The Problems with Medicare-for-All: CBO Reaffirms Numerous Pitfalls

What is Medicare-for-All (M4A)? M4A would force all Americans – regardless of age, income, or intent – onto a new national, government-run, single-payer health care program at an enormous expense to both family and federal budgets. Three independent cost-estimates of M4A projected the federal government would spend at least an additional $32 trillion over 10 years.[1],[2],[3] In May 2019, the Congressional Budget Office (CBO) released a report that examined options policymakers should consider when designing a single-payer system which contained numerous problems and pitfalls.[4]

Following the release of the report, the House Committee on the Budget held a hearing with CBO to discuss the report’s finding, which further highlighted these many issues, such as changes that could occur to the quality of health care and disruptions that seniors and individuals with private insurance would face.[5]

Today, CBO once again confirmed the dangers of a single-payer system.

Here’s what CBO said[6]:

“If coverage was nearly universal, cost sharing was very limited, and the payment rates were

reduced compared with current law, the demand for medical care would probably exceed the

supply of care – with increased wait times for appointments or elective surgeries, greater wait

times at doctors’ offices and other medical facilities, or the need to travel greater distances to receive medical care. Some demand for care might be unmet.”

“[Longer wait times] would be the case under a single-payer system in the United States that had little or no cost sharing.”

“If all hospitals were paid 100 percent of Medicare fee-for-service rates, some would close unprofitable departments or close entirely, and fewer new hospitals would be built in the future, reducing access to care.”

“Less spending on medical services could also alter manufacturers’ incentive to develop new technologies or providers’ incentive to invest in capital, which could affect patients’ choices over the longer term.”

“A potential treatment that a doctor deems reasonable might not be covered by a single-payer system…Some patients in such situations obtain care in other countries.”

“[Little or no cost sharing and reduction in payment rates] would contribute to a shortage of physi­cians in the United States.”

Is M4A a sound health care plan? Here’s what Democratic presidential candidates said in last night’s debate about M4A:

“I don’t think it is realistic…” Former Vice President Joe Biden

…you shouldn’t have Washington dictating to you, you cannot keep the plan you have.” Former Vice President Joe Biden

“Let’s get that straight, $30 trillion over 10 years.” Former Vice President Joe Biden

“The idea that you’re going to be able to save that person making $60,000 a year on Medicare for all is absolutely preposterous. Sixteen percent of the American public is on Medicare now and everybody has a tax taken out of their paycheck now. Tell me, you’re going to add 84 percent more and there’s not going to be higher taxes?” Former Vice President Joe Biden

How would the U.S. pay for M4A? Presidential candidates can’t seem to reach an agreement:

“ … I’m going to make available to people for a full health care coverage for 135 million people. It will be at no cost at all.” – Senator Elizabeth Warren

“It’s going to increase personal taxes.” Former Vice President Joe Biden

“That’s right, we are going to increase personal taxes.” – Senator Bernie Sanders