Are we heading towards Medicare for all?

IN SUMMARY: The Democrats control the Senate now,. A poll last April shows that 69 percent of registered voters support Medicare for All, a plan that would create a national health insurance plan available for all Americans. (The poll was conducted by the Washington, D.C. newspaper The Hill and the market research company HarrisX). But are we asking the right questions in these polls?

Medicare for all has been a political hotbed topic for a long time. Now that the Democrats have control of the Senate and the House, it may become a hot political topic again, but we need to understand Medicare’s motivation for all.

Single-payer health care, the kind that exists in Canada and some European countries, would make medical care free or nearly free for all Americans. Under some versions of these plans, private insurance would be eliminated, and all Americans would be covered under one, government-run plan, similar to Medicare. Instead of premiums and deductibles, under Medicare for All Americans would pay for their health care through taxes—although who would payand how much are matters of great dispute.

The horrors of American health care have become so clear that Medicare for All feels, to many, like a refreshing breeze of simplicity. Medicare for All is easy to understand and promote on social media. The idea is hashtag-friendly—#Medicare4All or #singlepayernow—in a way that “create a Medicaid buy-in” or “add ACA subsidies for people making more than 400 percent of the federal poverty level” are not.

The reason that people want Medicare for all is simple: cost control. The media has done a great job at highlighting the stories of people who have gone into bankruptcy to pay for medical expenses. But is it the the real truth?

The percentage of people with health insurance coverage for all or part of 2019 was 92.0 percent. Private health insurance coverage was more prevalent than public coverage, covering 68.0 and 34.1 percent of the population at some point during the year, respectively.

Overall, tsurveys finds that most people with employer-sponsored insurance (ESI) are generally satisfied with their health plans, and large shares say they feel “grateful” and “content” about their insurance while fewer say they are “angry” or “frustrated.” However, insurance does not offer iron-clad protection against health care affordability challenges. Four in ten report that their family has had either problems paying medical bills or difficulty affording premiums or out-of-pocket medical costs, and about half say someone in their household skipped or postponed some type of medical care or prescription drugs in the past year because of the cost. Seventeen percent say they’ve had to make what they feel are difficult sacrifices in order to pay health care or insurance costs; for some, the sacrifices they report making are extreme.

Seven in ten people with employer coverage report engaging in some cost-conscious health care shopping behavior in the past 12 months, the most common of which is asking for a generic instead of a brand-name drug (47 percent).  However, employee health insurance costs are rising and, in some cases wiping out annual salary raises.

With the major failure of the COVID vaccine rollout, one has to wonder if the public really believes the government can do a better job managing healthcare than private insurers. I’m sure lobbyists will also flood politicians’ pockets with money to fight any government controls around healthcare costs.

What should be your main takeaway from this buzz? Our healthcare system cannot continue on the present course, and that some type of price control initiative is imminent. I believe that the federal government WILL negotiate drug prices with drug companies for Medicare patients and that Medicare won’t cover more prescription drugs (me-too).

This January, the drug industry raised prices on over 400 prescription drugs. It clearly shows that it’s business as usual but before you say “shame on you,” PBM’s and insurers also have to take s huge share of the responsibility as they rake in millions of dollars in profits.

Change is coming, maybe a lot sooner than some believe. Are we ready?