Prior to her sudden silence after becoming the Democrat presidential nominee, Kamala Harris had been an eager, full-throated supporter of single-payer medicine like the Bernie Sanders-Pramila Jayapal Medicare for All Act of 2023. This would put the federal government in complete control of all aspects of health care: financing, staffing and credentialling, and all medical decisions.
Presumably, if Harris attained the presidency, she would “do whatever it takes,” just as Barack Obama did with the (un)-Affordable Care Act (ACA), to pass her version of Medicare for All. Preserving just one payer for health care is the best choice. That should be the patient, not the federal government.
Although the specifics of Medicare for All are variable and complex, the major elements are straightforward. D.C. promises to deliver cradle-to-grave medical care at a cost of $32.6 to $40 trillion over a 10-year period. The higher figure is according to Sanders.
For perspective, consider the following amounts. The ACA cost $1.76 trillion. The U.S. expended $4.8 trillion on medical care in 2023 when the U.S. gross domestic product was $27.3 trillion. In 2023, the combined GDP of all nations was $105 trillion. Harris would spend nearly half the productivity of planet Earth on her single-payer health care.
Medicare for All would abolish all public and private insurance plans, except Indian Health Service and Tricare, replacing them with a single federal plan. A national health budget would dictate payments for both services and goods. Patients would pay nothing directly but a massive amount indirectly, as Medicare for All would be funded by taxes. Given the cost of Medicare for All, the tax burden could easily double for Americans. In Sweden, a cradle-to-grave socialist economy, the top tax rate is 52.2 percent.
The 2023 Medicare for All plan would cover most Americans. Harris intends to add approximately 11 million illegal entrants, at least initially. The Medicare for All bureaucracy would determine what care individuals get, when, by whom, where, and even if. Medical autonomy, the freedom to choose one’s care, would be nullified, just as in the United Kingdom’s single-payer system.
The seesaw effect describes a decrease in the availability of medical services when the number of government-insured patients increases. This is due to the diversion of funds from paying for patient care to paying for insurance and bureaucracy. If all 333 million Americans were covered by Medicare for All, the maximum wait time for care is likely to increase dramatically from the present 122 days, to years!
With Medicare for All, Washington would credential and license care providers — and punish those deemed miscreant, or worse, spreaders of “disinformation.” Anyone who was involved in the censorship, canceling, and devastating mandates imposed during the Covid scam shudders at such anti-patient, anti-scientific federal tyranny.
From this physician’s perspective, it is also likely that Medicare for All would induce thousands of senior physicians to quit, making the current British “MD exodus” problem look trivial. That would also extend wait times into years, and result in not enough people to train future physicians.
Harris’ Medicare for All plan amounts to a centrally controlled economy — a market with no free-market forces. Without proper economic incentives, costs and spending rise without limit while service suffers, quality declines, and innovation ceases. Recall the wait lines in the U.S.S.R.’s centrally controlled economy.
At present, federal BARRCOME — bureaucracy, administration, rules, regulations, compliance, oversight, mandates, and enforcement — consumes 31 percent to more than 50 percent of all U.S. medical spending. The money to pay for BARRCOME is taken from money for care, just as Obama took $716 billion from the Medicare trust fund to pay for the Affordable Care Act.
With Medicare for All, the volume of BARRCOME is certain to increase exponentially, leaving even less money to pay nurses and doctors for patient care. That is the Medicare for All world Harris wants for America: no care providers, no money for care, death-by-queue, and bankruptcy for the nation.
Having only one payer for health care (the service) is the right idea; but it only works when the patient, not the federal government, is the one who pays. Return control of health care spending to Americans. Let them shop for their care and watch how it becomes affordable when sellers (providers) compete for patients’ dollars.
Give employees the money employers currently pay to insurance companies. After all, it is the employees’ money! Remove restrictions on health savings accounts, and let people put their health care dollars into an unlimited family HSA. Repeal regulations that dictate what policies insurance companies can sell. Revive catastrophic coverage for events that cost more than most individuals can afford, like cancer and bad car accidents.
Let the free market function. For the small number of medically vulnerable Americans, states can create more efficient and effective safety nets than Washington’s one-size-fits-all Medicaid.
If the single-payer were the patient instead of Washington, Americans would gain timely, compassionate, affordable health care. Spending on health care would decrease, possibly by half! Spending would become dollar efficient instead of wasting precious dollars on unnecessary BARRCOME. Individual freedom — medical autonomy — would be restored. The only losers would be federal politicians and sycophant bureaucrats.
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