‘Medicare for All’ will turn into health care for none

Whether we can use the results as legitimate or not, the Iowa caucuses and New Hampshire primaries showed one thing — progressive policies articulated by former South Bend, Ind., Mayor Pete Buttigieg are currently resonating with Democratic voters. But while he has surged in popularity over longtime Democrat party players, how would his policies play out nationally?

Buttigieg has roughly outlined numerous platform policies, but the roughest right now is his health care plan: “Medicare for All Who Want It.” This idea is to offer a public option that will compete in the health care insurance market against employee sponsored plans, private plans, and plans introduced through the Obamacare Exchange.

A public option would crowd out those in our health care system who need its services the most. It could increase costs to those who do not want to be insured but are forced to via a government mandate. We are a country that values choices, and this would ultimately remove those from our health care system.

Buttigieg’s plan would automatically enroll anyone in the public option who is uninsured, starting first with those who reside in non-expansion states, including Texas. There are people who chose to be uninsured in these states — because they have the freedom to (many of these folks sought out affordable coverage elsewhere). They would not have that option under Buttigieg’s plan.

While the details of automatic enrollment are being worked out, physicians who see an uninsured patient would be reimbursed by the government. But if you know that the government will cover your bill if you are uninsured, why would you pay the premiums for your employee or private insurance plan? Or, due to the notorious inefficiencies of the government, would physicians take the risk of accepting uninsured patients without a timely reimbursement plan in place?

As Buttigieg’s plan states, this is a “natural glide-path to Medicare for All.” When we look at our current examples of single-payer systems in the United States — Medicare and the Veterans Administration (VA) — patients’ needs are often unmet, and costs continue to rise. It has been found that the VA is inefficient, filled with unnecessary costs, and patient wait times lead to increased complications and sometimes death. Medicare has been overspending for decades with Medicare for All predicted to increase the deficit by $14 trillion over 10 years.

With an increase in people on the same health care system — remember, the goal of Buttigieg’s plan is Medicare for All — there will be less access to services for everyone. Currently, Medicare and Medicaid pay less than the private market in reimbursement rates and there are fewer and fewer providers even accepting Medicare and Medicaid patients. There is the potential for a major physician shortage in the next two decades, and Medicare for All Who Want It, or any variation thereof, will not be the carrot to bring more suppliers in.

Buttigieg’s plan cites as an example a 60-year-old in Iowa making $50,000 a year who currently pays $12,000 in premiums. His plan states that the Iowan will pay no more than 8.5 percent of his or her annual income, or $4,250 annually. For many that close to retirement age, that can still be too much. Without government intervention into the market, this individual can enroll in a direct primary care plan which is $77 a month on average, or $924 annually, a much more affordable choice that lets Americans save more of their hard earned money.

We as a country do not have to go down this path. The Personalized Care Act companion bills introduced during this Congress by Sen. Ted Cruz (R-Texas) and Rep. Chip Roy (R-Texas) would allow more Americans to use health savings accounts and health care sharing ministries to help fund their care. Increasing access to these funding choices can increase access to services for average Americans.

Buttigieg’s plan is a step in the direction of Medicare-for-All-Because-the-Government-Says-So. Automatic enrollment would crowd out the system to those who need access to services. We have seen the negative effects of the single payer system through the VA and Medicare. What Americans need is more choices, not to be forced into something.

Elizabeth O’Connor is a legislative fellow at the Texas Public Policy Foundation. She has a masters in Public Service and Administration from the Bush School of Government and Public Service at Texas A&M University and has studied at Manhattan College and Trinity University, Dublin.