Why Medicare For All Won T Work?
(was Re: Answering Conservative Lies)
Date: Sun Jan 20, 2007 2:43 pm
Subject: Re: [DDO] medicare for all won t work?
(was Re: Answering Conservative Lies).
The Medicare Voucher Lie
By NEIL MARSH
Published: January 18, 2007
Senator John McCain has a health care plan, and he doesn't seem able to keep it straight.
He told Republican audiences last year that "I will not support a plan that leads to a government takeover of health care." But in his new book, "Character Is Destiny," he writes that he wants to "give every American the same health care choices that members of Congress give themselves." To that end, he says, "Congress will have to pass a law mandating that all health care plans include a minimum level of coverage and benefits."
Mr. McCain's book isn't the only place where he has contradicted himself on health care. He said to CBS News in 2005, "I am not in favor of a government takeover of health care" and, in the same interview, "I believe the private sector can provide health care to individuals in this country. We have the finest health care in the world."
But in the first presidential debate, Mr. McCain said that Americans "need to have the same kind of health care plan that members of Congress do," which means that they would get their insurance from private companies but would have to use the government's Medicare program.
And in his book, he is emphatic that private insurance companies will have a big role to play under his plan. "Let insurance companies compete for the business of people who now have Medicare," he writes.
Mr. McCain's plan is to give a tax credit to people who buy their own insurance. It would be a "coupon," the Republican candidate says, that "would be accepted by any health insurance company."
Is he serious?
Does he really think that the private insurance companies will accept coupons that would give their customers access to the world's best health care without having to pay anything close to the true cost?
This isn't the 1950s, when Aetna sold insurance to doctors so that they would take their patients.
Anyone who thinks that the insurance companies won't find a way around the "coupons" is naive.
But even if Mr. McCain is right, even if the insurance companies accept Medicare's rate schedule, the system won't work. Medicare has two huge problems. First, it's run by the government. Second, it reimburses doctors, hospitals and other providers much less than the cost of caring for older patients. As a result, many providers refuse to accept Medicare patients.
The reason this is a problem is that about 25 percent of the population is 65 or older. When Medicare was first enacted, in 1965, that figure was 9 percent. By 2030, it is expected to be 36 percent.
Mr. McCain is on record as saying that Medicare needs to be fixed. "I was born at a time when Medicare didn't exist, and I'm going to die at a time when Medicare is going bankrupt," he told The San Francisco Chronicle in May. "I want to fix it."
The only way to fix it is to give doctors and hospitals enough money to take care of older Americans. That means the government has to pay the bill, and the government has to pay the bill in a way that reflects the true cost of medicine.
The whole point of a voucher system is that the government doesn't have to pay the bill, and the government doesn't have to pay the bill in a way that reflects the true cost of medicine. It can pay whatever it wants. And if it doesn't want to pay the true cost, Medicare will be an empty shell.
Mr. McCain may say he doesn't want that, but it's where his plan leads. And it's where his plan leads to quitters. He may say that he will never, ever give up on Medicare, but will Americans really be happy if they have to use Medicare vouchers to buy insurance from private companies — and then the private companies refuse to pay the doctors and hospitals what they need to provide the care?
At that point, American voters will face a choice. They can keep Medicare and go on paying for it by increasing taxes. Or they can "fix" Medicare by turning it into a voucher system and watching the whole plan disappear.
Mr. McCain may be a straight shooter. But this plan is as crooked as a dog's hind leg.
Neil H. Buchanan is an economist and legal scholar and a professor of law at George Washington University. He teaches tax law, tax policy, contracts, and law and economics. His research addresses the long-term tax and spending patterns of the federal government, focusing on budget deficits, the national debt, health care costs and Social Security.