During the next 18 months, voters are going to hear a lot about “Medicare for all”—the Bernie Sanders plan to bring all Americans into a government-run health care system resembling Medicare.
When Sanders introduced the plan while running for president in 2016, it had fringe status. Sanders is running for president again, and his plan now enjoys the support of other Democratic presidential candidates, including Senators Elizabeth Warren, Cory Booker and Kirsten Gillibrand.
But Medicare for all would be expensive, and it might also undermine the current program that seniors generally like. “We think the focus should be on strengthening and protecting our Medicare program, not trying to weaken it by adding more people to the program,” Seema Verma, who oversees the Medicare program at the Department of Health and Human Services, told Yahoo Finance at the Milken Institute Global Conference in Los Angeles. “Seniors don't deserve to be put in the back of the line to wait for health care.”
A new government program
The Sanders plan wouldn’t enroll all Americans in Medicare. Instead, it would establish a new government program, modeled on Medicare, that would cover everybody, with no fees or out-of-pocket costs. There would no longer be employer-provided coverage or any kind of private health insurance. That would save businesses and consumers trillions of dollars, but it would also require sharp new tax increases and move nearly 180 million people out of the private health system, which works reasonably well for many of those patients. Many health analysts say the transition would be so disruptive that Medicare for all is politically impossible.
Medicare has its own problems. The latest annual assessment by Medicare’s trustees found it will start running short of money in 2026, just seven years from now. “The trustees have been warning about the problems that we have in the Medicare program,” says Verma, “which is why it's so concerning that we're hearing calls to add 180 million people.”
‘Free market’ measures
The whole issue of how to make health care more affordable, and extend coverage to nearly 30 million Americans who don’t have it, is highly partisan. Congressional Democrats have introduced at least a dozen health reform plans, with only about a third of them calling for a full government-run health care system. Others would preserve most of the private system while offering a public option or other methods for people who can’t find coverage through an employer.
The Trump administration has proposed more modest measures to lower costs and give consumers more buying power. “We need to address this issue through the free market and empowering patients to make decisions about health care,” Verma tells Yahoo Finance in the video above. The administration plans to require the public posting of prices for prescription drugs and, perhaps, some medical procedures, so consumers can shop for health care the way they shop for most other things. And new regulations are coming that would require health care providers to make patients’ medical records available electronically, on a smartphone.
Democrats seem to have the edge on health care, however. Voters consistently say health care costs are a top concern, and Republicans are known mostly for trying to repeal the Affordable Care Act, without a coherent replacement plan. “President Trump’s health care gyrations reflect a political fact: he and Republicans have to have a health plan to run on in 2020,” writes David Blumenthal of the Commonwealth Fund. “You can’t fight something with nothing.”
Rick Newman is the author of four books, including “Rebounders: How Winners Pivot from Setback to Success.” Follow him on Twitter: @rickjnewman