By Grace-Marie Turner
Editor’s Note: The following is excerpted from Grace-Marie Turner’s testimony at a Medicare for All hearing at House Rules Committee.
There is no question that many millions of Americans are frustrated with our current health care system. Care costs too much, and many are simply priced out of the market for health insurance. Many who are not eligible for subsidies say the premiums are unaffordable, especially for exchange policies with such high deductibles and ultra-narrow provider networks.
Millions remain uninsured and even those with insurance can face thousands of dollars in “surprise billings.” Patients without generous cost-sharing subsidies can face out-of-pocket costs so high they say they might as well be uninsured.
These and other frustrations, I believe, are generating interest in a bold plan that promises universal coverage for everyone, with no premiums, copayments, or deductibles, and the ability to choose any provider or hospital participating in the new system.
But it is hard to see how consumers would be more empowered when dealing with a single government payer. In a country that values diversity, will one program with one list of benefits and set of rules work for everyone?
I was in the gallery the night the House passed the Affordable Care Act in March of 2010 and heard member after member talk about the importance of passing the bill in order to “finally achieve universal coverage” and guarantee that everyone will be able to access quality, affordable care. Former President Obama promised repeatedly that people would be able to keep their doctors and their plans and that the typical American family’s premiums would drop by $2,500 a year.
Nine years later, our nation still is struggling to achieve these goals of access and affordability. They are understandably skeptical of new promises. When informed that Medicare for All would mean higher taxes and losing the coverage they have now, support plummets.
Still More Government
Proponents of a single-payer health care system argue that if all the money flowing through the health sector today were put into one program, the U.S. could more than afford the new program. But unrestricted access to benefits is virtually unprecedented, and it is difficult to anticipate the impact of this new system.
We do know from the experience of other countries that global budgets lead to rationing, waiting lines, and lower quality of care. These and other forms of rationing seriously compromise access to care.
The Fraser Institute in Canada finds that the median wait time for medically necessary treatment in Canada was 19.8 weeks.
We regularly see articles in UK papers about patients stuck in ambulances for hours in London waiting for an opening to a hospital emergency room. And once patients are admitted, they can be warehoused in hallways for days, with some dying before a hospital bed becomes available.
Nearly a quarter of a million British patients have been waiting more than six months to receive planned medical treatment from the National Health Service, according to a recent report from the Royal College of Surgeons. More than 36,000 have been in treatment queues for nine months or more.
Access to new medicines and other medical technologies also is limited in these countries. In just one example, my colleague Doug Badger recently surveyed access to new drugs in a number of countries with government-dominated health systems. He found the French have access to only 48% of new drugs introduced between 2011 and 2018. Americans, by contrast, have access to 89% of those innovative medications. Nor is France an exception. The Swiss have access to only 48% of newly-developed drugs, the Belgians 43%, and the Dutch 56%.
A group of policy experts — the Health Policy Consensus Group — has developed a plan to help the millions of people who are struggling to afford health insurance, particularly in the small group and individual markets, to have access to more choices of more affordable insurance while protecting the poor and the sick, including those with pre-existing conditions.
It is based upon formula grants to the states, using existing Obamacare resources, but with guidelines that incentivize states to provide people with more choices of more affordable coverage. It provides generous resources for those needing help in purchasing coverage and important protections for those with expensive and chronic illnesses. It is based upon a plan that came closer than is commonly believed to passage in the Senate in the fall of 2017.
An analysis by the Center for Health and Economy has shown the Health Care Choices Plan would reduce premiums by one third while keeping coverage numbers level. By encouraging healthy people to remain covered, insurance pools are healthier, and resources can be directed to help those with greater health needs.
Americans want more, not fewer choices in health coverage, and Medicare for All would put them all on a single government program. When government officials are making decisions about what services will be covered, how much providers will be paid, and how much citizens must pay in mandatory federal taxes, consumers will have even fewer choices and less control than they do today. Medicare for All will take away coverage options, pay providers less, reduce access to new technologies, stifle innovation, and result in a near-doubling of the tax burden.
Grace-Marie Turner is President of the Galen Institute.
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