Sen. Bernie Sanders (I-VT) has an idiotic alternative to Obamacare: “Medicare for All.”
The wild-eyed socialist stated his intention to propose such a bill at a recent town hall, saying, “It is a common sense proposal, and I think once the American people understand it, we can go forward with it.”
Here are eight reasons why that proposal is foolish:
1. Medicare underpays doctors. Since 1999, the program has paid doctors about 80 percent of what private insurers pay, according to CNN Money:
Private insurers allow an average of $1,226 for low-back disc surgery, while Medicare will only permit $654, for instance.
And the gap can grow wider depending on where the patient is. In New York, insurers allow $1,352 for a gall bladder removal, compared to $580 for Medicare.
Some services are more comparable. For office visits by established patients, for instance, Medicare will allow 92% of what insurers do.
According to The Wall Street Journal, Medicare’s low reimbursement rates have resulted in some doctors being compelled “to see 30 or more patients a day to make ends meet.”
The reason for Medicare’s underpayment is that the program uses a centralized point system to assign values to various services, creating reimbursement rates that are below market value and forcing doctors to raise costs elsewhere to make up the difference.
2. Doctors and hospitals using Medicare must abide by a complex web of codes. According to Mark Levin’s book, Plunder and Deceit: Big Government’s Exploitation of Young People and the Future, rampant “administrative minutiae” bogs down doctors, such as “one code for suturing an artery will become 195 codes, designating every single artery, among other variables.”
3. Medicare is particularly vulnerable to fraud. Levin notes that a 2014 Government Accountability Office (GAO) report declared that Medicare has been “a high-risk program since 1990” due to “the program’s size and complexity,” although the exact amount is “unknown.” A 2013 GAO report concluded that there were nearly $50 billion in improper Medicare payments that fiscal year; a 2014 Inspector General report found that Medicare issued $6.7 billion in erroneous payments in 2010 due to confusing billing codes and “lack of documentation.”
Although improper payments are not necessarily indicative of fraud, they reflect how the enormous and complex nature of the Medicare program results in waste, fraud, and abuse.
4. Medicare is trying to require doctors to use an electronic records system, putting patients’ privacy at risk. Medicare has threatened to penalize doctors who don’t use the system. Not only are some doctors resistant to changing their habitual methods, they are also concerned about patient privacy. For instance, The Wall Street Journal pointed to Yale School of Medicine professor, Mary Minkin, who discovered that “the electronic records system displayed patients’ gynecological records to other providers they consulted.”
“There’s no reason the dermatologist has to know about my patients’ libido issues,” Minkin told the Journal.
5. Fewer doctors are accepting Medicare. A 2015 Kaiser Family Foundation survey found that 21 percent of doctors won’t take new Medicare patients, compared to 14 percent of new private insurance patients. Additionally, a 2013 Centers for Medicare and Medicaid Services (CMS) report found that “9,539 physicians who had accepted Medicare opted out of the program in 2012, up from 3,700 in 2009,” reported The Wall Street Journal, suggesting that 2015 was not an outlier year for doctors opting out of Medicare. After all, why would doctors want to deal with lower payments to battle Medicare’s maze of codes?
6. Medicare denies claims at a higher rate than any private insurance company. The American Medical Association (AMA), which endorsed the public option, found that Medicare denied claims at a rate of 4.92 percent in 2013. By contrast, Aetna, United Healthcare and Cigna denied claims at rates of 1.5 percent, 1.18 percent and 0.54 percent that year, respectively.
This also seems to be a trend. Medicare had “more than double any private insurer’s average” in the AMA’s 2009 report card.
7. Medicare faces $36.8 trillion in unfunded liabilities over the next 75 years. According to the Medicare Trustees’ 2015 report, “Medicare’s 75 year total spending in excess of dedicated revenues is $27.9 trillion. Using the CMS Actuary’s more realistic alternative scenario, that figure soars to $36.8 trillion.”
The report also projected that Medicare Part A – the hospital insurance aspect of the program – will be bankrupt by 2030.
8. Single-payer health care systems are a massive failure. “Medicare for All” would be a single-payer program for everybody. Canada is an example of a nationalized single-payer system that the Left loves – but it’s riddled with problems:
A 2014 study by the Fraser Institute found that wait times for medically necessary treatment in Canada have increased from 9.3 weeks in 1993—not great—to 18.2 weeks. Wait times were especially bad if you needed hip, knee or back surgery (42.2 weeks) or neurosurgery (31.2 weeks).
As we know from the scandal involving the U.S. Veterans Health Administration, health care delayed is health care denied. The people who suffer the most under the Canadian system are those who can’t afford to hop on a plane or pull strings to get treated in the United States.
Martin Samuels, the founder of the neurology department at Harvard’s Brigham and Women’s Hospital, found this out when he worked as a visiting professor in Canada. “The reason the Canadian health care system works as well as it does (and that is not by any means optimal) is because 90% of the population is within driving distance of the United States where the privately insured can be Seattled, Minneapolised, Mayoed, Detroited, Chicagoed, Clevelanded and Buffaloed,” Samuels wrote recently in Forbes. “In the United States, there is no analogous safety valve.”
Medicare clearly faces a series of critical problems stemming from the program’s enormous size and complexity; expanding it cover all Americans would only exacerbate those problems further. But Sanders never allows facts to get in the way of his ideology.