'Medicare for All' will never work, so let's stop pushing it

'Medicare for All' will never work, so let's stop pushing it
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Americans are fed up with skyrocketing health-care costs and it’s still one the most important issue among voters.

According to the Kaiser Family Foundation, health-care premiums for average employer-sponsored health plans —which cover most non-elderly Americans — have reached nearly $20,000 this year; a 55 percent increase since 2008. Average deductibles have also increased by more than 50 percent in just the past five years. 

Due to the increasing costs and frustration there has been increased support for "Medicare for All,” which up to 70 percent of Americans now back. Two-thirds of Democrats in the House have co-signed the “Medicare for All” Act, including Sens. Cory BookerCory Anthony BookerOVERNIGHT ENERGY: EPA rule extends life of toxic coal ash ponds | Flint class action suit against Mich. officials can proceed, court rules | Senate Democrats introduce environmental justice bill Senate Democrats introduce environmental justice bill Overnight Defense: Guardsman to testify Lafayette Square clearing was 'unprovoked escalation' | Dems push for controversial Pentagon nominee to withdraw | Watchdog says Pentagon not considering climate change risks to contractors MORE (D-N.J.), Kamala HarrisKamala Devi HarrisThe 'pitcher of warm spit' — Veepstakes and the fate of Mike Pence Crump, attorney for George Floyd's family, endorses Harris for Biden VP pick Davis: My recommendation for vice president on Biden ticket MORE (D-Calif.), Elizabeth WarrenElizabeth Warren4 reasons why Trump can't be written off — yet Here are top contenders to be Biden's VP Kamala Harris to young Black women at conference: 'I want you to be ambitious' MORE (D-Mass.), Kirsten GillibrandKirsten GillibrandOvernight Defense: Guardsman to testify Lafayette Square clearing was 'unprovoked escalation' | Dems push for controversial Pentagon nominee to withdraw | Watchdog says Pentagon not considering climate change risks to contractors Democrats urge controversial Pentagon policy nominee to withdraw Desiree Tims outraises longtime GOP Rep. Michael Turner by more than 0K in second quarter MORE (D-N.Y.) and Bernie SandersBernie SandersGOP lawmaker: Democratic Party 'used to be more moderate' 4 reasons why Trump can't be written off — yet Progressives lost the battle for the Democratic Party's soul MORE (I-Vt.) are vocal supporters.


Clearly this policy proposal has momentum, but is it workable and it right? 

“Medicare for All” would dismantle the existing Medicare system for seniors and create a whole new bureaucracy that would nationalize American health care. Not only would the bill payoff the "clerical, administrative and billing personnel in insurance companies, doctors offices, hospitals, nursing facilities and other facilities whose jobs are eliminated due to reduced administration" but also it would create a new national bureaucratic apparatus.

This includes appointing a national director with multiple sub-directors, new regional, state and national bureaucracies and federal board that, among other duties, would define best practices, staffing and salaries. Health-care quality, technology and "design and scope of work in the health workplace" would be determined by the government.  

Increased bureaucratization and centralization would reduce health-care quality, as we have seen with the Department of Veterans Affairs. This is especially true in the existing Medicare system, into which seniors have paid their whole lives, as it becomes diluted by suddenly being made available to everyone. Today's Medicare program already faces significant challenges as a result of an aging workforce, problems which would be magnified under a "Medicare for All" system

Already, the increased bureaucratization of health care in recent years has led to nearly half of American doctors considering retirement or a career change. This Dr.-exit would only be hastened by a full-scale government takeover of medicine and the resulting wage controls and regulations on doctors. 

Then there's the trust issue. "Medicare for All" outlaws private insurance, which was made mandatory, under penalty of fine, by ObamaCare in 2014. Such an about-face should raise the suspicions of anyone remotely concerned about government power and individual liberty.

According to an estimate by the Mercatus Center, "Medicare for All" would cost $32.6 trillion over its first 10 years. Even doubling corporate and individual income taxes wouldn't be enough to fund it. And keep in mind that health-care cost projections are notoriously low

For these reasons, Medicare for all legislation has failed wherever it's been tried, including recently in Vermont, Colorado and California. For instance, in Vermont, "Green Mountain Care," passed in 2011. It would have doubled the size of the state budget, necessitating payroll tax increases of 11.5 percentage points and income tax increases of up to nine percentage points.

If Medicare for all can't work in Vermont, one of the wealthiest, healthiest and smallest states in the union, it can't work nationally. 

There is a better alternative to cut health-care costs. Policymakers must take a scythe to the labyrinthine bureaucracy that is holding back health care, while at the same time pursuing transparency reforms that would allow the system to work more productively and efficiently. 

Consider: The number of health-care administrators — many drawing salaries well into the six figures — has risen by 3,200 percent between 1975 and 2010. (The number of physicians grew by 150 percent over the same timeframe.) This bureaucratic bloat diverts precious resources away from treating patients and inflates the cost of care. Reversing this administrative growth to all but the most critical positions could allow for a dollar-for-dollar offset in health-care costs. 

Meanwhile, the clerical burden on doctors continues to grow. Doctors now report spending two-thirds of their time on paperwork. If this administrative burden could even be halved, doctors would have twice as much time to see patients, making the system far more productive and cheaper as a result. 

Simple transparency reforms such as the widespread publication of prices for health services from X-Rays to blood-work would also bring down prices because it would encourage competition, economization and more efficient resource allocation.

The best part? These reforms are easy to understand, bipartisan and can be implemented without the disruption associated with wide-scale health-care reform. 
We just need the political will. For that, voters must educate themselves on the real issues holding back American health care while ignoring the siren song of single-payer. 

Dr. Marion Mass M.D. is a pediatrician and co-founder of Practicing Physicians of America.