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What is Medicare for All?

What is Medicare for All?

Democrat candidates for President all support Medicare for All. Although many details are not determined, the Democrat Bill H.R.676 introduced into the House outlines the bill’s basic provisions Democrat presidential candidates are proposing. This article reviews some of Medicare for All’s basic provisions. It is important to note that Medicare for All is not Medicare. In fact, it is a single payer or socialist medicine law that would replace Medicare, Medicaid, Tricare, and CHIPs.

The bill would cover all residents, leaving it up to the Secretary of Health and Human Services to determine how to define residency. As we know, residents and citizens are not the same, so it would appear to cover both legal and illegal residents. Bypassing border security and living here illegally would most likely give someone the right to free healthcare in our country, as it currently does in several states, including California and New York. In fact, money paid by seniors for years to be eligible for Medicare along with all money allocated to Tricare, a system that supports active duty and military retirees, would be channeled toward providing free comprehensive healthcare to those who enter our nation in violation of the law.

Medicare for All would cover all medically necessary procedures, including basic healthcare, mental health, prescription drugs, long-term care, dental care, eye care, hearing, and home health. It would abolish the health insurance industry, not allowing them to sell insurance for anything that was covered under the Act. It would allow physicians to opt out of the Act and accept patients for cash only (however, if they wanted to have hospital rights they would need to opt-in to the Act).

The question arises, what is a necessary medical procedure? Apparently, abortion-on-demand for any reason is a medically necessary procedure, as are cosmetic sex change operations. It appears the definition of medically necessary will be quite broad, but again many details would probably be left up to the Secretary.

Medicare for All would require hospitals, nursing homes, assisted living facilities, home healthcare providers, and other institutions to become public, non-profit entities. It would also eliminate all insurance relating to long-term care. For those that have been prudently planning for their futures by paying for long-term care insurance, that investment would be lost: your insurance and insurance carrier would be eliminated. Patients would have the option of going to an over-crowded public facility or paying in cash for long-term care in a private facility, assuming that private long-term care facilities are still available when you decide you need one. It is interesting to note, that some versions of Medicare for All would not allow patients to privately contract with any medical provider for any services covered under the Act. While it is hard to believe that this restriction on freedom would pass constitutional muster for even Justice Roberts, all of that would be decided in the future by the Courts.

Physicians would be paid standard rates or perhaps a salary. The details are fuzzy, but if doctors were paid at Medicare rates and there was no private insurance, studies have shown that doctors would take a 20% to 30% cut in pay. Today about 22,000 physicians refuse to take Medicare patients and many others limit the number of Medicare patients they will accept. These doctors cite below cost reimbursement by Medicare, inordinate amount of required paperwork, and excessive government intrusion as reasons for refusing to take Medicare patients. There can be little doubt that Medicare for All would cause a large exodus of medical professionals from the medical field. An even greater cost would be the loss of incentive for bright young professionals to enter the medical field. If later, the country decided to reverse these crazy provisions, it would still be difficult to restore our current healthcare system. Research into new medical procedures and drugs would be greatly curtailed since there would be no way to recoup the cost and liability of creating and testing them. Many local medical facilities would close their doors, and these buildings would be repurposed. It would take at least a generation to get back to the readily available medical care we take for granted today.

Medicare for All would prohibit any type of cost sharing. Therefore, it will cost “nothing” to get medical care. This, combined with loosened rules as to what is medically necessary and who is a resident, will no doubt cause a large influx of “patients” into our healthcare system. So as new patients flock to our country and medical professionals exit the field, we can expect longer and longer wait times for even the most basic procedures in the future.

It is hard to imagine what Medicare for All might do to our economy. It would restructure 1/5th of our economy causing massive layoffs as many companies are forced out of business. Although we do not know how much Medicare for All would cost, we do know that in their current form, Social Security and Medicare are projected to run a staggering $82 trillion cash deficit over the next 30 years. Medicare for All would make these deficits seem inconsequential in comparison. Even the most optimistic Medicare for All proponents admit there will be large layoffs and tax increases. They propose increasing income taxes, taxing investments, taxing savings, and instituting a per-person excise tax (but probably not for immigrants; citizens would pick up this tax burden).

So the stakes are high for the 2020 elections. If we allow socialists to gain control of our country, our healthcare system could be in for a very rough ride.

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