The Corner

Health Care

‘Medicare for All’ Is Really ‘Medicaid for All’

Senator Bernie Sanders speaks during an event to introduce the “Medicare for All Act of 2017” on Capitol Hill, September 13, 2017. (Yuri Gripas/Reuters)

The Delaware primary results notwithstanding, the hard-left flank of the Democratic party has been on the march, successfully toppling several so-called centrists. This means that single-payer health care — popularized as “Medicare for All” by Senator Bernie Sanders — is going to become a major issue in the coming election.

I hear conservatives using that term too. They should stop immediately! Not only is using the opposition’s lexicon a stupid political mistake, but a close look at Sanders’s bill (S-1804, “The Medicare for All Act of 2017”) shows that it has much more in common with Medicaid — the health-insurance welfare program for the poor — than it does Medicare so beloved by seniors:

  • Medicare is a much more limited program, mostly covering people age 65 and over. That’s about 15 percent of the population, or 44 million people. Sanders’s bill would cover all 330 million (or so) of us.
  • “Medicare for All” promises “free” health care, meaning no out-of-pocket costs for patients. Medicaid provides that benefit now. But Medicare doesn’t. Beneficiaries under Medicare are responsible for about 50 percent of their health-care bills.
  • Medicare allows a thriving private supplemental-insurance industry, which, of course, isn’t offered or required for those on Medicaid. In fact, if like me, you are of Medicare age, your mailboxes will soon be filled with advertisements for private-enterprise “medi-gap” insurance policies. Sanders’s bill would outlaw all private health insurance — including policies offered by employers, privately purchased, and even medi-gap plans.
  • Medicare, is expensive — $672.1 billion in 2016 — but that is nothing compared to “Medicare for All,” which is projected to cost $32 trillion in its first ten years! And note: Medicare is already scheduled to go broke in 2028.
  • It is worth noting that Medicaid is a mess, with many doctors refusing to participate due to low payment schedules. Beneficiaries often face lines and delays in treatment. Such difficulties will surely worsen if we are all forced into a one-size-fits-all government program.

Total government control of health-care insurance means total control of what will and will not be covered. Rationing — either by invidious discriminatory categories (such as age or “quality of life”), or long waits for care, is a hallmark of all socialized systems. We would be no exception.

Moreover, “Medicare for All” would exacerbate the country’s already bitter culture wars. For example, Sanders’s bill would require the government provide free abortions — killing the Hyde amendment — and destroy all existing federal medical-conscience protections, potentially driving many capable doctors out of medicine.

It would also provide free health care to illegal aliens. From Section 102 (my emphasis):

a) In General.—Every individual who is a resident of the United States is entitled to benefits for health care services under this Act. The Secretary shall promulgate a rule that provides criteria for determining residency for eligibility purposes under this Act.

(b) Treatment Of Other Individuals.—The Secretary may make eligible for benefits for health care services under this Act other individuals not described in subsection (a), and regulate the nature of eligibility of such individuals, while inhibiting travel and immigration to the United States for the sole purpose of obtaining health care services.

Note that the proposal does not refer to citizens or legal residents, but “every individual who is a resident of the United States.” That means illegal aliens would be entitled to full health-care coverage as soon as they established a residence here. Also note that the “sole purpose” clause of Part B is a meaningless restriction: If the illegal alien came here for work, or to be with family — as well as to obtain free health care — they would be eligible for benefits.

“Medicare for All” polls well, at least in part, because people have a positive view of the current Medicare program. Moreover, the details of the radical proposal have not been adequately exposed by its opponents.

That needs to change. “Medicaid for All” is more apt descriptor. It shouldn’t be hard to illustrate to voters that when it comes to this Utopian proposal, the devil really is in the details.


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