{"id":688,"date":"2019-03-01T23:30:06","date_gmt":"2019-03-02T04:30:06","guid":{"rendered":"http:\/\/commoncents.blogwyrm.com\/?p=688"},"modified":"2023-05-06T16:56:06","modified_gmt":"2023-05-06T20:56:06","slug":"medicare-for-none","status":"publish","type":"post","link":"https:\/\/commoncents.blogwyrm.com\/?p=688","title":{"rendered":"Medicare for None"},"content":{"rendered":"

Representative Kamala Harris recently tossed her hat into the ring as a contender for the Democratic Party\u2019s nomination for president in the 2020 election.\u00a0 The one plank in her platform that has stirred the most discussion is Harris\u2019s bid to institute a single-payer health care system for every American, called Medicare For All<\/a>.<\/p>\n

Her reasons for this, in her own words<\/a> are:<\/p>\n

\nhttps:\/\/commoncents.blogwyrm.com\/wp-content\/uploads\/2019\/03\/Medicare-for-All.webm<\/a><\/video><\/div><\/center><\/p>\n

In her conception of health care access, Medicare for All would eliminate all existing private insurance companies.\u00a0 As the end of the clip shows, when asked about their fate, Representative Harris simply said \u201cLet\u2019s eliminate all of that.\u201d<\/p>\n

Now there are obvious political ramifications for such a single-payer proposal.\u00a0 Doctors and the health systems they work with and for have powerful lobbyists.\u00a0 Insurance companies also have a great deal of influence in politics given their financial holdings and their presence in every state.\u00a0 And whether such a plan would be popular with a majority of voters has yet to be tested.\u00a0 But let\u2019s leave that all behind and simply ask what economic factors exist that support Harris\u2019s assertions and what factors refute it.<\/p>\n

One of the cornerstone ideas in economics is the law of supply and demand that dictates that the price goes down when the supply is higher than demand.\u00a0 The primary way to encourage an ample supply is to allow the suppliers to reap a profit when they persuade a consumer to buy their offering.\u00a0 Ideally, we would want more health care professionals to enter into the market than is strictly necessary by statistics alone.\u00a0 These individuals would compete fiercely with each other, driving the price down and forcing less-competent professionals out of the marketplace, in the process making way for more-competent ones to enter.\u00a0 Less expensive health care would go a long way to addressing her complaint that \u201c[H]aving a system that makes a difference in terms of who receives what based on your income is unconscionable.\u201d<\/p>\n

Currently, competition in the health care arena is blunted primarily by two factors.<\/p>\n

First, by government regulation, insurance companies only compete amongst themselves within specific states.\u00a0 No buying of insurance across state lines is permitted.\u00a0 For example, the ugly battle between UPMC and Highmark<\/a> only takes place within western Pennsylvania with neighboring states being completely ignorant.\u00a0 UPMC mostly furnishes health care through its networks of hospitals.\u00a0 Highmark is the largest insurer in Pennsylvania.\u00a0 While their battle is fierce, it is between payor and payee with neither having strong competition in their own sphere.\u00a0 As a result, the western PA consumer gets to watch two behemoths smack each other around, wasting resources that could be better put to use.\u00a0 How much better behaved would these institutions be if there were credible health care providers and insurers who could swoop in while UPMC and Highmark were distracted with their little war?<\/p>\n

Second, since the primary mechanism by which most of us get our health care coverage is through our employment, competition is further limited to the number of choices provided by people (i.e. employers) who aren\u2019t directly consuming the product.<\/p>\n

Under Harris\u2019s plan for a single-payer system, competition would be erased rather than enhanced.\u00a0 With the elimination of private insurance would also go any incentive for the provider, in this case the Federal Government, to lower costs.\u00a0 Without competition, the average bureaucrat would have little reason to push for a higher efficiency and almost no motivation to put patient\/customer first.\u00a0 For the health care practitioner, the situation could go one of two ways.\u00a0 Either the government would attempt to fix prices in order to address costs, or it\u00a0would subsidize the activity, thus the pervasive government regulations would likely discourage the really good people from becoming doctors and nurses while encouraging substandard ones to become part of what, for them, would be a lucrative payday.<\/p>\n

