Why Some Groups Want to Kill Medicare for All

March 28, 2019

While the Democratic House and Democratic presidential candidates tout Medicare for All, opposing forces are also at work.

While the Democratic House and Democratic presidential candidates tout "Medicare for All," opposing forces are also at work.

The Partnership for America’s Health Care Future (PAHCF), is one example. PAHCF is a coalition of some of the nation’s leading clinicians, hospitals, health insurance providers, and biopharmaceutical researchers and manufacturers who are partnering to improve upon what’s working in healthcare and fix what’s not. 

“For millions of Americans, our current healthcare system is working, even though more can and should be done to improve it,” says Lauren Crawford Shaver, executive director, PAHCF. “Today, market-based coverage such as employer-provided care is working together with public programs to extend quality healthcare coverage to more Americans than ever before; in fact, more than 90% of Americans are covered. Furthermore, today’s patients have stronger protections. For example, people with preexisting conditions are protected under the ACA and young adults can stay on their parents’ health plans until age 26.”

Eight in 10 Americans surveyed by Gallup in December rated their care as either “good” or “excellent.”

To improve upon the current healthcare system, Crawford recommends working within the existing system to lower costs and extend coverage to millions of more Americans by expanding coverage at the state level through Medicaid, by expanding federal subsidies so more people at all income levels can afford insurance, and by using tools such as reinsurance to stabilize premiums.

“Medicare for All means eliminating the employer-provided and other market-based coverage millions depend on, causing disruptions to patients’ care and forcing every American into a one-size-fits-all plan run by Washington,” Crawford says. “The costs would be enormous.”

Two independent analyses predict a $32 trillion cost over 10 years, and the Committee for a Responsible Federal Budget found that paying for it would mean increasing federal spending by 60% and require the equivalent of tripling payroll taxes or more than doubling all other taxes.

Related: Medicare for All: Four Things Health Executives Should Know

According to Jeff Cohen, executive vice president of public affairs for the Federation of American Hospitals, a member of PAHCF, “We believe in improving the current system. Disrupting private health insurance and eliminating the popular employer-based health insurance system, which more than 180 million Americans rely on, isn’t the answer.”

Marilyn M. Singleton, MD, JD, president, Association of American Physicians and Surgeons, whose organization supports killing Medicare for all but is not a member of PAHCF, says, “The current Medicare for All bills prohibit duplicative private insurance. Patients wouldn’t have any choice in how they want to receive their medical care. The two-tiered healthcare system that the bills purport to avoid will be created. Only the wealthy will be able to afford to pay out of pocket for quality care with no rationing of services and harmful wait times for basic procedures. Even western countries with government-sponsored programs allow parallel private insurance. Canada and Cuba are the two exceptions.”

Singleton maintains that a vibrant, competitive market could develop rapidly if permitted. “Rather than try to control our medical care, the government must do everything it can to remove barriers to competition and to improve transparency,” she says. “Optimal prices, which bring supply and demand into balance, can only be determined by voluntary interactions between buyers and sellers.”

Some of the needed conditions to bring choice and competition to delivery of America’s medical care, according to Singleton, are:

  • Honest pricing. All medical facilities should be encouraged to post their prices.

  • Honesty in reimbursement. Patients should demand access to information about what insurers reimburse for specific procedures before buying a policy and before undergoing elective procedures.

  • Tax fairness. Individually owned policies should receive the same tax treatment as employer-owned policies-including exclusion from payroll tax.

  • Repeal of insurance mandates that require everyone to pay for costly coverage they don’t need or want.

Karen Appold is a medical writer in Lehigh Valley, Pennsylvania.