EVERYONE should have health insurance coverage and access to health care. Is Bernie Sanders' Medicare-for-All proposal the best way for the U.S. to achieve that? In his essay on the topic, Michael Cannon, the Cato Institute's director of Health Policy Studies, answers an emphatic no.
His answer emphasizes three major themes. First, he argues that no country as vast as the U.S. limits the availability of private insurance, centrally controls health prices and provision, and provides health insurance coverage to its entire population. Second, he contends that it is farfetched to expect large savings from replacing private insurance and Medicaid with federally managed public insurance given the government's long track record of failure at managing Medicare. Finally, he notes that formally acknowledging health care as a right would limit access, worsen quality, and strip away Americans' rights to seek their own care or coverage outside the monopolist Medicare-for-All system.
The first two points that Cannon raises are simple matters of fact. The scale of the U.S. system swamps other countries' systems. Of course, Sanders' supporters point to the scale as a feature, not a bug, with large potential for savings through lower administrative costs and paying less to providers--and scope itself is not destiny. After all. even small Vermont's single-payer experiment failed to launch under the weight of its costs.
We agree with Cannon's second point: across the history of Medicare, the U.S. government never has been able to implement and stick with value-enhancing reforms when they threaten special-interest groups. To adapt the Chicago Cubs' unofficial motto, "Anyone can have a bad half-century." This is a record to run from, not to run on.
Cannon's third point is a grim prophecy. Imposing one-size-fits-all coverage, shifting all pricing decisions and costs to the Federal government, and prohibiting any outside option will harm Americans' finances and freedoms with nothing to show for it in terms of health.
Now, about those cost savings: with the Federal government fully financing our healthcare system, politicians have incentive to shift away from on-the-books budgetary costs to off-the-books but very real expenses. Headlining these costs is at least an additional $600,000,000,000 per year needed to finance the budgeted two trillion dollars per year due to the economic drag caused by the excess burden of taxation.
There also are palpable costs to...