Exit polls showed that health care was the top factor in motivating voters in the 2018 election. Democrat candidates successfully stoked fears that the Republicans would end coverage of pre-existing conditions.
Despite repeated assurances from President Trump that pre-existing conditions were safe, almost 60 percent of voters said they trusted the Democrats on this issue. This likely provided part of the margin that switched the House from Republican to Democrat control.
{mosads}If Republicans had hammered home the statistics of health-care coverage, they could have torn down the propaganda that pre-existing conditions could cause one-quarter to one-half of Americans to be denied coverage.
Although the subject of pre-existing conditions attracts a sympathetic following, relatively few voters are actually at risk of denial for pre-existing conditions. Here’s why:
Employer-provided health insurance and Medicare and Medicaid do not permit denials for pre-existing conditions. According to Kaiser Foundation statistics for 2016, 82 percent of Americans (257 million) are protected against denials for pre-existing conditions, leaving 18 percent (56 million) in the private market or uninsured.
These are the ones at risk of being denied coverage. Private markets deny roughly one out of every seven applicants in private markets for pre-existing conditions. At this rate, some 7 million (2 percent of the population) are at risk of denial.
Seven million is a far cry from the widely cited 100 million-plus figure. Given its relatively small size, pre-existing conditions could be managed by other arrangements, such as high-risk pools.
Granted it requires patience, skill, and effort to explain to voters that few Americans are denied coverage for pre-existing conditions, the Republicans did a miserable job. They were completely left-footed by the Democrat health-care scare campaign. It is next to impossible to explain the truth of pre-existing conditions in short sound bites.
The Republican failure on pre-existing conditions, however, could have been more than offset by focusing on the glaring Democrat liability of their HR676 bill, also called “Medicare for All.” HR676 would end the entire American health-care system as we know it, including its most popular provisions.
In short form, HR676 would outlaw employer health insurance and nationalize all health providers, from doctors to opticians. If made aware of HR676’s contents, the Democrat’s Medicare for All bill would have driven frightened and outraged voters in droves away from Democratic candidates.
Republicans have criticized Medicare for All for its multi-trillion-dollar costs, but I focus instead on four provisions of HR676 that would be unacceptable to the vast majority of American voters:
First, HR 676 makes health insurance illegal. HR676 clearly states that: “It is unlawful for a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act.”
HR 676 includes all conceivable medical benefits; therefore there is nothing left to insure. Those on employer plans — about 170 million people — will lose them. Employers can no longer offer employees health insurance coverage, nor can health insurance be sold on private exchanges. Health insurance is outlawed and ceases to exist.
Second, everyone will be thrown into a common government health-care system that is run by government bureaucrats.
HR676 proposes to enroll all U.S “residents” into a system of government-dictated health-care providers. As to the definition of “resident,” HR676 clearly states that: “The Secretary shall promulgate a rule that provides criteria for determining residency for eligibility purposes under the Medicare For All Program.”
It is up to the secretary to decide whether undocumented aliens are eligible. The 50 million Medicare recipients, most content with their coverage, would be joined by 250 million new claimants who compete with them for doctors’ appointments, hip operations, access to new drugs and so on.
‘The result will surely be long waiting lines and services provided only at the discretion of health-care bureaucrats.
Third, medical services can only be provided by government-run institutions and non-profits. HR676 clearly states that: “No institution may be a participating provider unless it is a public or not-for-profit institution.”
All for-profit medical practices must accordingly be converted to non-profit status. They have no choice. According to HR676, for-profit medical establishments are supposed to be compensated by government for their loss of income.
Many customers will see their medical providers disappear as they leave the business or are converted to government or non-profit entities.
Fourth, all forms of medical services must be provided by Medicare for All. Under HR676, patients must receive an all-inclusive list of peripheral medical services from Medicare for All, including physician care, hospital stays, mental health, eye glasses, dentistry, chiropractors, prescription drugs and just about everything else that is medically-related.
{mossecondads}This means that pharmacies, chiropractors, optometrists and all other medical providers must also convert to non-profit status along with doctors and hospitals — also supposedly to be compensated by the government for lost enterprise value.
Under HR676, staffing levels and salaries of medical professionals will be determined by a board of bureaucrats. Young people considering becoming medical professionals must therefore worry whether they will be adequately compensated for the many years of training they must complete.
Medicare for All has been a pipe dream of the left for decades. We could perhaps dismiss HR676 as an election stunt to entice the base to the polls. Do not be so confident. The left is serious. This is not posturing.
HR676 could become law if American voters pay no attention to its real contents and fall under the spell of the promise that everything will be free.
Paul Roderick Gregory is a professor of economics at the University of Houston, Texas, a research fellow at the Hoover Institution at Stanford University and a research fellow at the German Institute for Economic Research.