Judd Gregg: ‘Medicare for all’ means rationing for everyone

The battle cry of the left today when it comes to healthcare is “Medicare For All.”

This idea arose with Sen. Bernie Sanders (I-Vt.) during his 2016 campaign for president.

Sanders knew that the term “nationalized medicine” would be seen as pejorative by a majority of Americans, so he renamed the concept. 

{mosads}Nationalized healthcare became “Medicare for All.”

It was very creative on Sanders’s part.

This has become the essence of the left’s proposals for how to pursue medical reform, now that ObamaCare has become too heavy a political burden to bear and is essentially non-functioning.

Even Democrats who presented themselves as being more moderate than the socialist Sanders — such as Sen. Jeanne Shaheen, who represents my home state of New Hampshire — have globed onto Medicare for All as the most convenient way to demonstrate their support for dramatic improvement in our nation’s healthcare system.

It is a spurious claim. It does not pass the smell test of political opportunism.

To assert that Medicare For All — or to use its more honest label, nationalization — would actually produce a better, more effective healthcare system for Americans is a hard sell when one looks at the facts.

The proposal is said to be legitimate because, after all, Medicare works fairly well for the older Americans who are insured by this national plan. So why would it not be just as good for everyone else?

This seems like a reasonable view until it is submitted to rational analysis.

Medicare works because the cost of the healthcare that is delivered to seniors is highly subsidized by those Americans who have private insurance.

It is estimated that the unreimbursed costs of hospital care under Medicare and Medicaid are approximately $58 billion a year. The vast majority of this cost is Medicare-driven.

This means that the federal government, when it so generously provides hospital coverage to people over 65, is only paying a limited amount of the real cost of the care.

The rest of the burden is borne by everyone else who has private insurance or by the hospitals eating the costs.

Thus if you go to a Medicare for All system, where everyone gets federally-paid health insurance — a nationalized system — the result will be billions and billions of dollars in unreimbursed costs.

Covering those costs becomes extremely problematic.

If you look at the two major nationalized systems that presently are wrestling, unsuccessfully, with this problem, Canada and the United Kingdom, it is evident that the quality and delivery of healthcare services are dramatically and negatively impacted.

Rationing, both overt and indirect, is one consistent outcome of a Medicare for All system as presently used in Canada and Britain.

In Canada, the average total wait time to see a general practitioner, then a specialist, and then have a procedure is 20 weeks. This puts people at serious risk. It is one of the reasons that Canadians who can afford it come in droves to the United States for treatment.

In the UK, there is actually a board that determines whether or not a patient qualifies for a procedure. In part, it weighs the patient’s age against the costs and outcomes of the procedure. If you do not meet the criteria, you do not get the procedure.

These are only limited examples of the effects of rationing in these nationalized systems.

A significant reduction in the quality and number of people being attracted into the healthcare system is also a discernible result, as salaries are capped and costs related to quality are foregone.

The incentive to innovate and generate new medicines and procedures is also radically muted under nationalized systems.

The capital needed to pursue these expensive undertakings dries up due to the lack of adequate returns on the investment and the excess regulations of the government bureaucracy.

It takes about 12 years and $1 billion to bring a new, dynamic drug to the market. This type of investment simply cannot realize an adequate return in a nationalized system, and the development of breakthrough drugs and technology is therefore chilled.

Medicare for All, a.k.a. nationalization, is one of those ideas that sounds good as a phrase in a stump speech. But if it were actually pursued, Americans would see a deterioration in their healthcare.

All Americans would find that at some level their access to better care was rationed.

The track record of socialism in so many arenas is abysmal but it is especially so in healthcare. Yet this is the direction in which the left wants to take this country.

The left calls out in full-throated hyperbole for a system they claim will give Americans Medicare for All.

It is a failed and cruel policy but it has been sugar-coated in focus-group language.

What the left should really be saying is that it wants Rationing for All.

That would be a more honest statement of what would happen under the system of healthcare the leftists propose.

Judd Gregg (R) is a former governor and three-term senator from New Hampshire who served as chairman and ranking member of the Senate Budget Committee, and as ranking member of the Senate Appropriations Foreign Operations subcommittee.

This column was updated at 10:39 a.m. on May 22, 2018.