Proponents of “Medicare for all” tend to balk at conservative criticism of the costs involved with the simple repudiation: Lives are at stake!
They are. And if we’re going to appeal to pathos, then I’m all in. Let me explain why America moving to single-payer would kill people.
The most comprehensive cost analysis of the Medicare for All bill estimated that the legislation would cost $32.6 trillion over its first decade. This estimate is conservative at best, and comically so at worst.
It assumes that physicians and hospitals would take home a reimbursement rate 40 percent lower than private insurance, which nearly three-quarters of the country currently use. (Government insurance programs, such as Medicare, already reimburse far less than private insurance, rendering the current average reimbursement rate 20 percent lower than our private one.)
One of two things would happen as a result.
Physicians could play hardball with the government and demand more pay, thus blowing out that $32.6 trillion figure.
Or, more realistically, there would be a mass exodus of providers from the market.
It wouldn’t happen overnight, but we’re already seeing it happen in Europe, as cracks emerge in their universal healthcare systems.
Physicians would either age out of the market as young people don’t see the value in entering the profession, as is occurring in France, or they could physically emigrate, as they are doing in Romania, which has lost half of its physicians in the past decade.
Soviet-style shortages of providers would hurt Americans, but the effects of Medicare For All would reverberate across the country.
The United States comprises 4.4 percent of the world’s population, yet we produce 44 percent of the world’s medical research and development. This is not a coincidence. Of the $171.8 billion we spend on R&D, the federal government contributes just one-fifth, with private industry footing the overwhelming majority of the bill.
From 2013 through 2016, private industry made up the lion’s share of growth in R&D spending, revving up their funding by 25 percent. The federal government increased its spending by half that, and state and local governments by even less. And even then, 95 percent of state and local governments’ contributions to medical R & D went to universities.
Americans also foot the bill of pharmaceuticals for the rest of the world’s nations.
We only account for a quarter of the world’s income, but we pay for up to 78 percent of total pharmaceutical profits, effectively subsidizing the cheap list prices of drugs for every other country. Those countries can and should pull their weight, but, alas, socialized systems don’t incentivize economic growth, research, and development. If we stop doing the heavy lifting, they’ll suffer even before we do.
None of this accounts for the opportunity cost of the tax rates required to fund Medicare For All. The federal government collected $1.7 trillion in income taxes for fiscal year 2018, an all-time high. We’d need to collect more than twice that at least to fund a worse healthcare system.
We’re the single most charitable nation in the world, with $33 billion going to health organizations and $22 billion going to international affairs.
If you think that would continue with a socialized system — our boots-on-the-ground medical initiatives in the developing world and life-saving treatments distributed globally — do I have a bridge to sell you.
Socialists are correct that healthcare is a matter of life and death. And they sure are correct that our current, overly regulated system is flawed. But it could get a lot worse, and it sure would be a shame if we kneecapped the most productive, innovative, and charitable healthcare system in the world.
James E Windsor, Overpasses News Desk
February 1st, 2019