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Problems with Medicare for All

Demonstrators - for Medicare for All
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By: Robert B. Charles – amac.us – April 24, 2019

Imagine that Russia – or China – wanted to hit Americans where it would hurt.  What would they do?  How could they most efficiently undermine America’s ability to stay strong?  The best way would be to undermine us physically.  That would also be fastest.  But how?

One way would be to promote drug abuse, running over young Americans by promoting addiction.  Put aside money-makers behind marijuana legalization, note China is where fentanyl comes from – along with many precursor chemicals used in deadly synthetics and methamphetamine.  Note the Soviet Union’s erstwhile leader, Nikita Khrushchev, advocated promoting illegal drugs in America.

But think bigger.  How could an adversary who wished us ill, turn our nation upside down in a hurry – making us literally ill?  The obvious answer is to destroy America’s healthcare system, diminishing the ability to stay well – and bringing down 20 percent of the US economy.

How best to do that?  Attack hospitals?  Medical schools?  Reservoirs?  Food supply?  No, none of those would be effective for long.  None would affect more than a smattering of Americans.

They would have to undermine the entire system.  They would have to destroy the incentive behind medical schools attracting top students and creating top doctors, destroy the free-market forces that encourage pharmaceutical companies to produce state-of-the-art medicine, and shut hospitals down.  They would have to demoralize those who make, administer and use America’s life-saving health care.

How could anyone do that?  How could an adversary throw our cutting-edge medical system into disarray, destroying the economic power and physical advantages which attend it?

The answer is simple:  Destroy the incentive mix that encourages life-saving medical care.  Reduce diagnosis and treatment options, destroy the quality, proven effectiveness, incentive to innovate, inspire, conduct path-breaking medical research and create quality medical professionals.

And how?  By destroying return on investment that comes from being a doctor, medical researcher, practitioner and quality medical institution, bankrupting the hospitals, labs and learning centers; undermining pharmaceutical companies, providers and investors; blocking free market forces that fuel our state-of-the-art medical industry.  This, in turn, would weaken American confidence in their own healthcare system, undermining options, quality, economy and health.

In short, push “Medicare for all,” so American voters fall for socialist nirvana, and call it a day.  This is so much cheaper and more effective than mass hacking, cyberwarfare, conventional or nuclear war.  The Americans will never know what hit them, between promoting drug abuse and destroying their health care.

If you think this is just Tom Clancy stuff, maybe a post-Mueller conspiracy, you may be right – but only barely.  Here are sobering facts.  As reported in a recent New York Times article, fittingly entitled “Hospitals Stand to Lose Billions Under ‘Medicare for All’,” we are gambling – even now.  Any presidential candidate who supports “Medicare for All” is nuts – or perhaps “colluding.”

All jesting aside, the facts are clear.  By way of example, a knee replacement typically costs about $37,000 if privately insured, and patient, insurer, hospital and manufacturer end happy.  Under Medicare, that same surgery gives a hospital $17,000, less than half the real cost.  Likewise, gallbladder removal is about $8,000 if privately insured, but a hospital gets $4,200 under Medicare – about half.

So, what gives?  The answer is – everything.  If Medicare is expanded to “all,” America’s hospitals, private insurers, manufacturers and patients would all be losers – and immediately.  Quality care and options contract as patients get fewer choices, hospitals fail and go under, manufacturers stop researching, investing and just go cheap.

Private insurers would diminish, then vanish.  Medical schools would discover that – without a payday, entrants are less inspired, qualified and incentivized.  The system would shudder, crack and begin to fail.

Our adversaries would, of course, celebrate – until they needed American medicine, which many of them oddly do.  If you doubt this prognosis, consult even the New York Times.  In that recent article, they admit “the yawning gap between payments to hospitals by Medicare and by private health insurers for the same medical services may prove the biggest obstacle for advocates of ‘Medicare for all’, a government-run system.”  No kidding?

To the point: “If Medicare for all abolished private insurance and reduced rates to Medicare levels — at least 40 percent lower … there would most likely be significant changes throughout the health care industry, which makes up 18 percent of the nation’s economy and is one of the nation’s largest employers.”

What kind of changes?  “Some hospitals, especially struggling rural centers, would close virtually overnight, according to policy experts.”  What else? “Others, they say, would try to offset the steep cuts by laying off hundreds of thousands of workers and abandoning lower-paying services like mental health.”

Anything more? “The prospect of such violent upheaval for existing institutions has begun to stiffen opposition to Medicare for all proposals and to rattle health care stocks,” since the endgame is terminal – which sounds bad.

Bottom line:  Lovely “Medicare for All,” in parlance of old America, is a crock.  The idea would make our adversaries happy, and most Americans unhappy, unwell, and undeniably disappointed.  The idea is a non-starter.

If even the New York Times had begun to cast rocks at this glass house of socialized medicine – “Medicare for All” and “Quality for None” – you know the thing is doomed.  A candidate that embraces it should face a similar fate.  But don’t count this idea dead yet – Russia, China and Democrats are mulling it.   Just be ready.

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Source: Medicare for All – An Adversary’s Dream Come True! – AMAC – The Association of Mature American Citizens