Health Care

'Medicare for All' Would Exacerbate a Leading Cause of Death

"People assume universal health insurance would equal better health outcomes. This isn't true."

Jordan Candler · Jan. 8, 2019

With ObamaCare on the cusp of imploding, Democrats are predictably crusading for centralized health care. Leftist members of Congress have their eyes set on “Medicare for All,” a system under which all health care would be managed by the federal government. According to Sen. Bernie Sanders’s website, “The only long-term solution to America’s health care crisis is a single-payer national health care program.” But as Reason Foundation’s Nicholas DeSimone reminds us, “People assume universal health insurance would equal better health outcomes. This isn’t true.”

The evidence is nauseating. For example, DeSimone notes that in the U.S., heart disease and cancer are ranked number one and two respectively in leading causes of death, each taking well above half a million lives annually. But sitting in third place is something unbeknownst to most people. Sadly, recent research by Johns Hopkins found that medical errors produce a quarter-million deaths each year, although other research suggests 440,000 annual deaths. Yet even these guesstimates could be dwarfed under a Medicare for All scheme. As DeSimone writes:

Our current health care system is based on a fee-for-service (FFS) reimbursement model that rewards doctors for providing more treatments than necessary because payment is dependent on the quantity, not quality, of care. … Unnecessary tests and treatments have accounted for $200 billion annually and have been found to actually harm patients. That’s because the FFS system is volume-based, not necessarily value-based. Therefore, any increases in the volume of care equal increases in medical errors. … If Medicare for All covered all 325 million Americans — which include the nearly 30 million uninsured Americans and the 41 million more with inadequate health insurance — it would be the most disastrous third-party payer ever, once cost was not a primary factor. Including fatal medical errors and the hundreds of thousands of deaths resulting from longer wait times — already exhibited by VA health care — this could presumably make Medicare for All the single biggest factor to the leading cause of death in the US.

Clearly, Medicare for All provides no health-care cure, doing nothing is harmful too. That’s why American Enterprise Institute resident fellow James C. Capretta argues, “To Keep Medicare for All at Bay, Offer a Better Alternative.” He rightly observes, “It may not be enough just to be against government-run health care if the public perceives the alternative as inadequate, and, currently, there is widespread agreement that the status quo is inadequate. The provision of medical care remains far too costly. Waste is rampant. Administrative costs are high. The system is fragmented and uncoordinated, the paperwork is maddening, and the quality of care provided to patients is uneven. The persistence of these problems over many years is a major reason why the U.S. has been on a steady march toward greater government control of the health system, even without a full embrace of a nationalized plan.”

Capretta adds: “Opponents of Medicare for All shouldn’t try to defend the dysfunctional status quo. Instead, they should advance reforms that would make the system work better for patients, and bundle them as the alternative to Medicare for All. The last two years have demonstrated how difficult this challenge will be for Republicans.” Indeed it has. However, capitulating is a recipe for even greater disaster. As Capretta concludes, “Making the case for market-driven health care to a skeptical public is a tough assignment, but there is no real alternative to trying. At some the point, if the market is never tried, the public will get fed up with the waste and dysfunction, and Medicare for All will look like the only answer.” Conservatives mustn’t let that happen. Unify, and stay on message.

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