Foolish Rebuttal to Medicare for All (2018 Sep)

by Barry A. Liebling

In the Summer of 2018 leftists and Democrats (often the same people) are attempting to energize their voting base for the midterm elections. And one of their most discussed proposals is “Medicare for All.” The plan is being touted by two of the best known “democratic socialist” advocates – the senior citizen Senator Bernie Sanders of Vermont and the youthful newcomer congressional candidate Alexandria Ocasio-Cortez of New York.

The essence of the Medicare for All plan is to have the government pay for and take over nearly all of the healthcare in the United States. Fans of the proposal say that this move will bring down the total costs of healthcare because the government would focus on doing the right things for the “good of society” – in contrast to private interests that are intent on making profits.

Of course Medicare for All is only one component of the democratic socialist plan to radically transform (that is, ruin) the way people conduct their lives. Even as leftists chant that “healthcare is a right” (so the government should be in charge) they go on to say that other things including free education, adequate housing, a guaranteed job, nutritious food are all “rights” that should be provided and closely supervised by the state.

There are two major appeals of the proposal to further socialize the healthcare system. To the less sophisticated voter the prize will be a lot of “free services.” There is no need to pay directly for medical services (some people imagine) when government enthusiasts are more than willing to take care of everything. What could go wrong?

The more sophisticated leftist voters realize that nothing is free. The money to fund Medicare for All has to be taken from somewhere. But if the funds needed come from higher taxes on “the rich” and from “greedy corporations” that is a good outcome by itself. The more the oppressing classes are penalized the better. And, to someone who is is committed to leftist ideology, government action is always preferable to allowing individuals to do things on their own. After all, unfettered individuals are liable to behave in ways that socialists do not approve of.

So what is the problem with Medicare for All? Here is the real bottom line. Every increase of government involvement in healthcare takes freedom away from individuals to decide what they will do, and it thwarts their ability to act according to their own judgement. If the government pays, the government calls the shots, and the bureaucrats who work for the government are the bosses. If you understand the crucial importance of individual liberty you appreciate that the proper (limited) role of government is to prevent the initiation of force and fraud.

Even as there are public expressions endorsing Medicare for All, there are conservative pundits who are speaking out against it. While they are correct that the proposal is a step in the wrong direction, many conservative commentators do not seem to appreciate the essential principles that apply.

Charles Blahous, a Senior Research Strategist at the Mercatus Center at George Mason University (one of the most distinguished “free market” institutions in the United States) has done a quantitative analysis of the Medicare for All proposal. He asserts that the democratic socialist plan would be too expensive to be implemented. Dr Blahous describes scenarios where healthcare providers would be accepting Medicare payments (which are lower than private payments) and prescription drug prices would be decreased due to government action. According to his calculations , “even doubling taxes wouldn’t pay for Medicare for All.” Since it is unrealistic to expect that voters would permit taxes to be increased so dramatically, Dr Blahous concludes that the notion of Medicare for All is a non-starter.

Note well that the “conservative” retort provided by Dr Blahous plays directly into the hands of Medicare for All advocates. If the essential problem with the proposal is money, the solution is to make it more affordable. The simplest move would be for leftist enthusiasts to say, “OK, we cannot afford Medicare for All right away, so let’s just expand Medicare and put many more people (not everyone yet) on it. In a few years we will demand that it be expanded again.”

Alternatively, Medicare for All can be made to work very quickly. Socialized medicine boosters can insist on severe price controls on all prescription drugs. Health care providers can be forced by the government to work for less money. After all, they are already making more money than leftist policy makers think they deserve. This is already done in other countries. The government can go directly to the source by requiring that all new medical students work under the Medicare umbrella if they expect to graduate and be licensed. With new government mandates wise bureaucrats can ration services to make sure that medical procedures that are not “really necessary” and do not provide the benefits “the country truly needs” are not performed.

Here is a message to citizens who detect that socializing healthcare is the wrong way to go. The rationale of leftists who support Medicare for All does not depend on economics. It is based on a flawed sense of morality. The socialist ideal is to put all power into the hands of the state and have individuals submit to the directives of government officials. How much or how little money is involved is not the crucial point. The only valid way to refute the leftist call for socialized healthcare is to recognize that every person has a natural right to manage his or her own life. The job of the government is limited to protecting natural rights. Medicare for All is a leap in the wrong direction.

*** See other entries at in “Monthly Columns.” ***

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