Edward BatesI just want to take a few minutes and address a topic that has been getting more press lately than it deserves. With all the challenges we have with our United States health care system one of the plans being set forth is Medicare style health insurance for all.
They basically cite all the reasons why this may make sense but leave out one extremely important factor, COST. The CBO (Congressional Budget Office) in 2018 came out with their estimate of what a Medicare for All program might cost. Their estimate was $32 Trillion over a 10 year period. With all the large numbers thrown around Washington one might suggest that we simply prioritize our spending and make this happen.
Well maybe we should take a closer look. The US annual discretionary and non-discretionary spending is $3.2 Trillion and that comes with about $800 billion added to our national debt each year. That amount over 10 year is $32 Trillion (assuming no increase over that period). That also adds $8 Trillion to our national debt over the same period. So, if the US government stopped spending any money on anything whatsoever they would have enough money to fund the Medicare for All plan.
Result, no expenses paid and still $8 Trillion more in debt.
That obviously is a ridiculous scenario and we as a nation would never intentionally cause the total collapse our economy over a medical care issues. What then can be done to fund a program like this? Europe uses a value added tax (VAT) on all purchases. Essentially the government would set a percentage necessary on all purchases in the US that would generate $32 Trillion over 10 years.
Wait a minute. You mean for 17.7% of our economy, which is health care, we would charge the American citizens more than they currently pay in taxes annually.
Insurance premiums are sounding better all the time. The US spends 23% more on health care annually than our next rival in the world counties. That is money that is charged by the medical community for services rendered, not insurance premiums for health care coverage.
Americans demand the best health care in the world and they get it and much of it is elective and non life-threatening services. So Medicare for All would not only cost more than America would be able to reasonably pay, but there would have to be many services now covered under insurance programs that would have to be eliminated or charged back to the consumer. A VAT tax of $3.2 Trillion a year and less services covered, does not sound like a viable solution. And don't forget about wait lines and lack of many specialty services, such as High Risk Prenatal Care not offered in Canada because of the cost, that many Canadians either go without or receive in Seattle Washington.
ACA started down this road with the concept that we all will pay for those services that can't be afforded by some. An example the ACA plans require a male 60 years old to pay for maturity coverage. Child dental care is spread over the cost of all the ACA plans whether you have children or not. These efforts to help the less fortunate resulted not in the savings of $2500 per family per year according to former President Obama, but huge deductibles and coinsurance exposure and 20-50% increases in premiums. That is what happens when the government feels it knows best what its citizen's need in health care and stops listening to their thoughts.
If I have one wish in the coming years as all this plays out; it is that everyone knows and understands the core message in this article. National Health is not a viable option to be considered and if that is ignored it could economically destroy the financial integrity of this country or its citizens. I too want everyone to have affordable health care but let's discuss feasible options.
