Medicare-for-All is Doable (2019 Dec)

by Barry A. Liebling

In a gesture to boost the enthusiasm of their base supporters some 2020 presidential Democratic party candidates have bragged that they intend to institute Medicare-for-All. The proposal is deceptively advertised as a way of assuring that all Americans have access to healthcare. (Question – do all Americans already have access to healthcare?) But the deep motivation of its proponents is to take autonomy (what is left of it) away from private individuals and to consolidate power over healthcare decisions in the government.

Leftists are split on the Medicare-for-All issue. Some see the proposal as a progressive step towards the government-supervised society they strive to bring about. Others are wary of the call to action because they worry that ordinary people (not part of the woke political cabal) will fear the sudden change and will not vote for the Democratic presidential candidate.

For those who understand and appreciate the virtue of freedom, Medicare-for-All is unacceptable. In a free society government interventions are kept to a minimum. Advocates for liberty look for ways of influencing public policy so that individuals make their own decisions about their own healthcare. That means rolling back state control and encouraging private solutions in the healthcare arena.

It is noteworthy that a lot of conservatives reflexively object to the Medicare-for-All proposal but fail to recognize the core issue. Instead, several pundits on the right have criticized the government expansion on pragmatic grounds. They claim that it will not work. Essentially they argue that it will cost an enormous amount of money to institute Medicare-for-All and that the advocates of government expansion cannot explain how they will fund it. Furthermore, some critics of the attempted putsch point out that healthcare providers themselves might be reluctant to cooperate.

The conservative pragmatic rebuke is strategically inept. It unintentionally plays into the hands of leftist progressives. If the focus is on money or on medical professionals’ support, government zealots can answer their critics easily. Statist programs can always be made to work, at least until citizens refuse to be abused. Consider several scenarios where the Democratic operatives would come out on top.

First, opponents of Medicare-for-All complain that taxes will have to be increased. It is true that most citizens do not want to pay more in taxes. But the Democrats can assert that the new tax bite will be levied exclusively on “the rich.” This is a highly attractive proposition to envious citizens who long to see wealth confiscated from more affluent people who “really do not deserve it.” After tax increases are put in place (and affect everyone who pays taxes, not just “the rich”) advocates of Medicare-for-All can proclaim that they never promised no tax increases for the middle class (whether they did or did not). While ballooning taxes are hard on most people, they are acceptable to the Democratic base as long as they are described as hitting the wealthy the hardest.

Second, Medicare-for-All boosters can say they are willing to compromise. Instead of everyone being covered perhaps the government can put more people into the federal system. This will cost much less money than universal coverage, but it is a step in the direction of reducing the number of people who obtain their healthcare privately. At a later date progressives can again say they favor putting everyone on Medicare, and again show their flexibility by settling on a modest increase. Can you see where this will go?

Third, there is the topic of rationing. More Medicare members without a lot of new funding means a longer wait time for medical services. Conservatives have pointed out that in advanced countries where the government monopolizes healthcare delivery the service is slow. Think of Canada and the UK where citizens have to make appointments weeks and even months longer in advance than their counterparts in the United States. Leftists are not impressed with this criticism. Waiting in a longer line is a small price to pay if the result is more people are funneled into the program. Efficiency is not the end goal; control is.

Fourth, what happens if healthcare providers object and refuse to participate in Medicare-for-All? Conservative alarmists ask this question and assert that the overall amount and quality of healthcare will decline. Even now not all physicians participate in Medicare, but most do. The progressive response is there is nothing to worry about. Younger people who are entering healthcare fields are likely to support the progressive left vision of government control. After all, that is exactly what they have been taught in school. The federal government does not decide who gets into medical school and who obtains a license. That happens separately in each state. But by providing additional funding to states – with lots of strings attached – the feds can have a strong influence on who becomes a healthcare professional. Public policies can be adjusted to make life difficult for providers who do not support Medicare-for-All.

The bottom line lesson is that the proper way to refute leftist proposals such as Medicare-for-All is to concentrate on the core essential issue – humans have a right to freedom and individual autonomy. Government supervision and manipulation of the healthcare system delivers citizens to the mercy of the state – which is directed by leftist zealots. Memo to conservatives – pay attention.

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