Having the majority of Americans secure their health coverage through their workplace, a vestigial practice left over from the wage-controlled years during World War II, also blunts our ability to engage in the marketplace, and this lack of market knowledge leads to higher prices and lower quality.\u00a0 By having our employer provide health care coverage as a \u2018benefit, we lose sight of the cost we incur (lowered wages) and, therefore, we have less motivation to push back on the market.\u00a0 As a previous blog discussed<\/a>, each of us is a far savvier consumer of car repair than human repair.\u00a0 Our knowledge of the mechanic market not only allows us to usually figure out when we are being scammed but also places a strong pressure on repair shops to be reputable.\u00a0 Most of us develop and groom this knowledge because we directly bear the cost.\u00a0 But, because we often don\u2019t perceive the cost of employer-supplied coverage, we know far less about the business side of medicine.\u00a0 As a result, we have no sense of quality or proper cost and so doctors and insurers have no pressure to provide higher quality.<\/p>\n

Under Harris\u2019s plan, we would become even further removed from the marketplace.\u00a0 At least when we receive health care coverage through our employers we can always quit and go somewhere else with better benefits.\u00a0 Once the government is the only game in town, how do we go somewhere else for benefits?<\/p>\n

There are plenty of stories of how single payer systems drop the ball on quality.\u00a0 Well-documented problems in the Veterans Administration, Britain\u2019s National Health System<\/a>, and a particularly gut-wrenching piece on Canadian care (video excerpt follows \u2013 click here for Steven Crowder\u2019s full video<\/a>) abound.<\/p>\n

https:\/\/commoncents.blogwyrm.com\/wp-content\/uploads\/2019\/03\/Canadian-Health-Care.webm<\/a><\/video><\/div><\/center><\/p>\n

Closely associated with the quality facet is the timeliness of receiving health services.\u00a0 With a profit motive driving delivery, markets are incentivized to deliver high quality in as speedy a fashion as possible.\u00a0 After all, the higher the throughput, the greater the profit (and for those worried about the lowering of quality in order to increase speed refer to the discussion of market knowledge you just read).\u00a0 Under a single-payer government system, no one is incentivized to do anything rapidly.\u00a0 No additional profit flows for timely action.<\/p>\n

Having just criticized a single-payer Medicare-for-all solution, the reader may be asking if I am defending our current system.\u00a0 The answer, in a word, is no.\u00a0 Our current system delivers excellent care but for too high a price.\u00a0 To get costs in line with benefits, I would recommend four things:<\/p>\n

    \n
  1. Eliminate tax incentives for businesses to offer health care coverage as a \u2018benefit\u2019. Each person should purchase their own insurance as they do for home, car, or property.\u00a0 By having \u2018skin in the game, each of us would become more market-aware.<\/li>\n
  2. Eliminate barriers that prevent insurers from competing with each other nationwide as is done for home, car, and property.<\/li>\n
  3. Significantly curtail the AMA\u2019s ability to shield a health care professional\u2019s reputation. I don\u2019t care if a doctor spent years in school, he needs to deliver in the here and now.\u00a0 Education of the public on the shortcomings of licensing would also help here.<\/li>\n
  4. Significantly curtail tortious suits against health care professionals. Society doesn\u2019t need to punish a doctor with punitive damages yet allow him to continue to practice.\u00a0 Damage to his reputation will rid him from the market with far less human cost than the system we engage in now.<\/li>\n<\/ol>\n

    To close, I appreciate the human cost that\u00a0Harris spoke passionately about and her desire to see that everybody, regardless of station, receives timely, quality health care.\u00a0 I share those ideals with her \u2013 and that is why I am against Medicare\u00a0For\u00a0All.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Representative Kamala Harris recently tossed her hat into the ring as a contender for the Democratic Party\u2019s nomination for president in the 2020 election.\u00a0 The one plank in her platform... Read more ><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-688","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/posts\/688","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=688"}],"version-history":[{"count":12,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/posts\/688\/revisions"}],"predecessor-version":[{"id":1185,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/posts\/688\/revisions\/1185"}],"wp:attachment":[{"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=688"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=688"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=688"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}