Sen. Bernie Sanders (I-VT) has stated that he will be unveiling a “Medicare for All” bill soon.
“We’re tweaking the final points of the bill and we’re figuring out how we can mount a national campaign to bring people together,” the crazed socialist told CNN’s Jake Tapper on Sunday.
The problem with such a proposal is that Medicare is already on an unsustainable trajectory, so it follows that expanding it to cover everybody is unfeasible.
Here are five things you need to know about Medicare.
1. Medicare consists of four separate parts. They are as follows, via Mark Levin’s Plunder and Deceit:
- Part A: Hospital Insurance.
- Part B: Medical Insurance.
- Medicare Advantage: People can use a lump-sum subsidy toward private insurance.
- Part D: Prescription drugs.
Michael Tanner notes that each part of Medicare has “its own funding mechanism, cost-sharing requirements, and other rules” that “can’t help leading to bureaucratic confusion.”
2. Medicare’s bureaucracy distorts the market. According to Levin, Medicare assigns costs to various procedures based on a system known as the Resource-Based Relative Value Scale (RBRVS) based on recommendations from a small number of members from the American Medical Association (AMA) every year. Around 80% of private insurers use the RBRVS’s system in determining how they distribute payments.
When adding the RBRVS to the 68,000 medical codes that are included in Medicare’s billing process, the entitlement program has an adverse ripple effect on the entire health care sector. Levin explains:
The retail price for a loaf of bread is different in New York than it is for Alabama. There are differences in price for a loaf of bread between towns and cities in the same state – such as Brooklyn, New York, and Utica, New York. The reason is there are untold factors relating to resources, allocation, labor, administration, and so on, which go into the cost of planting, harvest, transporting, processing, baking, packaging, labeling, and transporting again a loaf of bread, as with any product. There are also countless regulations and taxes at every level of the process, from beginning to end, and they differ from jurisdiction to jurisdiction.
Imagine the disorder and dislocation, including cost increases, supply shortages, and instability, if the federal government were in charge of supervising the production and delivery of a loaf of bread. It has been tried by many totalitarian regimes with terrible consequences. Yet the health-care system, which the federal government increasingly monopolizes, is far more complicated and intricate than the numerous processes involved in putting bread on the family table.
3. Medicare faces $58 trillion in unfunded liabilities. It’s not hard to see why once you see that “the average two-earner couple pays about $150,000 over their lifetime in Medicare taxes and premiums, while collecting almost $450,000 in benefits,” according to Tanner. As great as that may sound, it’s not a sustainable model, which is why Medicare Part A is projected to go bankrupt by 2030.
4. There is no evidence to indicate that Medicare has resulted in a higher quality of care. Via Tanner: (emphasis bolded)
It is not as if this tide of red ink is buying us the highest possible quality of health care. For example, in 20 years of intensive research, the Dartmouth Atlas Project, which uses Medicare data to examine the relationship between expenditures and outcomes, has found that death rates and other outcomes are no worse in areas with low Medicare spending than they are in areas with the highest per-patient costs. The Atlas researchers estimated that as much as 30 percent of Medicare spending provided little or no benefit.
Another study, published in the Journal of the American Medical Association, found that for 16 of 40 standard indicators, Medicare patients received recommended care less than two-thirds of the time. Other studies have shown that Medicare patients receive a lower quality of care than do similar patients with private insurance. And a study in the Journal of Health Services Research found that “Medicare coverage at age 65 for the previously uninsured is not linked to improvements in overall health status.” Similarly, a study by Amy Finkelstein and Robin McKnight for the National Bureau of Economic Research found that Medicare has had little effect on mortality rates among the elderly.
In other words, trillions of dollars spent and a maze of bureaucracy have not resulted in a better quality of care. A simple cost-benefit analysis shows that Medicare is not a program that can be sustained, let alone expanded.
5. The Independent Payment Advisory Board (IPAB) will eventually become a tool to ration Medicare. IPAB was spawned from Obamacare and will consist of 15 appointed bureaucrats – who each serve six-year terms and can only be re-appointed once – who will provide recommendations on maintaining caps on Medicare’s per capita spending. What’s particularly chilling about this is that IPAB’s proposals become unalterable law unless Congress passes alternative legislation that the president signs into law.
If Sanders’ Medicare for All proposal becomes a reality, then Medicare’s financial woes will only accelerate and then IPAB suddenly becomes the most powerful bureaucratic board in the country. Rationing always occurs in single-payer health care systems and IPAB will be the Left’s way to do it under Medicare for All.