… And Medicare For All

by Chris Campion

Bernie Sanders, “independent” Senator who’s not from Vermont but owns two houses there, has recently found the time in his busy schedule to suggest yet another unworkable, ill-conceived, and destructive way to increase federal power and reduce the choices people can make.  Whoops.  I meant “Give everyone something for free, again, without figuring out how in the hell to pay for it”.

Bernie even conveniently slaps a group of meaningless statements on the splash page of his shiny, new, taxpayer-funded website, where such complex ideas as payer mix and 4,000 pages of the tax code are easily, casually batted aside in favor of putting words up on the internet and hoping they mean something when he tries to run for President again in 2020.

Which really means he hopes they’ll buy him some votes.  But I repeat myself.

Bernie’s solution to a multi-trillion dollar health care problem is…more cowbell!  In the form of more (not less) Medicare!

But wait.  I thought Medicare had unfunded liabilities in the trillions of dollars ($28-35 trillion, but what’s ten or twenty trillion amongst friends?).  Why would a sitting (mostly sitting, but frequently kvetching) US Senator want to run up the credit card on US taxpayers, and worse, run it up on taxpayers who aren’t even born yet?

Let’s let some of Bernie’s ideas speak for themselves – these ideas should guide our thinking, and convince us that he’s got the best idea ever, right?  Here’s one:

“We must ensure all Americans can access the health care they need regardless of their income.”

It’s great to have someone who can afford 3 houses keep the little people of America in mind while he’s posting insipid graphics on a taxpayer-funded website.  But, to address his statement:  Everyone already has access to health care.

I’ll repeat it:  Everyone already has access to health care.

What they don’t have is a government-issued insurance card, which does not guarantee access to health care, or hire or train one more doctor, nurse, or anesthesiologist.

So the issuance of a new “Medicare For Everyone!” insurance card won’t increase access for anyone.  Anywhere.  In fact, given the reality that many providers won’t take Medicare patients, because this version of single-payer does not reimburse providers at cost, it will likely mean even fewer people will have access to health care, which really means access to a provider.

Health care spending is “running away” for a host of reasons, very, very little of which has to do with waste.  The rate of private insurance price increases has everything to do with the cost-shift from Medicare (and Medicaid) to private insurers, which results in even less access to care.  From the link:

“We must get our runaway health care spending under control by eliminating waste and focusing on our patients.”

Once again, each round of Medicare cost shifting to non-Medicare patients routinely shows up in higher insurance premium costs for younger workers and their families, who are already paying the bulk of Medicare bills through their taxes. The level of Medicare cost shifting and the impact on private health insurance will vary from year to year, but these additional costs are in the tens of billions of dollars annually.

In sum, today Medicare imposes financial obligations on most taxpayers in three ways: (1) through their payroll taxes, (2) through their general revenue subsidies of Part B and Part D, and (3) through higher premium costs in their own private coverage to offset Medicare payment policies. For upper-income Americans, the new Medicare tax of 3.8 percent on their “unearned” income, such as stocks and bonds, is earmarked for funding the provisions of the PPACA, not Medicare.

Oh, and that Mayo Clinic picture, above, that Bernie uses on his website?  Here’s some revealing Medicare text directly from the Mayo Clinic:

“Although Mayo Clinic doesn’t participate with Medicare Part B, Medicare will help pay for services provided by Mayo Clinic. Claims will be filed to Medicare Part B and supplemental or secondary insurance companies on your behalf. Medicare Part B and supplemental or secondary insurance payments may be sent directly to you. Patients will be responsible for reimbursing Mayo Clinic for any payments they receive and any balances not covered by their insurance.”

In other words, Medicare doesn’t cover everything the patient is charged.  It’s not a free medical cost deflector shield.

But let’s have just one more bite at Bernie’s Medicare apple:

“Providing “Medicaid for All” would not change a millionaire or billionaire’s ability to pay for their own insurance, or handle out of pocket expenses.  Assuming, again, by this statement, that the system only works for rich people is hilarious on its face, if you’ve ever worked at a hospital.  Or been rational in your thinking.We need a system that works not just for millionaires and billionaires, but for all of us.”

And since Bernie seems to forget economic reality as part of his morning wake-up routine (after eating his taxpayer-funded breakfast), let’s remember that the richest people in the United States pay the vast majority of income taxes collected.  In fact, the top 10% of earners pay 70% of all income taxes collected.  And half the country pays no net income taxes, at all.  77.5 million households don’t pay any income tax.  Inevitably, Bernie will want to tap the incomes of the people he seems to hate the most, regardless of how much of a burden they already carry.

So what does Bernie really want?  More power, centralized, in the government, to be controlled by him and the rest of the clown show that thinks it’s qualified to make decisions on your behalf.  When the country drowns in debt and unfunded liabilities, and a recently failed presidential candidate thinks we should double down on that destructive debt strategy, then we clearly have put the wrong clowns in positions of power.

 

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