The Perversity of Medicare for All

Another nugget from Jonathan Lipow’s book Public Policy for Development.

I’ve posted three times now on Lipow’s book (here, here, and here). The thing I like most about Jonathan is that although he is a progressive, he is also an economist. And he does not leave his economy at the door of the policy.

Here is an interesting insight into Medicare for All as a solution to health care spending.

You write:

Another indication that Medicare is part of the problem and not the solution is that no American under the age of 65 is on Medicare, and the US spends only moderately more per capita on health care for this population than other OECD countries. Meanwhile, all Americans over age 65 on Medicare, [DRH note: not quite true. My wife and I are on Medicare Part A but not on the rest of Medicare. As a federal retiree, I retained my employer-provided health insurance] and American health care costs per capita for this group far exceed that [of] other OECD countries. Legally, that doesn’t prove anything, but where there’s smoke there can be fire—and Medicare is shrouded in a thick cloud of smoke.

Later he reveals:

The first change is the “Medicare for All” proposal that would make traditional Medicare eliminate all co-payments, deductibles, and premiums. That would turn Medicare into an FFS-like “fee-for-all” program. [fee for service] insurance policy studied in the RAND study. Remember that a study found that “FFS free” insurance increased bills by 30%, while achieving only negligible benefits in terms of health. Could the same thing happen if we adopted “Medicare for All?”


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