Medicare for All – and also a pony
Remember the old saying “There is no free lunch”? It was a popular phrase when I was young.
According to Google AI:
Science fiction writer Robert Heinlein popularized the acronym TANSTAAFL (“There Ain’t No Such Thing As a Free Lunch”) in his 1966 novel The Moon Is a Harsh Mistress. …
Milton Friedman heavily used the phrase as the title of his 1975 book to argue against government-subsidized programs, price controls, and free-spending policies.
However, both then and now, the left’s favorite tactic is to promise free lunches in various guises, and then fail to deliver them. The hope is that the voting public won’t catch on. Here’s an example:
Democratic Senate candidates Troy Jackson (Maine) and Abdul El-Sayed (Michigan) have renewed the push for Medicare for All, a signature feature of Bernie Sanders’s presidential campaign a decade ago. Now, as then, the issue has proven an effective vote-winner in Democratic primaries.
Among other things, “Medicare for All” makes use of the envy and anger of many in the younger generation towards the Boomers. They’ve got Medicare; why can’t we? However:
But the mechanics of Medicare for All proposals tend to be far less popular than the slogans. For instance, the Medicare for All Act, cosponsored by 117 House Democrats last year, would cap total revenues at each hospital as a core financing mechanism. Evidence from a unique policy experiment in Maryland shows that such revenue caps reduce the number of patients hospitals can treat, while making care costlier for those whom they do treat. …
Medicare for All advocates argue that private health insurance inevitably creates enormous inefficiencies. They claim that the government could save hundreds of billions of dollars every year by paying less for drugs, hospital care, and insurance administration. These savings could then fund a big expansion of benefits, broadening access to care and picking up costs that are currently borne out-of-pocket.
In reality, other developed countries deal with many of the same painful trade-offs between cost and access to care that Americans lament. The U.S. health-care system, for all its flaws, allows residents to obtain more cutting-edge medical procedures, without the long waiting lists found in other nations. And catastrophic out-of-pocket health-care costs in most European countries are similar to those found in America.
The article goes on to describe a Maryland policy from 2014 that did the following:
… allowed revenues at each hospital in the state and trusted those facilities to ration care for patients. This payment arrangement, known as “global budgeting,” drives much of the savings assumed by single-payer proposals and constitutes Section 611 of the Medicare for All Act.
Unfortunately, global budgeting has had the opposite of its intended effect in Maryland. With total revenues fixed, the state’s hospitals started treating fewer patients and charging more for each patient whom they did treat. Community hospitals have increasingly dumped seriously ill patients on the state’s once-prestigious academic medical centers, like Johns Hopkins, leaving these centers short of funds to deliver the most complex medical procedures. From 2012 to 2023, the state went from performing 61 percent more kidney transplants per capita than the nation to 40 percent fewer. Emergency department waiting times have surged to 153 percent of the national average, substantially higher than any other state. Because Maryland hospitals could maintain total revenues while delivering less care, the cost of common inpatient procedures rose 7 percent to 34 percent more than they did nationwide, depending on the procedure.
So, what do Americans think? They want Medicare for All as long as it’s a free lunch:
A recent poll found that Americans approved of Medicare for All in principle by a margin of 66 percent to 34 percent—but they opposed it, 64 percent to 35 percent, if it would increase their taxes, and by 76 percent to 24 percent if it delayed access to medical tests and treatments.
As I said, the left relies on many voters to remain ignorant of the nearly-inevitable negative consequences of Medicare for All.
The Left says…
‘Nuff said…to know that the polar opposite is—or will be—far more accurate.
Meanwhile, it’s high time to update the battlefield, especially since there’s no longer any “home front” to speak of (otherwise known as “we’re all on the front lines”)…
“Our Post-Western Future” (by the formidable Nathan Pinkoski)—
https://americanmind.org/salvo/our-post-western-future/
H/T Powerline blog.
