Medicare for All

Senator and Progressive-Democratic Party Presidential candidate Bernie Sanders (I [sic], VT) has the canonical version of Medicare for All; the other Progressive-Democrat candidates have only slightly varied versions of it.  Here’s Sanders on his Next Big Idea for health care provision and health care coverage:

You will have a card which has Medicare on it, you’ll go to any doctor that you want, you’ll go to any hospital that you want.

Right.  Been there, done that.  Both claims were straight up lies then, too.  There is a major difference, though, between Sanders’ two lies and ex-President Barack Obama’s (D) two lies: Sanders would make private insurance illegal—both the selling and the possessing.  That, though, only potentiates the power of Sanders’ lies.

As The Wall Street Journal mentioned on the other side of the link,

The point of Medicare for All is to cut reimbursement rates to Medicare levels, which government can now set so low only because private commercial reimbursement rates are so much higher. Cutting reimbursement rates would “probably reduce the amount of care supplied and could also reduce the quality of care,” CBO says.

Not could—would.  Reducing availability cannot help but reduce quality, if only from denying it altogether to many who need it or would merely benefit from it.  But that’s not the only pathway: that reduction in availability will flow, at least in large part, from that reduction in reimbursement rates.  As a result of that, those doctors and hospitals whose talents and skills warrant higher pay will limit their practices to the bare minimum.

That’s not out of personal greed, either: costs of care delivery go up markedly as the number of patients go up.  Absent meeting costs with fees charged, these providers would have no choice but to limit their costs by limiting their services and the numbers of potential patients served.

There’s another cost path, too: the more complex or difficult, or even merely rare, a medical problem, the more expensive it is to provide services for dealing with it.  Capped reimbursements will limit the availability of that care. And—lower reimbursement rates again—lower the quality of those providers willing to provide the care.

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