Medicare for All Versus Healthcare for None

It's time for some quasi-political commentary. Elizabeth Warren has put out her "Medicare for All" program.  I have mixed feelings.  Where do I start?

I believe that everyone should have healthcare and it shouldn't be prohibitively expensive.   What's wrong with that concept and belief?  Today, if you are below the poverty level, or a little above it, you get your healthcare for next to nothing.  But what kind of healthcare do you get?  That depends on the state and how Medicaid is delivered.  It also depends on how the ACA operates in your state, and what insurance companies have done with it.

Healthcare in the United States today is about making a profit for insurance companies, pharmaceutical companies and medical specialists, many of whom are not providing evidence-based care with positive outcomes.  If your health insurance doesn't cost much, you generally don't have many choices. You rarely can choose your own doctor.  In fact, you might be stuck going to doctors you don't like.  Your healthcare choices are often taken away from you.  The focus for the insurance company that is responsible for your healthcare is shareholder profit, not your health and well-being.

If you're lucky, you have good health insurance through your employer, although how much you have to contribute might still be significant.  You might even be stuck with high deductibles.  The days of great health insurance coverage without substantial deductions to ones paycheck are pretty much over. If you've been fortunate enough to retire early, you're screwed. Health insurance is quite expensive.  But, since you're well off enough to retire, I guess it's ok.  If you're on Medicare, you're in great shape!  Hmmm.  Maybe Warren is on to something.

It's often said that people vote with their pocketbook.  If that's the case, Medicare for All has some potential.  For the vast majority of Americans, they will see more disposable income.  They won't have health insurance deducted from their paycheck and they won't have high deductibles. If you're relatively poor and have been getting lousy health insurance for free, you'll suddenly have more choices.

Who won't like this new program?  Billionaires won't like it, nor will people with high incomes and lots of capital gains.  Maybe Elizabeth Warren has done the electoral math.  The number of people who won't like the new program is actually very small.  For those who say that the negative impact on the high earners will harm the economy don't really understand high earners.  They'll figure out how to make more money!  They always do.

So, why do I have mixed feelings?  Because Medicare has many flaws, and by creating Medicare for All, we'll most likely be setting those flaws into stone.  I think that there are other fundamental changes that need to be made to turn around our badly impaired healthcare system.

What about those that say that health insurance companies will be devastated?  There's something called Medicare Advantage.  Why wouldn't Medicare Advantage continue to exist with Medicare for All?  In fact, just as Medicare Advantage provides the ongoing challenge to traditional Medicare, it should do the same for Medicare for All.  Health insurance companies may just have to work a little harder to develop competitive products that provide good health outcomes.  Hmmm.  Maybe Warren is onto something.