The 3 Big Questions That Are Not Being Asked About “Medicare For All”

Authored by Laurence Vance via The Future of Freedom Foundation,

Congress recently held its first hearing on “Medicare for All” legislation that would eliminate most private insurance, phase out Medicare and Medicaid, and institute universal socialized medicine.

The House Rules Committee heard six hours of testimony on the Medicare for All Act of 2019 (H.R.1384). Introduced by Rep. Pramila Jayapal (D-Wash.) on February 27, the legislation now has 108 co-sponsors, all Democrats. A number of Democratic presidential contenders have also expressed support for the proposal.

The Medicare for All Act “establishes a national health-insurance program that is administered by the Department of Health and Human Services (HHS).” The program must

(1) cover all U.S. residents;

(2) provide for automatic enrollment of individuals upon birth or residency in the United States; and

(3) cover items and services that are medically necessary or appropriate to maintain health or to diagnose, treat, or rehabilitate a health condition, including hospital services, prescription drugs, mental health and substance-abuse treatment, dental and vision services, and long-term care.

The bill “prohibits cost-sharing (e.g., deductibles, coinsurance, and copayments) and other charges for covered services.” Private health insurers and employers “may only offer coverage that is supplemental to, and not duplicative of, benefits provided under the program.” Health insurance exchanges and federal health programs (except coverage provided through the Department of Veterans Affairs or the Indian Health Service) “terminate upon program implementation,” which “must be fully implemented two years after enactment.”

Jim McGovern (D-Mass.), the House Rules Committee chairman and a co-sponsor of the bill, remarked about the legislation, “We need to expand the definition of national security to include more than just the number of bombs we have. It should also mean quality health care.” He argued that it shouldn’t be “too much to expect the federal government to protect us against illnesses here at home.” Echoing Barack Obama, McGovern maintained, “People are not going to lose their health care: you can keep your doctors, go to your hospitals that you currently have. The only difference is you wouldn’t have to deal with your insurance companies.”

Among those testifying at the hearing was Ady Barkan, a 35-year-old progressive activist for single-payer health care who has ALS (Amyotrophic Lateral Sclerosis, or Lou Gehrig’s disease). Sitting in a wheelchair and speaking with the aid of a computer, Barkan emotionally insisted, “Health care is not treated as a human right in the United States of America. This fact is outrageous and it’s far past time we change it. Health care is a human right.” This “right” is something that most Democrats, including House Speaker Nancy Pelosi, have pushed for many years.

But House Republicans at the hearing pushed back. Ranking member Rep. Tom Cole (R-Okla.) likened the Medicare for All Act to socialism: “This bill is a socialist proposal that threatens freedom of choice and would allow Washington to pose one-size-fits-all plans on the American people.” Charles Blahous, a senior researcher at the Mercatus Center at George Mason University, who was invited to testify by the Republicans, estimated that the bill “would cost up to $38.8 trillion in additional government spending over 10 years.”

Liberal media outlets were eagerly anticipating the “Medicare for All” hearing. HuffPost used the occasion to raise “3 Big Questions Now That ‘Medicare for All’ Is Getting a Hearing”:

  1. What does Medicare for All actually mean?

  2. How should government control health-care spending?

  3. What are the consequences of doing nothing?

The writer describes two possible meanings of “Medicare for All”: A government program that covers everything “with essentially no out-of-pocket expenses” (like the Jayapal bill) and a system “in which everybody has insurance, the government plays a much larger role in controlling health-care spending, and the profit motive doesn’t interfere with people’s ability to get care.” To make sure that everyone has “generous health insurance,” and that “spending will be no more and maybe even less than Americans spend on health care today,” the government “would have to get a lot more involved in controlling the price of health care, either by fixing prices or setting overall budgets.” This would, admittedly, “affect every part of the health-care industry ― not just drug companies and insurers, but also doctors and hospitals.” The consequences of doing nothing are dire: “As private insurance gets more expensive, people who buy insurance on their own and aren’t eligible for the Affordable Care Act’s tax credits face premiums that are more and more unaffordable.”

The problem with these three questions is that they never get to the root of the issue. Libertarians maintain that there are 3 big questions that are not being asked about “Medicare for All”:

  1. Is it constitutional?

  2. Is it the proper role of government?

  3. Who should pay for health care?

The answers to these questions are really quite simple.

1. Not only is there nothing in the Constitution that authorizes the federal government to have a Medicare for All program, there is nothing in the Constitution that authorizes the federal government to have a Medicare program for anyone. Just as there is nothing in the Constitution that authorizes the federal government to have Medicaid, the Children’s Health Insurance Program (CHIP), the Centers for Medicare and Medicaid Services (CMS), the Center for Medicaid and CHIP Services (CMCS), the Affordable Care Act (ACA or Obamacare), the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the Republican version of Obamacare), the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), federal laboratories, the Food and Drug Administration (FDA), or the Department of Health and Human Services (HHS).

2. It is an illegitimate purpose of government to provide or pay for all or part of anyone’s health care or health insurance. Just as it is an illegitimate purpose of government to maintain or fund medical research, insurance exchanges, community health centers, clinical trials, family planning, HIV/AIDS prevention initiatives, databases of Americans’ medical records, or vaccination programs; issue nutrition guidelines, regulate the sale of mandate insurance coverages, have medical-licensing laws, restrict the sale of bodily organs, or have medical-record requirements; issue mandates or regulations regarding physicians, dentists, nurses, midwives, psychiatrists, psychologists, hospitals, medical devices, pharmacists, insurance companies, medical schools, nursing homes, drugs, or drug companies; or make health care and health insurance more affordable or institute a safety net to ensure that the poor have adequate health care.

3. No American is entitled to health care provided at the expense of another American. No American should be forced to pay for the health care or health insurance of any other American — regardless of how poor, old, sick, disabled, or needy that other American is. All charity should be private and voluntary. Health care is not a right; it is a service that can and should be provided on the free market just like any other service.

Don’t look for liberal media outlets to ever raise these three fundamental questions. And as for conservatives, they have no real answers to them when it comes to health care and health insurance because they can’t answer them without equivocating and making exception after exception.