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jealousmedicare

The Ben Jealous Medicare Scheme is Hazardous to Your Health

Wednesday night Socialist Democratic candidate for governor Ben Jealous is bringing Democratic Socialist U.S. Senator Bernie Sanders to Baltimore today to hold a rally in support of providing Medicare-for-all.

Sanders has been pushing his Medicare-for-all scheme in Congress and Jealous, who as we have pointed out agrees with Bernie Sanders a lot, will be proposing a state-based system funded by you, the taxpayer.

Realistically, Jealous has absolutely no idea how he is actually going to pay for this Medicare-for-all scam. That probably has a lot to do with why Jealous, when announcing this rally, refused to release details on how he was going to pay for it or what it was going to look like.  But it will probably look a lot like the Sanders proposal, which is based on Canada’s disastrous single-payer health care system.

What the Jealous campaign is probably hoping that you forget is that this Medicare-for-all type system has actually been tried in three states already. And it’s failed in each and every one of them.

Vermont

One of the states that went most aggressively into this void was Vermont, which established Green Mountain Care back in 2011. Unsurprisingly, it never really got off the ground because Vermont’s Democratic Governor and Democratic legislature couldn’t actually figure out how they were going to pay for the system. Why? Because the proposed cost of the program at the time was $4.3 billion, at a time that the state budget was only $4.9 billion. To fund the program, Vermont was contemplating an 11.5 percent increase in the state payroll tax and a 9 percent increase in income taxes on individuals.

As noted in the linked Daily Beast article, “According To Critics, From The New York Times’ Paul Krugman To USA Today’s Editorial Board, Sanders’s Single-Payer Plan Is Something Between A Well-Intentioned Fool’s Errand And A Political Pipe Dream, An Unrealistic Idea That Has Been Proven Not To Work In The Senator’s Own Backyard.”

In addition to the Daily Beast article (which I recommend you read entirely) I recommend you also read this article from Vox detailing the disaster that was Green Mountain Care.

California

Democrats in California proposed an even more expansive and even more expensive with their Healthy California initiative. That bill would have required $200 billion in new spending, doubling California’s already massive state budget, without identifying a funding mechanism.

As The New Republic points out, “In a state where Democrats have super-majorities in both legislative chambers and a Democratic governor, the conventional wisdom is that if California can’t pass single-payer, it can’t be passed anywhere.”

The New Republic also points out extensive problems that the Democrats would have with their own backyard:

Many blame corporate interests for the death of single-payer in California. According to reporting by the International Business Times, since 2012, groups opposing the single-payer bill have donated $1.5 million to Democratic Assembly members. Rendon himself has taken more than $100,000 from pharmaceutical companies and $50,000 from major health insurers. Single-payer would clearly hurt these industries, putting some entirely out of business.

The California Chamber of Commerce also opposed the bill, calling it a “job killer” that would “result in significant new taxes on all Californians and California businesses.”…..

Still, the politics of the issue are treacherous enough to spook lawmakers. While it’s true that California Democrats have a super-majority in the legislature, this also means that the party is a big tent with a number of ideological fault lines. As a state, California might look blue overall, but there are still conservative pockets—and it remains a challenge for progressives to push the party leftwards.

California’s experience is a mirror-image of what Jealous’s proposal will look like.

Colorado

Colorado is the one state that took the issue of single-payer health care to the ballot. Colorado voters soundly rejected the creation of ColoradoCare, with over two-thirds of Coloradans voting against it. The plan, which would have completely replaced private health insurance for most Colorado residents, had a myriad of political opponents on both sides of the aisle. The Colorado proposal, if passed, would have created $25 billion in new payroll taxes. Even then, non-partisan groups “estimated that ColoradoCare’s costs would exceed the payroll tax revenue and create an $8 billion deficit.”

* * * * * * *

The evidence in those three states, two of which are among the most radically left-wing states in the country, does not bode well for the implementation of the kind of dangerous scheme that Jealous will be proposing tonight. Attempts to implement medicare-for-all have already shown that the system is too expensive to actually implement and that if it were to be properly implemented would require radical regressive tax increases on every man, woman, and child across the state.

