Why "Medicare for All" Would Mean Quality Care for None

You can’t significantly cut costs without cutting quality.

In a CNN interview on January 28, Democratic presidential hopeful Kamala Harris came out in brazen support for Medicare-for-All, i.e. single-payer healthcare in the US.

Confronted with pushback from all those to the right of Bernie Sanders, she has since backpedaled, with an adviser saying “she would be open to more moderate reform plans.”

Nevertheless, the fact that a Democratic frontrunner unequivocally supported a government takeover of health insurance should be worrying to all Americans.

Like Your Insurance? Too Bad

Move on to what? To a government takeover that has proven ineffective and deadly all over the world?

After her jaw-dropping declaration, Harris was asked what she’d say to those Americans who like the insurance they have, which according to a recent poll, is 71 percent of employed Americans. Harris’s answer was, effectively, too bad.

“Let’s eliminate all that,” Harris said, speaking about private insurance and the hassle of getting approval for certain costly procedures. “Let’s move on.”

Move on to what? To a government takeover that has proven ineffective and deadly all over the world?

You Can’t Cut Costs without Cutting Quality

Democrats frequently point to the Nordic “success stories” as examples of how government-managed healthcare can save money. Little do they realize that these nations spend less on health care because they spend far more on social safety net services that help keep the poorest among them healthy.

You’d likely end up paying almost double as much as you currently do in taxes.

At the end of the day, the governments in Nordic countries spend far more per person, and in turn, their income taxes reach as high as 60 percent. In the US, even that level of taxation would not be enough. Bernie Sanders’s single-payer proposal would cost a whopping $33 trillion over its first 10 years, or about three-fourths of everything we already spend.

In other words, you’d likely end up paying almost double as much as you currently do in taxes (or we’ll just further run up the debt for our great-great-grandchildren).

Medicare-for-All proponents argue that this same estimate is actually $2 trillion less than what would be privately spent in those ten years. In other words, the doubled taxation would, for some, be offset by not having to buy health insurance.

But even these potential savings (of about 6 percent) open up a Pandora’s box of issues. For one thing, such a proposal would constitute taxation and redistribution the likes of which we haven’t seen since WWII, and such taxation is guaranteed to slow down and reverse the growth we’ve seen under President Trump.

You can’t significantly cut costs without cutting quality.

But moreover, as someone who’s worked in health care for years, I can assure you that, just like in any other field, you can’t significantly cut costs without cutting quality.

Sure, a certain proportion of resources goes toward regulations, which can be and should be made more efficient (though Obamacare—or ACA—has only made things worse, and anyone who’s been to the DMV knows our government isn’t a paragon of efficiency).

But the majority of our spending goes towards funding life-saving research and offering the best specialist services and procedures in the world. Cutting spending on drugs and procedures could reduce research spending by as much as to 40 percent.

Cutting salaries for doctors and hospitals could exacerbate the 100k physician shortage we already have, leading to wait-times like those in Canada or the UK. In Canada, Bernie Sanders’s “city upon a hill,” about 3 percent of the population is currently in line for some sort of medical procedure. The costs of single-payer are much higher than $33 trillion.

Insurance Isn’t the Same as Coverage

But Harris wasn’t done. Her main argument against private insurance was that some patients get denied coverage for certain procedures—an incredibly laughable justification considering how patients, under single-payer systems, are more likely to be denied coverage without any form of recourse.

In the UK, for instance, NICE decides whether a certain procedure is “worth the money.”

In the UK, for instance, the National Institute of Health and Clinical Excellence (NICE) decides whether a certain procedure is “worth the money.” The official policy is that if something that can prolong your life by six months costs more than 30,000 pounds, you’re out of luck.

Despite our similar lifestyles, people are more likely to die of cancer and heart disease in the UK. The likely culprit? Government rationing. When a certain life-saving heart stent tripled in price (from 300 to 900 pounds), NICE banned it altogether.

At least in the US, when your insurer denies you something expensive, you have the option to switch to a different insurer. In the UK, you’re stuck with whatever the government is willing to pay for, even if it costs you your life.

Trying to fix our current mess, wrought by too much government, with single-payer is like trying to put out a fire with gasoline.

Obama learned the hard way that giving all Americans health insurance is not the same as providing them with valuable health care. Under the ACA, as more sick people got insurance without a premium, rates skyrocketed and life expectancies fell. Trying to fix our current mess, wrought by too much government, with single-payer is like trying to put out a fire with gasoline.

Today, Kamala Harris no longer unequivocally supports single-payer, and with good reason. But when the election comes around next year, we mustn’t forget that Medicare-for-All was her original, knee-jerk answer.

Senator Harris will have to look deep into her heart to decide what she supports—if the government can afford her cardioscopy, that is.

For more on the drawbacks of government interference in healthcare and other sectors, read Adam’s new book Igniting Liberty.