Blog | Thursday, August 1, 2019

Medicare for all is bad medicine for the country

Last week, I presented my discerning readers with arguments supporting Medicare for All. Here in Part II, I will offer a few rejoinders and caveats to those proposals.

Sen. Bernie Sanders deserves credit for advancing this issue into our national conversations. And, many of his 22 rivals who are angling for the Democratic nomination for president in 2020, have embraced the position in their collective leftward migration. Indeed, if this leftward drift persists, we may soon be regarding Comrade Bernie as a moderate!

First of all, the Medicare for All being proposed now should be renamed as it goes far beyond our current Medicare system. The New & Improved Medicare for All promises the following additional benefits which are not included in conventional Medicare.
• Vision coverage
• Dental coverage
• Hearing Aids
• Long Term Care
• Medical Care for Illegal Aliens
• Minimal cost sharing, meaning no copays or deductibles

I'm surprised that the generous proposed benefits do not include coverage for pets, plants and backyard animals. Doesn't an ailing rose bush deserve healing? Do you really want to be seen as campaigning against roses, lilacs and lilies? Do you want to be labeled as a puppy hater?

And, how do we pay for all this? The standard bromide is to tax the wealthy, but will there be enough left from the greedy 5% after they have funded the Green New Deal, Free College For All, Refinancing Student Debt and raising teacher salaries by $13,500? Incidentally, the European nations who have nationalized their health care provide fewer benefits to their populace than do our Medicare for All proponents, a fact that is omitted from the presidential candidates' stump speeches. The strategy is to promise everything, claim that we can afford it or may even save us money, and when the cold reality emerges years later, blame someone else.

Look, I agree that health care reform is necessary, overdue and very complicated. And, we all know how the dysfunctional process is tainted by dozens of well-heeled constituents who think of their own interests and not the greater good. Feel free to peruse my postings under the Health Care Reform Quality category on this blog for additional rants. I'm also skeptical that the Medicare for All crowd is focused on our interests rather than their own political interests. For many of them, the notion of taking down the corporate framework of our medical system dovetails perfectly with their anti-Wall Street mission. If Medicare for All is such great idea, then let's pilot it in a few regions of the country and let us measure the medical and financial outcomes. When we have a new medical treatment that we think might work, we study it on a small group for obvious reasons. We don't open it up to the entire country and hope for the best.

There may be a planet out there where every individual can enjoy every conceivable benefit at low cost, or better yet, at a cost borne by others. But, we live on planet Earth. Hopefully, the Medicare for All space travelers can return back home so we can have a more down to earth discussion on how to make progress.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.