Broken promises: ‘Medicare for All’

Published 8:58 am Monday, May 13, 2019

As a physician, my entire career has been dedicated to caring for patients. I came to Congress because I believed we needed — and still believe we need — health care reform that improves quality and lowers cost. Instead, I watched Democrats ram through the Affordable Care Act (Obamacare), making promises they could not keep. They promised “if you like your health care plan, you can keep it — which ended up being branded the “Lie of the Year” by Politifact. They also promised you can keep your doctor, but that ended up being a lie as well. They promised having choices of plans and that premiums would go down; however, costs have exploded since 2009 with premiums on the exchange in Tennessee increasing 176 percent over 10 years, leaving 20 percent of consumers only one option for insurance. They predicted 27 million Americans would gain coverage in 2019, but the actual number was only 11.4 million.
Now, Democrats are making a new set of promises as they unveil their so-called “Medicare for All” plan. They claim patients will have no deductibles or premiums; there will be no copays; and it will end preventable deaths. They claim their plan will require no new taxes on the middle class and can be paid for entirely by taxing the wealthy. With their existing track record, we shouldn’t believe a word they say.
Unlike with Obamacare, one promise Democrats are not making this time is that you can keep your plan if you like it. That is because “Medicare for All” bans all private health insurance. This means 180 million people — including 22 million seniors on Medicare Advantage — would lose their health insurance coverage overnight. The American people will have two options: government run health care or no health care. You will no longer have the right to choose your general practitioner, your child’s pediatrician or your gynecologist.
What else would you lose under “Medicare for All”? Just look at countries like the United Kingdom (UK) that have universal health care. In the UK with a population just over 66 million — about one-fifth the U.S. population of over 327 million — people are waiting months for anything other than the most basic care. There are 4.3 million patients currently on a wait list, with 36,000 waiting over nine months to receive care. Unlike “Medicare for All,” the UK has a private system as well for people to pay for timely care.
To keep public costs down, the UK created the National Institute for Health and Clinical Excellence (NICE) to make treatment and coverage decisions, but there is nothing “nice” about this board. President Obama tried to implement a similar board, the Independent Payment Advisory Board (IPAB), in Obamacare — an unelected group of bureaucrats with sweeping powers to “reduce the per capita growth in Medicare spending.” Boards like NICE and the IPAB share the goal of cost reduction — not quality of care. If a treatment saves lives, but costs too much, they will not pay for it. I led the bipartisan effort to repeal the IPAB, which I believe was the worst part of Obamacare, and was grateful President Trump signed the repeal into law.
As Tennesseans, we know how this system will play out. Tennessee made its own attempt at universal health care under TennCare in the 1990s. First implemented in 1994, it promised to lower costs and expand coverage; unfortunately, it only reduced quality of care and nearly bankrupted the state. Once it collapsed, then-Governor Phil Bredesen had to disenroll nearly 200,000 people and slash benefits, not because he wanted to, but because he had to so the state would not go bankrupt. Now TennCare is one of the most restrictive programs in the country, limiting the quantity and quality of medications patients can receive and the doctors they can see.
According to independent estimates, “Medicare for All” will cost at least $32 trillion over 10 years, an annual amount double our entire federal budget. Even if we doubled all federal individual and corporate taxes, it would still not be enough. We know the plan will cost trillions more. Why? In 1967, Medicare was predicted to cost $12 billion in 1990, but it actually cost $110 billion. Medicare is on the path to bankruptcy in 2026 without reform — all before factoring in this plan.
After years of double-digit premium increases, exploding deductibles and costly copays, patient-centered reform has never been needed more. I stand ready to work with my colleagues on real reforms that will preserve the doctor-patient relationship, lower costs and improve quality.

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