Medicare for All: Democrats Political Fantasy Will Make Matters Worse

After accomplishing their goal of simply making the promise Democratsll ultimately blame others for the programs collapse

By J.T. Young

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WASHINGTON D.C. (Texas Insider Report) Medicare for All epitomizes the Democrats over-abundance of unrealistic promises. Their goal is really only to have made the promise itself. Simply espousing it puts a candidate in the vanguard of Democrats 2020 race to the left.

They promise that only the rich" will foot the enormous new bill. It takes a great degree of naivete to believe this and even greater cynicism to believe Democrat candidates.

Yet it remains the cornerstone in Democrats effort to promise themselves to the presidency.

There will be plenty of time later to blame someone else for their fantasys failure.

The Democrats response to todays fiscal reality is a political fantasy for the future that will make matters worse. They would extend Medicare from its currently unaffordable construction and make it over five-times bigger (the Census Bureau estimates U.S. population at 330 million now). 

Medicare for All would result in:

  • A massively larger beneficiary population
  • Additional covered benefits (since the expanded population would not be elderly) and
  • More government involvement.

Of course this is precisely the recipe albeit incremental thats gotten todays Medicare in its current fiscal fix.

Medicare in its current form is broken and broke.

Putting more people and more government into the problem goes beyond dubious to oblivious.

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Part of LBJs Great Society Medicare originally was intended to provide health services for the elderly. It followed Social Securitys social insurance model payroll tax payments from those currently employed would pre-fund some services (primarily hospital costs known as Part A) and participant premiums others (primarily doctor costs known as Part B). 

Ambitious then it seems quaint now as with all government programs Medicare grew in every conceivable way extending eligibility beyond the aged and greatly expanding benefits.  

In 2018 Medicare covered 60 million people more than one in six Americans. Now Democratic candidates are proposing to bringing in the other five." A huge problem with their proposal is highlighted by the Medicare Trustees last report:

The financial projections in this report indicate a need for substantial changes to address Medicares financial challenges."

Translating that into laymans terms: Medicare is broke and its getting broker" … fast. 

According to the report Medicare spent $740.6 billion in 2018 60 of total federal health care spending. The report estimates that equals 3.7 of GDP now and will reach 6.3 in 2043 and that is with relatively conservative estimates it could be considerably higher.

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These scenarios are for the current Medicare program and would certainly be far worse as promised in the Democrats Medicare for All mega expansion. 

If that one side of the ledger sheet were not bad enough the other is worse. Funding from outside the government does not begin to keep pace.  For Part A the portion with dedicated revenues (which have been bolstered several times):

In 2018 … expenditures exceeded income by $1.6 billion. The Trustees project deficits in all future years."

For Part B federal funds already account for about three-quarters" of its spending. 

All this is occurring before health care and Medicares too spending is supposed to increase even more. According to the Congressional Budget Office major health care program spending accounts for 28 of non-interest federal spending now; by 2049 it will be 41. 

As Medicare currently proves the government simply will not say no" to limiting costs and Democrat candidates are eagerly falling over themselves to say yes."

Nor will the government say yes" to realistic funding options and Democrat candidates are doing all they can to avoid these too.

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Further Democrat candidates are marching forward without a dedicated funding source something todays Medicare has but repeatedly outgrew to offset the enormous new cost.

It is possible that liberals truly do not care about Medicare for Alls unsustainability. More government is always better and more reasons to redistribute the private sectors wealth better still. That Medicare for All the justification for doing so is not plausible is no reason to not get the dynamic started.

It is also quite possible that the Democrat candidates themselves do not believe it. The problems are too clear for even them to ignore getting Congress to pass it and the U.S. Supreme Court (remember that the much smaller Obamacare hung in the balance there) to approve it are too unlikely.

Instead their goal is the promise itself. There will be plenty of time later to blame someone else for their fantasys failure.

Among these variations of the possible Medicare for All decidedly remains not one of them. Unsustainable in its current form and getting less so Medicare is no model for expansion.

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Instead it should be the top model for government reform.

But that of course would not win any Democrat votes in 2020.  

J.T. Young served in the Office of Management & Budget and at the Treasury Department.

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