How did 13 small colonies of the globe-spanning British Empire become the leader among nations in less than two and a half centuries? Answer: Freedom and its resulting “can do” culture. Freed from government controls and released from class constraints, the “new Americans” believed they could do anything and everything, and then . . . they did. In1825 U.S.A., Alexis de Tocqueville observed that the federal government was not involved in the daily lives of Americans. Entitlements did not exist.
Before 1776, Americans were entitled to whatever the British aristocracy gave to its subjects. In 20th century Union of Soviet Socialist Republics, comrades were entitled to whatever the Central Committee decreed. Have Americans reverted to become subjects of a new aristocracy–the federal professional political class? Are we a resurrected proletariat subservient to a totalitarian state? Will we replace freedom and capitalism with socialism and entitlement? If the Democrats manage to enact their single payer plan, Medicare-for-All, H.R. 1384, the answer would be an emphatic yes!
My analysis shows the following effects of Medicare-for-All on Americans. Sections 107 and 614 seek to eliminate the profit motive in healthcare, which supporters believe is the culprit for healthcare system failure. Section 202pointedly rejects all forms of personal responsibility such as cost-sharing and work requirements.
Per sections 102, 103, 601, and 611 through 614of H.R. 1384, freedom of choice, private property, and free market forces would be replaced by universal entitlement and central economic planning, along with price and wage controls just like communist Russia. With Medicare-for-All, Americans’ options for both care modalities and choice of providers would be determined by Washington, not by We the Patients.
Some supporters of Medicare-for-All claim it will save money. They point to other nations with single payer systems who spend less per capita than the U.S. by wide margins. Countries like Great Britain and Canada accomplish their savings by medical rationing: refusal to authorize expensive treatments and limiting allocations so that there are insufficient facilities such as operating rooms and burn units.
Patients in single payer systems like the proposed Medicare-for-All experience “death by queueing,” succumbing to treatable disease while waiting in line for care. Americans need not leave the U.S. to observe this phenomenon. Both the VA system and Medicaid have reported death-by-queuing, including the front page news and quite preventable demise of 12-year old Deamonte Driver from a dental cavity.
While patient care is undoubtedly the first priority for any healthcare system, dollar efficiency is the second. Rather than focusing on reduced spending, the U.S. should seek to acquire requisite value for monies expended. Since the desired value is timely, quality medical care, dollar efficient spending would devote the most dollars to care and the fewest dollars wasted on non-care activities such as federal bureaucracy.
Will Medicare-for-All save money? Will it be dollar efficient? No, and highly doubtful.
Official federal watchdog agencies such as the CBO have notyet scoredH.R. 1384. Cost projections are available from Democrat Senator Bernie Sanders and Professor Charles Blahous of the Mercatus Center at George Mason University.
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