And it looks like Lula, taking a page out of his American fellow traveler’s playbook, may well have finally succeeded in “fundamentally transforming” Brazil…
“Lula Runoff Shock Sparks Brazilian Market Carnage: Stocks Collapse, Real Plunges As ‘Bolsonaro Trade’ Implodes”—
https://www.zerohedge.com/political/brazil-stocks-crater-bolsonaro-seeks-annul-runoff-after-socialist-lulas-shock-victory
(So is it back to the 60s?)
+ BUT…(related):
“Is Brazil’s Market Crash An Overreaction?”—
https://www.zerohedge.com/news/2026-10-26/brazils-market-crash-overreaction
“Polar opposite”, continued…
‘CNN calls Karen Finney a “political commentator.”
‘Karen Finney was Hillary Clinton’s press secretary. She was also the communications director for the DNC.’—
https://instapundit.com/831672/
+ Related (sounds pretty diabolically clever to me, though…)
“For anyone curious about what it actually looked like to kill a generation of functioning cars, here’s an actual video from 2009 and brief explanation…”—
https://instapundit.com/831708/
They pulled the “free lunch” for ALL kids here in CO. It passed on the promise that it was fully funded, but it ran out of money in less than 6 months. Came back for more and it passed. We are in a budget crisis but Dems fail to recognize it, just want more money and a progressive tax. Got to tax the rich, make them pay their fair share, until they leave or run out of money, then the middle classes will have to make up the difference. Some people never learn
Of course those of us on Medicare know it’s not free. The Medicare Advantage programs, designed to save patients from higher costs, do so by restricting which doctors they can see. Those who choose traditional Medicare and a Medigap supplement get nearly unlimited access to doctors and clinics, but it isn’t actually cheap.
If they were honest they’d call it MedicAID For All ‘cuz that’s what you’re gonna be getting.
(and even MediCare has significant gaps that are usually filled by private insurance)
Every day I wake up wondering why we still have a functioning country. To steal from a known health/wealth gospel preacher “It’s a miracle!”
The evolutionary progression goes something like
MediCare —>
MediCAID —>
MAID.
(Canada is—proudly—leading edge in one aspect, at least, of “the warmth of collectivism”….)
I have a friend whose older sister was euthanized in Canada. She didn’t even get to say goodbye. Horrible.
“Medicare for All advocates argue that private health insurance inevitably creates enormous inefficiencies.”
There is nothing more inefficient than a government run health-care system. Just go live with one and try to survive without some form of private coverage.
Private health insurance probably is much more efficient at detecting and stopping fraud, because the company has to make money. Paying illegitimate claims would be bad business.
Years ago, my brother’s old friend followed her partner to the UK where he had a new job. She wasn’t employed and while he made decent money, I don’t believe he was an especially generous person. She told my brother, “Isn’t great! Now I get free healthcare in the UK.”
Now both my brother and his friend are committed lefties. But my brother is financially smart and informed, and his friend mostly wasn’t. He warned her. You know, people who want good healthcare in the UK have private insurance. I believe she was surprised to hear that.
It’s rather amazing to me that someone like my brother understands both the resulting realities of something like the UK healthcare system and at least a little bit about why those realities occur. And yet, they will vote for those mistakes over and over again.
Kate:
“Of course those of us on Medicare know it’s not free. The Medicare Advantage programs, designed to save patients from higher costs, do so by restricting which doctors they can see. Those who choose traditional Medicare and a Medigap supplement get nearly unlimited access to doctors and clinics, but it isn’t actually cheap.”
Yep, people think Medicare is just a magic card that makes health care free. It is not. Choosing which plan is best for you can be confusing and it’s not free. My Medicare Advantage plan was cancelled after one year. Your choice of health care providers can be quite restricted based on the plan you choose. Hey but at least I get $70 every 3 months to spend on dental floss and Band-Aids.
Bye bye medical care.
Civilization collapse is closer than one thinks.
By it’s history and nature the US.is a lot more difficult for Lefties to take over.
