Democratic presidential hopefuls cite ‘good, bad and the ugly’ of Medicare for All

Recent weeks have produced some dissension among Democratic presidential contenders regarding “Medicare for All,” a proposal championed by Sens. Bernie Sanders (I-Vt.) and Kamala Harris (D-Calif.) and some others in the race.

As The Washington Times reported on June 3,  Rep. Seth Moulton (D-Mass.), another presidential candidate, has concerns about Medicare for All, which stem from his experience as a combat veteran receiving care through the problem-rigged Department of Veterans Affairs (VA) system. In what he deemed the “good, bad, and the ugly” of a single-payer system, Moulton said that although certain health care costs, such as prescription drugs, may be marginally cheaper through the VA, access and quality of care there can be alarmingly inferior.

He recounted stories of former servicemembers who killed themselves while waiting for mental health treatment at VA hospitals. And he said: “I want different systems to compete, just like they do with other things in America, to give you the best health care in the world because that’s what you deserve.”  

Former Rep. John Delaney (D-Md.), another presidential hopeful, also took the stage at an event in California over the weekend and was met with a chorus of boos in response to his critique of Medicare for All. Although he said he wants Americans to have access to “universal health care,” he denounced Medicare for All, saying it is “not smart policy.” “Socialism is not the answer” if the party hopes to defeat President Trump in the 2020 election, he added.

Whether or not Medicare for All is a winning message for Democratic presidential candidates, there is ample evidence that it would be a losing policy for the American people. Nick Gillespie’s article in Reason outlined three reasons why the proposal is a bad idea: It would cost too much, increase wait times for care, and slow down the development of new drug treatments. Here’s a fourth reason: It would mean that states wouldn’t be able to use a federalist approach to design policies for the particular needs of their residents. This would also rob the nation of a chance to see the best ideas develop in the states and spread across the country.

Although the concept of Medicare for All has polled positively in recent months, support for it falls when respondents learn more about it. Many people are less willing to support the idea if it means increased taxes, which it most certainly will. We’ve seen this dynamic play out at the state level. Vermont came closest to passing a single-payer solution, but its payment scheme involving significant tax hikes ultimately was deemed unfeasible and marked the demise of the plan. Colorado voters widely defeated a similar single-payer proposal by 4-1 in 2016. Here in Michigan, a state lawmaker’s single-payer proposal last year failed to get a committee hearing and the House Fiscal Agency did not score the bill.  

These actions by state lawmakers, administrations and policymakers in Washington, though diverse, point to a widely held understanding that we still haven’t solved the health care problems that the Affordable Care Act  — known as ObamaCare — promised to solve more than nine years ago.

We shouldn’t double down on another high-cost federal health insurance program to layer on top of the flawed ACA. Instead, we should consider how the federal government can continue to decentralize components of the ACA and clear the way for states to develop lower-cost, market-based options for Americans to obtain health insurance and health care.

Lindsay Killen is vice president of strategic outreach and communication at the Mackinac Center for Public Policy, an educational and research organization based in Midland, Mich. Follow her on Twitter @LinsBoydtweets.