"Medicare for All" Isn't Medicare at All

Medicare for All would eliminate private health insurance companies, kill jobs, and reduce patients' options.

It was only days ago that Democrats were lambasting the Trump administration for its perceived indifference to the plight of 800,000 federal workers temporarily going without pay. Yet there seems to be little concern about the long-term fate of the more than half a million Americans who work in the health insurance industry from Democrats who support “Medicare for All.”

U.S. Senator Kamala Harris launches her campaign for President of the United States at a rally in her hometown of Oakland, California, U.S., January 27, 2019. Reuters/Elijah Nouvelage.

During a CNN interview Monday, anchor Jake Tapper asked presidential candidate Kamala Harris whether people would be able to keep their private insurance, if they preferred, under her MfA plan. Harris breezily responded: “Let’s eliminate all of that. Let’s move on.” Now, maybe some of these folks would end up working for the government helping to administer the expanded Medicare program. Others, seeing the writing on the wall, might start transitioning to other work before such a plan was ever implemented. The rest? Well, that’s the way the labor market churns, I guess. Millions of Americans gain and lose jobs every month, as it should be in a dynamic economy.

But it’s certainly worth noting the trade-off and acknowledging that there would be costs as well as benefits. Granted, consideration about employment disruption in the health insurance sector probably wouldn’t change public opinion about MfA. That, even though healthcare jobs overall have been a massive driver in the recovery of the US labor market since the Great Recession.

But other issues might. For instance, most Americans support MfA by a healthy 56-42 percent margin, according to a recent Kaiser Family Foundation survey. They are less likely, however, to support the idea once they hear about trade-offs such as eliminating private health insurance companies (37-58 percent) and requiring most Americans to pay more in taxes (32-60 percent). (Such numbers are hardly surprising if you know that an overwhelming number of the 180 million Americans with private insurance—70 percent, according to Gallup—rate their coverage as “excellent” or “good.”)

And then consider what the average American thinks they hear about “Medicare for All.” They probably think everyone would get the same Medicare coverage currently going to their parents and grandparents. Not so. Despite the clever branding, the MfA plan that Harris has supported is actually a universal coverage plan that covers more services than Medicare while eliminating deductibles, co-insurance, and co-pays.

Once more Americans hear about MfA, they might start wondering how total healthcare spending would be the same or even less under such a regime.

Indeed, once more Americans hear about MfA, they might start wondering how total healthcare spending would be the same or even less under such a regime. As my AEI colleague Ben Ippolito notes in a recent blog post, such fiscal estimates assume Washington would require providers to accept Medicare payment rates for treating all patients—a 40 percent reduction from what privately-insured patients currently pay. That’s a big number, and the comforting “Medicare for All” name barely hints at the sizable economic and policy implications—such as, Ippolito notes, tasking a single federal agency with setting the correct price of any given medical service or procedure—that come with it.

This article was reprinted with permission from the American Enterprise Institute.