Medical care and long term care are commodities. Real resources are deployed in the production of the services and the services are subject to considerations of scarcity and cost. Where you have scarcity, you have to have a rationing system. You can ration with prices, you can ration with queues, you can ration with administrative directives, but you must always ration. A reality which needs to be emphasized in discussions of medical care and long-term care is that these are services which are produced and a decision through some set of agencies to produce them incorporates within it a decision to not produce something else. Alas, leftoids commonly think only in terms of budgeting and not production. Something may be ‘free’ to the consumer, but it is not free to the social organism. The particular consumer is being cross-subsidized by various parties. Something may be cross-subsidized via risk-pooling schemes wherein people make regular and predictable payments into the risk pool to cover spikes in household demand for a service. Something may be cross-subsidized in a more thorough sense when taxes are collecting per some conception of ability-to-pay and the proceeds are used to pay charges directly or finance a household’s participation in a risk pooling scheme.
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One difficulty we’ve had for more than a generation is that too many parties fail to recognize that there’s a downside to any method of financing medical care and long term care you can imagine. If you modify systems, some set of parties will benefit and some will be injured.
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The usual methods of the media wing of the Democratic Party is to identify some minor population segment injured by a modification of systems and put them on the nightly news. It’s always in service of MOAR. Current levels of expenditure and state allocation of resources are never enough because of NEEDS.
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Whenever you state a ‘need’, you have an implicit purpose in mind. Your purposes are not everyone’s
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It was 27 years ago when Milton Friedman suggested that you replace existing programs of financing medical care and long-term care with publicly-financed insurance which kicks in over a high deductible, and that you append to this promotion of medical savings accounts. Right now, public expenditure to generate revenues for agencies producing medical care and long term care amounts to just north of 6% of gross domestic product.
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The premiums to finance the public expenditure might be a flat levy on one’s total income topping out at a dollar value which is a function of nominal personal income per capita and adjusted annually. At this time, the premiums might be financed by a levy of 11% of discoverable personal income not to exceed about $35,000. The deductible might be somewhere around $5,000 for a single person household, $10,000 for a two-person configuration, and $15,000 for a larger configuration. Below the parapet, a price system would operate where people finance care out of pocket from medical savings and providers would be compelled to publish their chargemaster and said chargemaster would have to have a prescribed format. The country could be divvied up in catchments and there might be annual auctions held to act as the insurer of blocs of households within a given catchment. The result of the auctions each year would determine who the insurer was for a bloc of households and what their deductibles would be.
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The foregoing would serve to cover all but some niche populations (some of whom could be covered by travel insurance), it would maintain public expenditure at a fixed share of total personal income flow, and it would promote some efficiencies by re-introducing actual prices in the provision of medical care and long-term care. (Among the efficiencies would be short queues). It would also relieve sclerosis in the labor market by allowing employers to provide more liquid compensation and remove an advantage large employers have. It would, however, be rather dissatisfying to large numbers of people.
Art Deco on October 27, 2026 at 9:18 am
A very nice statement of the issues and a potential set of solutions, although I am not sure I followed all of the subtleties from your discussion.
If you can afford public or private health insurance now, it seems to come down to the reputation of the insurance firm, any specialized services you might need or want, the sum of yearly premiums, and the maximum out of pocket costs assigned to a given policy package. I am not an expert but I gather the premiums can be between $3K and $20K per year, based on policy type and family size, etc.; plus maybe $4K to $10K per year for max out of pocket. If so, then you are protected against the major incidents where the costs approach $30K plus.
On this comment: “… and providers would be compelled to publish their chargemaster and said chargemaster would have to have a prescribed format.” we would have to be careful that weaselly firms did not game these forms and the contents/ numbers inserted into them.
The last time I was faced with something like this was in seeking a construction loan for my 2nd home. Supposedly all four banks filled out the same basic [federal?] form to identity subsets of the closing costs, but I still could not use their input to compare specific categories of costs between different banks becasue they all filled them in differently. At best I only had the final bottom line number for comparison purposes….and little information for negotiating adjustments.
But I do heartily endorse published price listings and paying standard known yearly medical costs as part of the normal family expenses; leaving the insurance to cover the risk mitigating events and unknowns that could strike anyone of us at any time.
“Yes there is”
Sid Rosner, shaking me down for lunch money, Roosevelt Jr. High School.