We all want access to affordable, quality medical care. “Medicare-for-All,” the catchy name for health insurance sponsored and controlled by the federal government, promises completely free, “medically necessary” medical services, including mental health, substance abuse, vision, dental, hearing, and long-term care, as well as pharmaceuticals.
If this sounds too good to be true, it is. Here’s why Medicare-for-All is the wrong prescription:
Private health insurance disappears
Medicare-for-All outlaws private and employer-sponsored health insurance for any benefits covered by the government program. That leaves very little room for private insurance.
Medicare has hidden traps
If Medicare denies a claim, a Medicare beneficiary cannot pay cash for a Medicare-covered service to a physician who receives Medicare funds from any source. With Medicare-for-All, once a physician privately contracts with one patient for covered services, they cannot participate in the government program for any patient for two years.
Medicare beneficiaries who do not want Medicare Part A (hospital insurance) lose all past and future Social Security benefits. Beneficiaries who delay enrolling in, and paying the premiums for, Part B (physician, labs, and other services) and Part D (prescription drugs) must pay a lifelong penalty compounded yearly and monthly, respectively. Would the same bullying happen with Medicare-for-All?
Your medical privacy vanishes
Upon request, for any reason, physicians who see Medicare-for-All patients must give the Department of Health and Human Services any medical records.
A promise for everything may give you very little
The Medicare Hospital Trust Fund will be depleted in 2026. The Medicare-for-All bills have no financing mechanism for its estimated $3.2 trillion per year price tag. Since the federal government collected only $3.33 trillion tax dollars in 2018, tripling everyone’s payroll taxes has been proposed. When the money runs out, the choice is either more taxes or fewer services.
With no private insurance available, we would see the two-level system, where only the wealthy can pay for services the government no longer covers.
The right prescription: Independent physicians
Independent physicians have always given patients their most precious cure: trust and time.
A great innovation in private practice is direct primary care. Here, a modest ($40-$100) monthly fee paid directly to the physician guarantees access to a physician, basic lab tests, and medications at up to 15 times less than retail. Some specialists treating chronic conditions, such as diabetes, use this model to provide individualized disease management, therefore decreasing hospital admissions.
Additionally, many cash-based physician practices provide charity care. Direct pay, coupled with a major medical (catastrophic) insurance plan costing less than $100 per month, makes medical care affordable without higher taxes.
Our innovative spirit and generosity will continue to create ways to deliver quality, affordable medical care to the most people without sacrificing choice.
Marilyn M. Singleton, M.D., President, Association of American Physicians and Surgeons, [email protected]