Giving Medicare for All a Facelift: the Ugly Is Still There.

• Author: Singleton, Marilyn M.

Medicare for All (M4A) retained its prominent place on the stage at the latest Democratic debate. In its purest Bernie Sanders form, concurrent with abolishing private health insurance, U.S. residents would be enrolled in "Medicare." The program would pay for unlimited "medically necessary" health expenses, including pharmaceuticals, mental health and substance abuse treatment, vision, dental, and hearing services, and long-term care with no out-of-pocket costs. Some supporters were scared off by the $32 trillion over 10 years price tag. Not to be outdone, Elizabeth Warren's "I'm with Bernie" plan comes with a $52 trillion over ten-years price tag including up to $34 trillion in new government spending. Our country's entire yearly budget is a mere $3.5 trillion.

For perspective, if your salary is $40,000 per year it would take 25 million years to earn 1 trillion dollars. As M4A's dark side emerged, the candidates distanced themselves from Bernie-care. Elimination of private insurance? Whoa, Nellie! Over 156 million Americans--half the country--are covered by employer-sponsored health insurance plans and another 23 million have private individual policies. And most of these folks like that arrangement. Then there was pushback from some unions who had excellent health insurance policies for which they had bargained and given up other perks.

In the June Democratic debate, the candidates raised their hands indicating they would abolish private health insurance. Mayor Buttigieg wants to "unify the American people around, creating a version of Medicare, making it available to anybody who wants it." Vice President Biden, noting his desire to keep patient choice stated, "we should build on Obamacare... adding a Medicare option in that plan, and not make people choose." Of course, Obamacare caused a rise in premiums, a decrease in choice of insurance coverage, and like any large government-run program was prone to mismanagement and waste. One analysis concluded that most Americans would suffer financially if M4A were implemented as proposed. An analysis by a bipartisan think tank estimated a 32 per cent increase in payroll taxes would be needed to fund M4A. Everyone--even the working poor--would have more payroll taxes extracted from their paycheck. The analysis concluded that most households would pay more in new taxes than they would save by eliminating their current spending on private health insurance and out-of-pocket medical expenses.

Senator...