The folly of Medicare-for-all
On September 13, Senator Bernie Sanders (I., Vt.) unveiled “Medicare for all” — an entitlement to comprehensive medical care for every resident of the United States, free at the point of use, to be administered and funded entirely by the federal government. The senator admits that his proposal to expand benefits, eliminate cost-sharing, and cover medical expenses currently paid for by private insurance would require an enormous increase in federal taxes. But realistic budget constraints mean that it is also likely to reduce access to essential care. As leading Democrats seek a return to power, they risk being stuck with a 2020 presidential nominee committed to a policy that has long distinguished itself by its unpopularity.
In one respect, Sanders’s proposal was hardly news. The Vermont liberal has introduced similar legislation in every Congress since his arrival in the Senate in 2007, never succeeding in getting it out of committee and usually failing to attract any co-sponsors. But after Sanders won 43 percent of the vote in the 2016 Democratic presidential primary, 16 Senate Democrats (many with an eye on the 2020 presidential nomination) embraced the latest version of the proposal.
Sanders is proposing not simply to expand eligibility for Medicare coverage but to transform that program. After a four-year phase-in, he would prohibit individuals from receiving competing coverage from private insurers and eliminate every sort of cost-control mechanism, such as provider networks, claims reviews, and cost-sharing — with the sole exception of $200 out-of-pocket costs to discourage the use of branded drugs. Sanders would expand the benefit package to cover dental and vision care and expand immigrants’ eligibility for public assistance, eliminating the five-year residence requirement currently associated with federal welfare and health-care benefits and extending coverage to “every individual who is a resident of the United States.”
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Chris Pope is a senior fellow at the Manhattan Institute. Follow him on Twitter here.
This piece originally appeared in National Review