Medicare for All

And the Two Issues that Bookend the Debate

Medicare for All could eliminate the private health insurance industry

Health care, and how to pay for it, is a big issue on the campaign trail because it is a big issue for just about everyone in America.  Elizabeth Warren and Bernie Sanders both support Medicare for All.  They both want single payer, through the government, instead of the current mix of public and private insurance.

Medicare for All seeks to deal with problems associated with our current health system - rising costs, denied treatment and medication, and personal bankruptcies caused by medical expenses.  It introduces a big, contentious issue (beyond higher taxes) - eliminating an entire industry in a short time.  

From a New York Times March 23, 2019 article titled "Medicare for all Would Abolish Private Insurance.  'There's no Precedent in American History'", authors Reed Abelson and Margot Sanger-Katz write:  "But doing away with an entire industry would also be profoundly disruptive.  The private health insurance business employs at least a half million people, covers about 250 million Americans, and generates roughly a trillion dollars in revenues.  Its companies' stocks are a staple of the mutual funds that make up millions of Americans' retirement savings."

And yet, because private health insurance companies are in business to make money, customers are often denied coverage.

From a March 19, 2019 article in InTheseTimes.com titled "Yes, We're Coming for your Private Insurance Plan", author Natalie Shure writes:  "The reliance on private insurance creates structural obstacles to reform.  For instance, a piecemeal web of competing insurance plans makes it difficult for any given insurer to command any leverage in negotiating prices with healthcare providers and drug companies."

There are other reasons why healthcare, in its current form, is so expensive in the U.S.  One driver of these costs is lack of transparency.  From a July 31, 2018 Wall St. Journal article titled "Why Americans Spend so much on Health Care - in 12 Charts", author Joseph Walker writes:  "Among the reasons is the troubling fact that few people in health care, from consumers to doctors to hospitals to insurers, know the true cost of what they are buying and selling.  Providers, manufacturers and middle men operate in an opaque market that can mask their role and their cut of the revenue."

Walker continues:  "One reason prices are rising:  Hospitals are becoming more consolidated and are using their market clout to negotiate higher prices from insurers."

Supporters of Medicare for All assert that only the federal government is large enough to bend the cost curve down.

Medicare for All may very well be able to erase many of the problems found in the current health care system.  In the plans supported by Bernie Sanders and Elizabeth Warren, though, it introduces a huge, troublesome issue - eliminating an entire industry and the jobs that go with it.