The cost prohibitive nature of establishing such a scheme doesn’t even begin to address the issues regarding quality of care related to the implementation of this kind of system. Invariably, your health care options will be more limited and your quality of care will go down if Jealous sees his system brought to fruition.

As Mark Siegel wrote in USA Today back in September:

This gap in services is growing, as Medicare struggles to cover emerging technologies that are not one-size-fits all while at the same time continuing to provide basic care. If Medicare is converted to single-payer or Medicare for all, as Sen. Bernie Sanders of Vermont proposes, tens of millions  more patients will be added to an already faltering system, and the gap between the promise of care and actual care delivered will widen.

Single-payer is the ultimate one-size-fits-all health care promise. Consider Canada, our single-payer neighbor to the north. One of my patients was visiting Toronto several years ago when he developed worsening angina requiring a cardiac stent. He was placed on a several-week waiting line before giving up and returning home for the procedure. The waiting-your-turn problem has only gotten worse since then. In 2016, the Fraser Institute found a median 20-week wait in Canada between a generalist’s referral and the time the patient actually received a definitive test or treatment/procedure from a specialist….

…. Single-payer isn’t the answer to providing health care in an exciting future where cancer and other treatments are genetic-based and personalized. For instance, CAR-T involves removing a patient’s immune cells and genetically engineering and reinserting them to fight cancer. Single-payer will never be able to justify payment for a $500,000 technology on a patient-by-patient basis.

Food and Drug Administration commissioner Dr. Scott Gottlieb told me recently that the insurance model isn’t necessarily prepared to cover the latest treatments where “a one-time administration of a drug could potentially cure a disease.” He added, “I worry about access to therapies, particularly effective new therapies so it would be concerning if we had really impressive new treatments and patients couldn’t get access to them because the models weren’t right or patients were uninsured or underinsured for the medicines that they use.” 

Concerns about Medicare and its expansion aren’t even new concerns, with concerns raised more than twenty years ago about the bewildering nature of Medicare’s costs, codes, and bureaucratic red tape getting in the way of doctors providing treatment and patients getting the health care they need.

Medicare-for-all proponents look towards Canada as a model for their proposals. We already noted in Siegel’s piece, above, about some issues with Canadian health care. But it is common in Canada for people to spend months or years waiting for treatment only to die on waiting lists:

Protracted wait times may also result in potentially treatable illnesses and injuries becoming chronic, permanent, debilitating conditions. In such circumstances, requiring patients to accept inordinately long waiting times, without the opportunity to seek alternative treatment denies them their basic human right to lead healthy lives (as recognized by the Supreme Court in 2005). It is precisely for this reason that Dr. Brian Day, former head of the Canadian Medical Association, is fighting a court case in British Columbia to allow private treatment for those patients who have fallen through the cracks of the public system. One of his co-plaintiffs has already died while waiting for the trial, while another is permanently disabled because of neglect on the public wait list.

Sadly, their stories are not isolated cases. In a recent study, Nadeem Esmail, Taylor Jackson and I investigated whether the changes (mostly increases) in wait times between 1993 and 2009 had any impact on mortality rates. After controlling for relevant factors (physicians, health expenditures, age, Gross Domestic Product, inequality, and gender), we found that there was, indeed, a statistically significant relationship between wait times and the incidents of female deaths.

Specifically, after crunching the numbers we estimated between 25,456 and 63,090 Canadian women may have died as a result of increased wait times during this period. Large as this number is, it doesn’t even begin to quantify the possibility of increased disability and poorer quality of life as a result of protracted wait times.

So what ultimately is being proposed by Ben Jealous? He’s proposing that your tax rates go up exponentially to pay for a health care system that will provide rationed care that will not cover all of your medical needs. He is proposing a system that will have fewer doctors available, and one that may force you to change doctors. What doctors you will be able to see you will need to wait months in order to get an appointment. What procedures it will cover you will need to wait months on end to receive, and you may very well wind up suffering needlessly for tests or treatment that you could easily have received had you had private health insurance instead.

Higher taxes. Rationed health care. And a lower quality of life. This is what Ben Jealous wants for you, and that’s exactly what he will be proposing with his Medicare-for-All scheme.






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