Ask voters whom they trust to do a better job on health care, and Democrats have a whopping 17-point advantage. That shouldn’t be a surprise after years of Republican sabotage on the Affordable Care Act, taking away coverage from people with pre-existing conditions, and their assault on women’s health care. But what should be a surprise is that some Democrats are looking to surrender that advantage in the general election with a proposal called Medicare for All.
Contrary to what many think, Medicare for All would put every person on the same government run health care plan. There would not be a choice. This is also referred to as a single-payer system because the government would be paying for care, meaning all private health insurers are eliminated. Candidates use “Medicare” in the name, but the actual health plan is very different. In fact, it would expand Medicare’s current coverage for medical care, emergency care, and prescription drugs to also include dental, hearing, vision, and long-term care. And there would be no premiums, copayments, or deductibles.
If it seems too good to be true, it’s because it is. Below the catchy name are a series of political and substantive issues that could sink Democrats’ chances to beat President Trump.
To start, Medicare for All would raise taxes on the middle class. Affording a program that costs more than $30 trillion over the next decade isn’t easy. Senator Bernie Sanders has openly said that it will increase middle-class taxes. Senator Elizabeth Warren developed a plan that tries to spare the middle class, but it has been criticized by experts up and down the aisle. Progressive economist Jared Bernstein claimed the plan was “…just like basically saying ‘I’m going to buy a unicorn and I’m going to pay for it with a unicorn.’”
Medicare for All would take away all private insurance and put everyone on a one-size-fits-all, government-run plan. In fact, page 8, section 107 of the Sanders Medicare for All single-payer legislation outlaws private health insurance. That means 156 million people who get coverage through their job would see their plans eliminated. In addition to that, more than one-third of people on Medicare are currently in Medicare Advantage, or private plans offering comprehensive benefits. Under Medicare for All, these plans would also be gone.
It would also likely eliminate the high-quality health care benefits provided by unions. For example, the Culinary Health Fund provides health care benefits, including medical, dental, and vision, to nearly 130,000 Las Vegas residents and their dependents. Under Medicare for All, unions would no longer have any control of their health care benefits. Bethany Kahn, a spokeswoman for the Culinary Union, has said, “We’re telling [Senators Sanders, Harris, Warren, and others] that the unions don’t want to lose their health care…It’s built by workers and run by workers.”
Medicare for All has some politically perilous consequences too. Over the past year, support for Medicare for All has fallen by a net of 17-points, according to the Kaiser Family Foundation. In another poll, support for Medicare for All drops when people learn that it eliminates private insurance (support drops from 56% to 37%), requires most Americans to pay more in taxes (support drops to 37%), or leads to delays in tests and treatments (support drops to 26%).
Medicare for All negatively impacts health care workers too. Nearly 2 million health care jobs nationwide would be eliminated, ending middle class workers’ jobs as insurance brokers, medical billing workers, and administrative employees. That is 10% of the more than 21 million Americans that work in health care. This would be huge shock to the U.S. economy, as health care represents 14% of all U.S. jobs.
Those who keep their job under this new system face a tough reality as well. Medicare for All could put the reimbursement for doctors and nurses at the whim of the party in charge of the executive branch. Senator Warren is proposing cutting reimbursement far below what private insurance pays now. According to the non-partisan Congressional Budget Office, cutting reimbursement rates would “probably reduce the amount of care supplied and could also reduce the quality of care.” Moving everyone to one government plan will have seismic consequences across the health care industry, creating instability for both the people receiving care and providing it.
Democrats are winning with a message of universal coverage, lowering health care costs, and addressing surprise medical bills. Let’s not surrender our advantage on Trump. There are far better ways to insure everyone and lower costs — and be best positioned to kick Trump out of the White House.
Gabriel Horwitz is the Senior Vice President for the Economic Program at Third Way, a Washington D.C. think tank.
