Senator Bernie Sanders (I-VT) advocated Medicare for All during his 2016 presidential campaign and he is beating the same drum for his 2020 campaign. Arguing an angle of compassion, he tweeted earlier this month:
“Medicare for All will end the atrocity of a profit-driven health care system in which thousands die because they can’t afford care.”
No one wants to see somebody die because they can’t afford health care. In this, Sanders is appealing to the compassionate side of our humanity. His appeal is simple: If you care about your fellow human, you will be okay spending as much money as the solution takes. However, crafting compassionate policy that is actually effective is not all about increasing government spending, nor is it based upon the ability to increase the scope of bureaucracy.
Medicare for All is itself a remarkable example of the problem with only thinking of a solution in terms of compassion with no consideration toward effectiveness or operation. It is too simplistic a solution even without taking into consideration the astronomical price tag that accompanies it.
Cato Institute scholars Charles Silver and David Hyman released a book in which they discuss the problems with our health care system, going into great detail about the problems to be found in Medicare. They refute Sander’s argument that Medicare would be an “efficient” system that could actually serve Americans in a better and more affordable way.
Silver and Hyman document government reports showing that fraud is responsible for 10 percent of the dollars it pays out to health care providers every year. However, most researchers think the government’s estimate is low. Malcolm K. Sparrow, a Harvard University professor who authored License to Steal, thinks it could actually be as high as 30 to 35 percent, totaling a staggering $185 to $216 billion taken annually from Medicare alone.
When you subtract the amount Medicare spends on fraudulent and wasteful claims every year from their actual budget, the real percentage of money spent on administration and overhead becomes much larger. And even this is not a great measure of efficiency or good care. Silver and Hyman explain:
“Unfortunately, what the consensus really shows is that a lot of smart people are thinking about efficiency in a really dumb way. It makes no sense whatsoever to assess Medicare’s efficiency by comparing its administrative spending to its total budget.” (pgs. 307-308)
Like I explained, even without diving into the enormous cost Medicare for All would have, it is already clear that simply expanding a government program to fit the country’s health care needs would come attached with some pretty weighty problems. And if you think I am simply attacking this policy because it is advocated by Sanders, let me make two points: I could attack so much more of what he argues for on the same premise, and there are so many other case studies to be found across the country.
Folks, just because policy seems compassionate on the exterior does not mean that it actually is. As much as we would like to find quick fixes to issues, there usually are none that would be truly effective. Crafting policy that has a sound foundation while being compassionate toward needy populations is a long and winding road filled with smaller moves, not poorly planned overhauls.
Spending more money on a problem and having government take over management might be a solution in a very few unique cases, but it certainly is not and should not be the blanket solution.