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The Inevitable Trade-Offs of Medicare for All

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Published October 13, 2022

Many people feel that “Medicare for All” sounds like a good idea: get rid of private health insurance and have the government pay for all medical care. But digging a little deeper reveals that creating government-provided coverage for all Americans while attempting to lower health care costs would come with some steep trade-offs. There are much less disruptive and more targeted ways to help those who cannot afford medical care.

Discussion Questions:

  1. Who is Medicare for All intended to help? Does it need to cover everyone?
  2. Would Medicare for All make American citizens more or less free?

Additional Resources:

  • Read Charles Blahous’s statement before the US Senate Committee on the Budget. Available here.

  • Watch “The Fiscal Consequences of Medicare for All,” with Charles Blahous on PolicyEd. Available here.

  • Read “Input and Output in Medical Care,” by Milton Friedman. Available here.

View Transcript

Many people feel that “Medicare for All” sounds like a good idea: Get rid of private health insurance and have the government pay for all medical care. The government would set prices, no patient would have to make copayments, and no one would be left without health coverage.

But digging a little deeper reveals that creating government-provided coverage for all Americans while attempting to lower health care costs would come with some steep trade-offs.

Because coverage would be more generous under Medicare for All, it wouldn’t be able to save money without making enormous cuts in payments to doctors and hospitals. Medicare already reimburses these providers at 30 to 40 percent less than they receive from private health insurers for the same procedures, and that’s often below what it costs them to provide care. 

If all medical procedures switched over to the government’s Medicare rate, many doctors and hospitals wouldn’t break even. The results would be predictable: Much longer wait times and lower quality care, as demand far outstripped available supply.

In order to provide coverage for a small population of people, we’d take away existing options for everyone else. 

There are much less disruptive and more targeted ways to help those who cannot afford medical care.