President Obama, Senate Minority Leader Harry Reid and House Minority Leader Nancy Pelosi have all stated publicly their preference for a single-payer health care system, where Americans pay higher taxes and the government pays the medical bills. And many have long argued that Obamacare was designed to fail so that the country would eventually accept a single-payer system.
If Republicans are unable to repeal or somehow bypass Obamacare, conservatives may eventually decide that a single-payer system—such as expanding Medicare to everyone—would be better than the Obamacare status quo.
To be clear, the best option would be to get the government out of the health care system and let the free market guide it, along with a government-backed safety net for the poor. That approach would ensure that people have access to the highest quality care at the lowest cost with the least interference in the doctor-patient relationship. But is that approach a viable option anymore?
Government has long been involved in health care. Prior to the passage of the Affordable Care Act, the government spent about 46 cents out of every health care dollar. With Obamacare spending billions of dollars in health insurance subsidies and Medicaid expansion, the government will be by far the biggest player—and payer—in the health care marketplace.
But Democrats knew they couldn’t pass a single-payer system so they rammed through on a strict party-line vote a convoluted mishmash that keeps the veneer of private sector health insurance but tries to make it work like Democrats think it should.
Now premiums are exploding for millions of Americans (including my family); millions can no longer see the doctor(s) they want; millions have chosen very high deductible policies and are having to go to free clinics because they can’t afford the out-of-pocket costs; health insurers and hospitals are merging so they can cut overhead costs and raise prices; nearly all of the socialist-conceived health insurance “co-ops” are financially underwater; and most states that created their own health insurance exchanges are complaining they can’t afford to continue funding them. Other than that, everything’s great. Just ask the president—and Chief Justice John Roberts.
Not everyone has felt the Obamacare sting yet. If you get coverage through a large employer, you may not have seen much change. Lucky you. But even those plans will evolve as new Obamacare mandates take effect, like the “Cadillac tax,” which will effectively cap how much your employer will spend on your coverage.
Even if the next president is a Republican who campaigned on repealing or reforming Obamacare, it’s not clear those efforts could leap Democratic hurdles—including the hypocritical accusation that Republicans were forcing millions to lose their coverage.
In short, we may be stuck with an expensive, inefficient system that the majority of people neither like nor want. So it’s worth asking whether a Medicare-for-all system would be better than Obamacare.
Medicare is fraught with problems, including fraud, and is financially unsustainable. Plus, doctors are increasingly declining to accept new Medicare patients because it pays so little. But arguably the same things can be said about Obamacare.
On the other hand, Medicare is much less complex than Obamacare. Workers pay the Medicare payroll tax, which covers hospital bills, and seniors pay premiums that cover part of the cost of doctors and prescription drugs. The federal government subsidizes those costs with taxpayer dollars.
And there are private sector options in Medicare. Seniors who stay in traditional Medicare usually by a private sector supplemental insurance policy to cover many of the costs Medicare won’t pay. And about 30 percent of seniors choose a Medicare Advantage plan, a private sector HMO in which the government pays the HMO a fixed amount and the health plan covers seniors’ needs.
And unlike Obamacare, Medicare is very popular.
Here’s hoping Republicans find a way to repeal or reform Obamacare. But if conservatives are eventually faced with the choice of a faltering Obamacare or an expanded Medicare program that covers everyone, we may decide Medicare expansion is the better option—not because Medicare is so good, but because Obamacare is so bad.