The Speciousness of Medicare for All Who Want It
by John Lawrence, October 25, 2019
At first sight Medicare for All Who Want It (MFAWWI) seems to have advantages over Medicare for All (MFA). But there are a number of ways that the political process could corrupt it just as traditional Medicare was corrupted by Medicare Advantage. The rich and healthy could opt out of government run Medicare and instead join a private insurance plan that catered only to them leaving the poor and sick in Medicare. This is sort of what happened with Medicare Advantage. The money that would be available in a Medicare for All plan would be siphoned off by private insurance plans set up just for the rich and healthy.
In an article for the San Diego Free Press in 2012, I wrote:
But Medicare Advantage has a dark side. With traditional Medicare you can go to any doctor you want, even specialists, without a referral. You can get a second opinion, even a third if you choose. With Medicare Advantage you have to stick to a certain network of doctors, and you can even be refused treatment under some circumstances. Ah, there’s the rub. Medicare Advantage will offer you lures — cheap lures but, when it comes down to those expensive operations, you might be refused the permission to undergo the operation by the insurance corporations. After all, that’s how they make their money – denying service for the expensive stuff while luring you in with the cheap stuff.
In a Medicare for All Who Want It plan, Republicans will be up to the same old tricks they were up to with Medicare Advantage which is really a privatized insurance plan competing with Medicare. And Elizabeth Warren is right. It will seem like a great deal until you come down with a really catastrophic illness and are denied that really expensive treatment. Private insurance may well be offered that is gold plated with really expensive premiums that is really only meant for rich people, but the privatized Medicare Advantage plans for the middle class will continue to be offered which lure people in with free gym memberships and suchlike while denying treatment for really expensive procedures.
That's why I'm coming to the conclusion that Bernie Sanders' or Elizabeth Warren's Medicare for All plans are really superior to the MFAWWI plans touted by Pete Buttigieg, Joe Biden, Amy Klobuchar and others. However, Bernie has laid out a plan in which taxes would increase modestly for most of the middle class and premiums, co-pays and deductibles would be eliminated while Elizabeth Warren has not committed to a funding plan. Both Bernie and Elizabeth have to make it clear why Medicare for All is superior to MFAWWI, and Elizabeth has to come out with a plan for how to pay for it. I think Bernie will raise taxes on the wealthy considerably in order to lessen taxes on the middle class in his funding plan. That's why it's important not to let the wealthy opt out of Medicare for All leaving only the poor and unhealthy in that plan with the rich putting their resources exclusively into private plans.
As time goes on Elizabeth and Bernie have to be clear as to their funding mechanisms. So far Bernie has been more transparent than Elizabeth. And they have to make it clear that their plans don't allow the rich to opt out for a very good reason, and that is that their money is needed to be into the plan so that the middle class and poor are not left with an unsustainably funded plan.
