”
No. I wish it were that benign, but no.
Politicians like to declare that math does not exist. Proof: 2+3=”shut up and think what you’re told.”
That’s all it is. “Lack of do-goody willpower” is just another way of saying “shut up and think what you’re told.”
It’s also important to remember that Medicaid and Medicare directly and indirectly support a huge number of people:
CMS has about 6000 employees
State governments have departments that administer Medicaid and Medicare programs within the state
Managed care organizations that handle the Medicaid and Medicare populations on behalf of the states have their thousands and ten thousands of employees
Beyond that, health care providers are often dealing with large fixed costs. You can’t not pay neurosurgeons when neurosurgery is slow this week or have them help out the pediatricians, and you can’t shut down a hospital for a slow week.
Consequently, even though health care providers “lose money on Medicaid and Medicare”, in reality these patients keep beds and offices full and money coming in the door when there aren’t enough commercial insurance patients.
Because most people on commercial insurance are healthy most of the time. (They’re getting insurance through their employer after all: the chronically ill don’t work much.) And the vast majority of health care spending is on people who are actually quite sick.
The national discussion on health care and how to pay for it studiously avoids this reality.
“Of course, you can raise Medicare reimbursement rates. But then Medicare would become far far more expensive than projected. … in the real world, math dictates what services can be provided for a given amount of money.” neo
“There’s plenty of money, It’s just in the hands of the wrong people.” Bill de Blasio
It’s irrelevant whether de Blasio really believes that or is cynically playing upon the beliefs of millions. Because millions of Americans, indeed the majority of humanity… do believe that.
On the one hand claiming they are not socialists, on the other hand demanding the government control the means of production of the entire healthcare industry.
“On the one hand claiming they are not socialists, on the other hand…”
On the gripping hand, “Shut up and think what you’re told.”
This is why argument and analysis is so weak against them. You are not arguing with a brick wall, but with a wrecking ball.
Remember the movie “Throw Momma from the Train”? That kind of represents Medicare for all. My hip replacement? Not, now, Momma, but thanks for paying into the Medicare fund for all your working years. Illegal immigrants’ medical needs?
They can step right up.
Wait until ugly people are given the right to be beautiful, too. Plastic surgery a basic right, I guess.
To paraphrase Instapundit: I may accept single payer healh insurance when the Legislature starts using it themselves. Somehow the Dems/Progs think they will have an upper tier system much better than the rest of us. If it ever comes to that: Tar, feathers and a ride out of town on a rail.
Delaney said the same thing when I saw him in CB. He’s correct.
At least Bernie had the honesty to admit that taxes on the Middle Class would have to go up to pay for Medicare For All and Free College. What happens when the MC runs out of money? The poor and lower income people don’t pay taxes now (ok SS they pay). And the rich have just so much too. Will Soros, Buffet, Gates and the others pay most of their wealth to the Feds for health care? They shelter so much now, will Bernie and the others change the tax code so money can’t be sheltered? Will they levy an immediate tax on retirement funds?
Remember. they are just getting started on the give a ways and other programs. Give it six months and lets see how much worse it gets.
“Give it six months and lets see how much worse it gets.”- Lynn.
Do we have to?
Actually, as I understand it many employers have ended their group health plan. For instance, Argonne Nat’l Laboratory, which is a DOE project, shut theirs down as of 1/1/16, if I remember rightly; they’d had it through Blue Cross for a long time. (Somewhere between 1990 and 1995, one the people who was with Employee Benefits, I think it was, told us that in fact Argonne’s insurance plan was self-funded; Blue Cross was just the administrator. Whether that was still the case when the plan was ended, I can’t say.)
OTOH, UPS still has theirs (at least in Illinois; I assume elsewhere as well).
“What happens when….”
Here’s a (not too, too surprising) hint:
https://www.zerohedge.com/news/2019-06-30/wealthy-chicago-households-hook-2-million-debt-each-under-progressive-solution
Why should migrants obey the law when americans cannot even get congress to be under the law? I.e. o care