Caveat lector: Two weeks ago, I discussed here the potential harm that the Democrats’ plans could do to U.S. health care and to “We the People.” Comments in response were primarily ad hominem attacks, without any evidence. This country was founded on respectful dialogue between persons with differing opinions. To those who disagree with what I write here, please limit your comments to evidence you believe refutes my conclusions.
On Nov. 3, it was not only COVID-19 but the ongoing failure of our entire health care system that was foremost in voters’ minds. More than 81 million Americans apparently believed that Democrats will produce a health care system we all want.
Whether implementing Medicare for All — favored by the Vice President-elect Kamala Harris and Sen. Bernie Sanders (I-Vt.) — President-elect Joe Biden’s Health Care Plan, or some combination, Democrats have promised to accomplish the following.
1. All Americans, including more than 10 million undocumented immigrants, will have free, government-provided health insurance: everyone will have coverage.
2. Patients can choose their provider and their care per Section 103, “Freedom of choice,” in the Medicare for All bill.
3. Care will be free at point of service.
4. Only the “wealthy,” those making more than $400,000 per year, will see increased taxes.
Before considering the evidence for or against future Democratic promises, one should consider the fate of their past promises or track record. Otherwise, to quote philosopher George Santayana, “those who do not study history [accept past reality] are doomed to repeat it.”
In 2009, President Obama assured us his namesake law would “bend down” the unsustainable health care spending curve. In fact, the Affordable Care Act (ACA) added $1.76 trillion to spending on health care. The promised family savings of $2,500 per year turned out to be smoke and mirrors: the ACA more than doubled health care costs for the average American family according to both Heritage Foundation and Health and Human Services.
Another well known false health care promise was, “if you like your doctor you can keep your doctor.” Millions of Americans lost their chosen doctor or preferred insurance coverage due to the ACA, also known as Obamacare.
But maybe this time, Democrats will do what they say.
Can the federal government give free health insurance to every man, woman and child in the country, legally living here or otherwise? Of course, it can. They just have to pay the insurance companies enough money. Then, there will be no uninsured Americans. Everyone will have a health policy, a worthless piece of paper.
Worthless because insurance only has value if it leads the timely care of the patient’s choosing. Evidence proves this Democratic promise is errant nonsense. To acquire the funds necessary to pay the insurance companies for our “free” coverage and to create all the new bureaucracy, Washington will have to reduce payments to providers by at least 40 percent. This will inevitably exacerbate the shortage of providers and lengthen wait times for care from the currently unconscionable months to literally fatal years-long waits. Death-by-queueing will become the norm, that occurs in single payer systems, including our own Veterans’ Affairs (VA) system.
“Universal coverage,” Section 102 of the Medicare for All bill most definitely does not produce timely or adequate care.
Care will indeed be free at point of service. Of course, you are likely to die waiting forever in line for that care. More important, if the care you need is deemed by Washington is “Not Cost Effective,” you can’t get it — ever.
Democrats are likely to follow the example of the British National Health Service and declare high-ticket items such as kidney dialysis “Not Cost Effective” in those over a certain age, for example, 55 years. In that situation, the brilliant 57-year old physician-ethicist with whom I shared a podium several years ago, would simply have to die despite having kidney failure, a treatable condition.
Finally, there is the promise of no new taxes on the middle class. This is deception, and everyone knows it except gullible voters who cling to their wish-fulfillment fantasies.
Consider these cost calculations. Less than one percent of Americans make more than $400,000 per year, say 3.3 million persons. They already pay a tax rate of 35 percent. Suppose Biden increases that rate to 50 percent. That will generate $198 billion additional tax dollars. Sanders estimates the cost of Medical for All at up to $40 trillion over 10 years. Increasing the taxes on the extremely wealthy will only produce $198 billion, which barely covers 5 percent of the $4 trillion per year price tag for Democrats’ favored health care plan. Who do you think will pay the other 95 percent ($3.802 trillion)? You and I will.
An ironic side note is Biden’s not well-publicized February 2020 dispute with Sanders over the cost of Medicare for All. Sanders claimed it would cost $30-40 trillion over 10 years. Then-candidate Biden demurred, saying that Sanders’ single payer plan, “would cost more than the entire federal budget that we spend now.”
Famous bank robber Willie Sutton said he robbed banks because, “That’s where the money is.” Democrats understand that the middle class is where the money is. The promise of no increased taxes for most Americans is false based on simple calculations as well as Biden’s own projections.
Based on both past history and available scientific evidence, the Democrats’ promises on health care are fraudulent. Those who believe them are willfully deluding themselves.
Deane Waldman, M.D. MBA, is Emeritus professor of Pediatrics, Pathology, and Decision Science; former director of Center for Healthcare Policy at Texas Public Policy Foundation; and author of multi-award-winning book, “Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine.”