I write about Politics and Current Events. Anything and everything economic, foreign policy, etc. will be covered.
Why do we need a medicare for all?
In order to truly weigh the options, we must know the alternative. In the status quo, roughly 30 million people have no access to healthcare. These are the people who fall through the gaps in our flawed system. Additionally, there are around 45 million Americans with subpar coverage. And even those with coverage feel the impacts of our disastrous healthcare system. Many Americans are hit with surprise costs due to gaps in their coverage. As senator Sanders puts it himself, 77 million Americans struggle with medical debt and medical expensiveness. In fact, 2/3 of all bankruptcies are a result of medical debt. It's fairly clear that change is needed and according to Sanders, that change is his new bill.
What would a Medicare for all option look like?
Let's take a look at one of the more recent bills proposed by senator Bernie Sanders. This bill eliminates all private options and enacts a new public option. This public option would be absolutely free to the consumer. No hidden fees, copay's etc. The biggest drawback to this bill is the cost. Experts estimate the total cost could come up to $40 trillion over ten years. This amount of spending is unprecedented in human history. So how would we pay for it.
How will we pay for it?
$4 trillion every year is an insane amount of money. It would more than double the current government spending. So how does Bernie plan to pay for this? There's three main ways that you can pay for this plan.
- Deficit spending. If you read my previous article then this will be pretty easy to grasp. Essentially, the government releases bonds which investors then buy. There are some people who say that deficit spending can go on infinitely because everyone will always have confidence in the US. Others say that the more bonds the US releases the worse things will be because it detracts investors from the economy. For the sake of simplicity, we aren't going to get into that in this article.
- Taxes: This is the system that is most favorable for Bernie. He's constantly told his supporters that he will tax the rich and redistribute the money to the poor. This system looks very appealing in theory, however in practice its not so pretty. Take France as an example. France implemented a similar system and taxed the rich. As a result, at least 42,000 millionaires left the country, taking 200 billion euros in assets with them. This is why you may have heard people like Reagan say that to increase tax revenues, decrease taxes. While it seems counter intuitive, sometimes it works. When taxes are lower, there is less capital flight and loophole utilization. While Sanders plan for taxes may seem appealing, it likely won't work.
- Cutting spending elsewhere: This one is pretty simple. Take a dollar from the military and put it into Medicare for all. The drawbacks however are that it can't produce that much money. You'd be lucky to wrangle more than 150-200 billion dollars using this method.
The best way to pay for it as a mixture of the three. For the sake of this article, lets just say you pay for 2.5 trillion through deficit spending, 1 trillion through taxes, and by some miracle you find 500 billion elsewhere.
Howard Gleckman explains the lack of financing
"But there is a problem: If the Urban estimates are correct, the two tax increases combined would cover only about one-quarter of the cost of a full-blown Medicare for All plan."
— Howard Gleckman
What are the Pros and Cons?
So you have the funding for Medicare for All, now you have the big red button on your desk that, once pressed, will switch all of the US to Medicare for All. Do you press it? The answer isn't black and white. Like with most things in life, we are going to have to weigh the pros and cons to come up with an answer. So what are the pros and cons?
- Everybody has access to healthcare
- No more Medical Debt
- Other items that weren't discussed in this article (Opioid crisis, rural hospitals etc.)
- Capital Flight
- Other items that weren't discussed in this article (Wait times, collapse of health insurance sector, etc.)
There are millions of arguments on either side but for the sake of simplicity once again we will only be talking about the four arguments discussed in this article.
Cost of the plan (Government side)
Solutions to the Opioid Crisis
Collapse of private healthcare
Cost of Treatment (consumer side)
Weighing the Pros and Cons
So lets see how they stack up. A simple way to do this is to use a "point system" we will pit one argument against another. If we are stuck at 1 "point" for each side we will go to a tie breaker where we weigh the "winners." Please keep in mind that this is where it comes down to opinion. I will try to keep my bias out it but it is nearly impossible to have unbiased journalism. Additionally, the side that we choose might not end up being the best side. This is because are only weighing four arguments. With those disclaimers out of the way, lets set up our battles.
The first point contest is between the cost of the plan for the government and the increase in access. If you look at it head-on, the winner is clear. Human lives matter more than money. However, if the government can't fully fund Medicare for All, there will be gaps in coverage. Either less people will get access, possibly even less than before, or people will get even lower quality care. Because being able to fund the plan is a prerequisite to the plan being successful, I'm giving one "point" to the cons.
The second point of contest is in capital flight and cost of treatment. Capital flight has no real effect on the quality of care. It will hurt the economy but ultimately, the poverty line will not be effected that much for a couple reasons. Firstly, the amount that capital flight effects the poor is extremely low. These assets that are leaving were never really circulating in the economy therefore it will have little effect. Secondly, the benefit of lower cost of treatment counteracts the capital flight. I'm going to have to give 1 point to the pros.
The tiebreaker. This is where it could go either way. While some of you reading this may disagree I think that the funding of the plan is necessary to ensuring that the cost of treatment stays at 0 for the consumers. Because of the lack of funding, it is entirely possible that Sanders won't live up to his promise of 0 cost on the consumer side. And if he does, quality of care will be so low that it won't be worth it. I must give the final point to the cons.
Sanders plan may look good, but there are many drawbacks that can prevent the plan from being successful. There are many point that weren't discussed in this article but that should definitely be taken into account. Namely, the opioid crisis and rural hospital collapse. While we decided not to pass Medicare for All in this article, we didn't weigh all of the pros and all of the cons. Your opinion might be different then the conclusion reached in this article. That's fine. I strongly urge you to research all of the pros and cons before making an opinion. Medicare for All is a complex topic and it ultimately comes down to how much you think the economy controls the quality of healthcare.