Finance Medicare For All: The Good, The Bad, and The Questions

Observers of national politics, often become concerned, because the rhetoric, insufficiently – developed programs and concepts, and populist appeals (with very little chance of becoming law), take a larger place, over reasonable, realistic, focused, viable solutions. Recently, the vast majority of elected Republicans, have devoted significant efforts, to repealing and replacing the Affordable Care Act (known to many as Obamacare), although, their suggested replacements, seem to achieve little (other than political), because they have, potentially, reduced coverage, added costs (for thorough coverage), made unrealistic prejudgments (such as taking the least, at – risk, out of the overall pool, and claiming it won’t raise everyone else’s costs, etc). Despite their majority in Congress, previous bills have been narrowly defeated, although there appears, to be another effort, coming in the very near future. Approximately 15 to 20 Democrats and Independents, led by Senator Bernie Sanders, have suggested, replacing this process, with what the refer to, as Medicare For All. While this sounds like a wonderful idea, there are certain good aspect, some bad ones, and certainly, many questions and uncertainties!


1. The Good: Supporters will state, Universal Health Care/ coverage, is prevalent, in nearly every other nation, in the world! While I agree with the concept, which states, health care and medical coverage, should be a right, not a privilege, I also feel, any idea, must be looked at thoroughly, and we must rationally discover and understand, the positive, as well as, the unattractive consequences. While Medicare, itself, has been a popular program, we must also recognize, Senior citizens, paid taxes into it, for many decades, and there are monthly fees, to continue, what is known, as Part B (Medical coverage/ doctors). These fees are currently $134 per month. In addition, Part B coverage, only pays about 80% of the costs, so, to be covered, some sort of supplemental insurance, is needed, and must be privately procured/ purchased. There is little doubt, there is a need for improvement, but, is this the best approach, and how likely (or unlikely) is it, it could ever become law?2. The Bad: While there are certainly many flaws in privately – administered health insurance plans, the government has not, historically, been the greatest, or most efficient administrators. There is also a question, of what happens to the thousands of people, employed by the existing companies? In addition, we must be careful, to fully examine, review, understand, and consider, the precise, total costs, this might create. How will it be financed, and who will pay for it? Beware, when you are told, this will be cheap, and your insurance costs will become unrealistically low, because, you know what happens, when it’s too good, to be true! What will be the tax rate, how will the escalating costs of prescription drugs, malpractice insurance, etc, be addressed, etc? Also, why would we believe, Congress would ever approve this approach?3. The Questions: So far, there are many more questions, than clear – cut solutions! Some of these include: How will it work?; What will happen to the existing Medicare program?; How will prescription drug costs (Medicare refers to these as Part D), which requires supplemental insurance coverage, be impacted?; How about hospital and malpractice costs/ expenses, be addressed?; etc. We can already hear, more conservative politicians, instilling fears and resisting, calling this idea, Socialist or Communist! How will the challenges faced in other nations, including waiting lines, two – tiered coverages, etc, be addressed? Even if the plan is better and more cost – effective, how will you get most Americans, to buy – into this approach! How about those who currently receive their health insurance coverage, from their employer – why would these people be willing to pay higher taxes? If this is funded via taxes, will it be, on the employee or employer, or both, and what about self – employed individuals? Who might make the decisions about allowable decisions, to assure these are based on health – related, medical needs, as opposed to political posturing?


As you can see, it’s often quite challenging, transforming an idea and/ or concept, to reality! This idea should be discussed, and considered, without bias and/ or prejudgment, but with eyes – wide – open!