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Prepare for buyers' remorse when Biden/Harris nationalize health care
Assuming we have a Biden/Harris administration in 2021, U.S. health care policy will take a hard turn to the left, all the way to nationalization. Americans should prepare themselves for buyers' remorse.
To those who might stop reading here, note the following: Every change in health care described herein was publicly asserted verbally or in writing by prominent Democrats.
Various names have been used to describe Democrat plans for health care: socialized medicine, single-payer, universal health care, and "Medicare for All." The most accurate descriptor is nationalization: the transfer of a major branch of industry or commerce from private ownership to federal control.
Nationalization of health care will involve some combination of the Biden health care plan with Bernie Sanders' single-payer Medicare for All. Vice-President-elect Kamala Harris strongly supports Medicare for All as detailed in H.R. 1384, a February 2019 bill that was never brought to a vote in Congress.
While there are some technical differences between the two plans, there are numerous common elements. The over-arching theme is the federal choice replacing individual or patient choice. The very first word of the Biden plan sets a tone for Americans' dependence on Washington: the federal government "Give[s]..."
Despite Biden's campaign promises to the contrary, private health insurance policies will cease to be available. Section 202 of Medicare for All prohibits private insurance by law. The Biden plan would create a public option which is a taxpayer-supported government insurance company. By low-balling prices, Washington will drive private insurance companies out of the market. Either way, Americans will have only one insurance option - what the federal government decides for us.
Biden health care will control all state Medicaid programs in direct contravention of Section 1801 of the Medicaid law, titled, "Prohibition against any federal interference." In those states that chose not to expand Medicaid under the ACA, Biden would expand Medicaid by giving free government-provided health insurance at no charge to the recipient but, of course, paid by taxpayers.
Section 614(b) of the Medicare for All bill decries capitalism and the profit motive as the reasons for health care system failure. Capitalism and freedom were the key factors that allowed 13 small colonies to become the world's superpower. The profit motive drives innovation, producing the medical miracles we now enjoy such as cancer cures, laparoscopic procedures, and non-surgical heart repairs.
Nationalization includes strict price and wage controls. Payments to providers and to drug companies will be reduced by a "national health budget," which is central economic control as was used in the Soviet Union and is now in effect in Venezuela The effects of wage and price controls are proven beyond doubt: shortages, low quality, insufficient quantity, and high cost.
Professor Blahous of Mercatus Center reported that nationalization will reduce payments to physicians by at least 40 percent. This will inevitably worsen the doctor shortage and lengthen wait times. Before the ACA, the maximum wait time to see a primary care physician was an unacceptable 99 days. After the implementation of ObamaCare, the maximum wait time increased to an unconscionable 176 days. With nationalization, the wait time could become years, not months.
Inordinately long wait times for care give rise to death-by-queueing. People will succumb to treatable illnesses while waiting in line for medically possible care that is not made available in time to save lives. Such death-by-queueing has been documented in Great Britain's vaunted National Health Service as well as our own VA system where "47,000 veterans may have died" waiting for care. This tragedy is coming soon to average Americans when Democrats nationalize health care.
With price and wage controls along with Biden's promise to "tackle market concentration," there will be no free market forces in health care. His promise that Medicare will negotiate lower drug prices calls to mind the image of a B-52 bomber "negotiating" with a foot soldier, rifle in hand.
Cost estimates of nationalization are $32.6 trillion to more than $40 trillion, the latter projection by Bernie Sanders himself. For perspective, the total GDP of planet earth is $86 trillion. To raise that kind of money, taxes will more than double, particularly for middle-class Americans.
Biden has assured us that only those making more than $400,000 a year would see higher taxes. This is blatant nonsense. Every politician knows the Willie Sutton Rule. When asked why he robbed banks, Sutton replied, "Because that's where the money is." Though the hyper-rich make nice targets for class warfare rhetoric, they are too few to generate trillions of dollars necessary for Democrats' health care plans. Such amounts of tax revenue can only come from the middle class.
One of the more egregious promises made about nationalization is the guarantee that government administration of health care will be simple, easy-to-use, and will save money. For starters, look at an organizational chart of the ACA - it's more complex than a roadmap of the Los Angeles freeway system. Then add all the new federal rules, agencies, and bureaucrats that come with nationalization. Such a massive, complex bureaucracy costs boatloads of money, trillions as noted above. The ultimate oxymoron is a user-friendly, inexpensive federal health care bureaucracy.
Democrats' promise of affordable care will suffer the same fate as their promise of $2500 in savings with ObamaCare. Care will be affordable, in fact, no charge, at point of service, but it will be quite unaffordable when the tax bill comes due: more than double what we pay now. The price tag for Democrats' nationalization, $40 trillion, will bankrupt our nation. Even with this massive expenditure, Americans won't get care in time to save us.
In December 2009, author Daniel Putkowski released a novel describing what medical care would be like for average Americans if U.S. health care were nationalized. In his book, a desperate father had to resort to black-market medical care to save his son who had a heart condition. The book's title, "Universal Coverage," was subsequently used as the Section 102 header in the Medicare for All bill. For patients, doctors, and our nation as a whole, it is terrifying to think that Putkowski's fictional dystopia may soon become our day-to-day fact.
Nationalization of U.S. health care will produce a system we can't possibly afford, a system that will not provide the care we need, most certainly not when we need it.
Deane Waldman, M.D. MBA is Emeritus Professor of Pediatrics, Pathology, and Decision Science; former Director of Center for Healthcare Policy at Texas Public Policy Foundation; and author of multi-award-winning book, Curing the Cancer in U.S. health care: StatesCare and Market-Based Medicine.