With the Democratic candidates for President of the United States all crowing about some form of Medicare for All, it becomes annoying that they are all trying to fix a problem that doesn’t really, in any true sense, exist (except of their own making). It attempts to address, as Bernie Sanders put it, “those who are uninsured and underinsured.”
So, who are the uninsured and underinsured?
People over the age of 65 (and some people with certain ailments, such as end stage renal disease) are covered by Medicare (around 16% of Americans). People who do not have coverage available through their employer but have an income at or around the federal poverty level are covered by Medicaid (around 28% of Americans). The majority of Americans (right at about 50%) are covered through health insurance subsidized by their employer. A portion of the American population (difficult to determine how many) also qualify for coverage by Native American Tribes, who have their own health care plans. There are also many State programs available to further subsidize health insurance premiums (Oklahoma will subsidize some employer sponsored programs by as much as 65%). Some people are dual eligible for certain programs, so it’s difficult to just add these numbers together to get a total, but it represents somewhere close to 85% to 90% or so of Americans.
With the passage of the Affordable Care Act (often affectionately referred to as Obamacare) in 2010, a reshape of availability of health insurance for individuals who are not covered by Medicare, employers, or native tribes came into being. It features subsidies, supposedly funded by tax credits, but ultimately it amounts to funding by US taxpayers.
Individuals and families can apply for subsidized health insurance through the Healthcare Marketplace, which is open for enrollment from November 1st to December 15th each year. Subsidies begin with those who have an annual income reported on their federal tax forms that is at the poverty level for the size of their family in the State in which they reside. Subsidies are available to those who have an annual reported income of up to three times the poverty level. This means about 87% of people who are not already covered through alternative sources are eligible.
So, the remaining people who are not eligible by alternate sources for subsidies and must find health insurance on their own represents somewhere between 9% and 15% of Americans who have a means of some sort of subsidized coverage. This leaves somewhere close to 1% to 5% of Americans who receive no subsidies of any kind for the purchase of health insurance. Currently, it could be estimated that some 95% to 99% of all Americans have subsidized health insurance available to them.
So, who are these 1% to 5% of Americans who do not qualify for any sort of subsidies? They happen to mostly be comprised of the wealthiest Americans. So, is the purpose of Medicare for All to cover the wealthiest Americans at their full cost of health coverage?
There is the argument one might make that, even with subsidies, health insurance can still be ridiculously expensive. I have spoken to people who receive subsidies from an employer that still have a cost of over $1,200 per month for their families. I have spoken to some people who receive subsidies through the Healthcare Marketplace that still have to pay over $1,500 per month for their coverage. In fact, the affordability of health insurance, even with subsidies, has created a situation where 12.4% of Americans have elected to have no coverage.
When one examines all the commentary by those who supported the ACA, it’s truly evident that it was fully designed to make health insurance premiums higher in order to trick Americans into thinking there is a need for something like Medicare for All, but that’s for a different time in a different discussion. However, the main contributor to the expensiveness of health insurance is the ACA.
Since the ACA was passed, the average cost of a family’s health insurance plan has gone up by some 110% by many estimates. The average out of pocket max (the amount at which health insurance pays for 100% of medical costs) for an individual has gone up by some 60%. So, the potential costs for Americans’ health care for what they pay out of their pockets has gone up by perhaps as much as 120% or more since 2010, when Obamacare came into being.
Medicare for All is an attempt to fix problems caused by government intervention into health insurance, among other problems the government has caused. It apparently attempts to cover many people who are the same wealthy people complained about by its supporters. People have become under insured because the government made health insurance more expensive and forced out of pocket maxes to increase. If the true concern is for the 12.4% of Americans who can’t afford insurance (or have just decided they don’t want it), then the best way is to allow the market to lower its premiums by getting out of the way and removing ACA entirely, as well as any other government intervention.
Medicare for All is sham, and it’s a way for power hungry politicians to grab more control over individual citizens. It has nothing to do with helping people, and it has everything to do with power-hungry tyrants that just want more control over Americans.