What are the arguments against Medicare for all?

Please PLEASE don’t jump in with rantings. I’m not going to read rantings. I’d like to know, preferably from liberals, even, what the strongest arguments against it are. What do I need to consider before I say I’m for it? Everything has a down side.

If you know citations, that would really help.

You will have to pay more taxes so poor people can get something for free.

Vermont abandoned medicare for all because it was too expensive.

Even though a study found medicare for all would reduce medical expenses by 25% in a decade, they decided to scrap it in one of hte most liberal states in the US that had already passed a bill for it, because they worried the tax hikes would harm business investment.

Because our health care system is so overpriced, implementing the taxes will be very cumbersome. Adding a 10% payroll tax and a progressive income tax can hurt business investment if you just dump it in overnight.

That is a major opposition point from people who might otherwise be open to it.

Arguments against from conservatives generally revolve around anti-statist attitudes, combined with the idea that they don’t like the idea of paying taxes to help ‘unworthy’ people.

Cost, quality of care and likely extreme and heavy losses in one of the largest sectors to our economy. The last is really what is keeping it from taking off. Medicare payments are very low in comparison to private insurance. Medicare for all would almost undoubtedly lead to lower wages in the healthcare sector and likely massive job losses. Healthcare have become the go to professions for rising into the middle class and a universal healthcare would likely make that a much harder route.

We still need to do it, but there will be a lot of people working in healthcare that will suffer for it.

“You will have to pay more taxes so poor people can get something for free.”

No. Europeans programs with 100% coverage have a total cost significantly less than the 90% or so coverage in the U.S. and Europeans live longer/are healthier.

“Vermont abandoned medicare for all because it was too expensive.”

There is a big problem with safety net programs varying substantially across states as it can result in the disadvantaged moving to take advantage of them.

“Medicare payments are very low in comparison to private insurance. Medicare for all would almost undoubtedly lead to lower wages in the healthcare sector and likely massive job losses.”

I would expect Medicare/Medicaif payments to rise from the very low levels. There would not be massive job losses among health care people who actually deliver health services (as opposed to people who sell health insurance, do complicated claims processing because of differing regulations…) because there are substantial unmet needs.

I didn’t say it was a good argument. Just that it is an argument against Medicare for all.

My first question is always “Do you mean ‘Medicare,’ specifically, or are you using Medicare as a stand-in for single payer?” Because my answer depends on that answer.

But, but socialism…

There are many billions of dollars in Medicare fraud annually.




Now imagine that on a scale 6-8 times greater.

Shit! That’s getting right up there with the Toxic Asset Relief Program! And not even given to banks, but squandered on people!

You’re talking at cross-purposes. You can’t lower costs and still expect to hire more people at higher wages. When you talk about the cost savings in Europe, it is heavily due to the fact that healthcare wages are about 2/3 of what they are here. Wages have gotten depressingly low for nurses across Europe and many countries are having to import nurses from the third world to fill their staffing needs. There’s a big funnel in nursing where the US imports their nurses from Europe and Canada and Europe imports theirs from Africa and the Philippines.

Yes, insurance companies siphon money off, but it’s a small percentage, somewhere around 5% of healthcare costs and not all of that would disappear since there is still a need for bureaucracy surrounding healthcare. The gorilla is that our salary costs are too high and they’ll have to come down if we want to implement a universal healthcare system with similar costs to European models. Total US healthcare costs are 3.3 trillion dollars. The entire revenue for the government was about 3.4 trillion. There’s no magic elixir that we can drink to give us an NHS without some bitter realities as to what that will do to the US economy and healthcare wages.

Which is on a program 6-8 times bigger. Same proportions. The answer is not to not expand but to step up efforts to reign in fraud.

The biggest argument against it is that it is simply unconstitutional.

Anything else, either pro or con, doesn’t really matter unless or until the government decides to become honest again and start obeying the Constitution.

The high cost of U.S. healthcare in general is an obstacle to single-payer and to other specific health plans.

One cost is insurance service. The U.S. insurance industry employs 3 million people IIRC (I’m not sure how many of these belong in the subgroup ‘health insurance’), and furthermore many health providers employ part-time or full-time clerks to interact with insurance companies. Whether through taxes, premiums, foregone salary raises, or medical bills, American households are each paying some dollars per day just to feed the paychecks of these insurance workers and red-tape processors.

This insurance service, which provides little value added anyway, is a major area where single-payer plans could save large sums. But to do so, government would need the will to say “Insurance company employees: you’re out of a job. Insurance company shareholders: your stock just tanked.” Is there the political will to do this? If not, single-payer plans will be designed to keep insurance companies involved unnecessarily; Medicare is already like that. In the U.S., insurance companies are sometimes involved in medical decisions even when they’re paying little or none of the bill.

America needs to strip away unnecessary red-tape from healthcare. Are “single-payer” plans designed to do that? Or are they designed to just add another layer of red-tape?

There is fraud in ALL insurance. All insurance companies have departments to fight it now.

Medicare is not unusual in this regard. Insurance fraud exists across all of it, not just Medicare. Insurance fraud is very popular among crooks.

I’m honestly curious: what passage in the Constitution do you believe makes Medicare-for-all unconstitutional?

And, secondarily: if such a passage exists, why has Medicare for senior citizens been allowed to exist for over 50 years?

I would guess that our friend is a strict constructionist where the Federal government possesses no powers not specifically enumerated in the Constitution. That means that lots and lots of things are out of bounds. The reality is that the US in its early days was a collection of countries that agreed to work together (not dissimilar from the EU. If you think of the US in 1800 as where the EU is now, a lot more about our government makes sense and some viewpoints that seem really crazy start to be more understandable.) Over time, the central government just took more powers to itself (income taxes is one that sticks in the craw of strict constructionists.) The Constitution doesn’t specifically say that the federal government has a right to set up a universal health plan, so strict constructionists would say that right is reserved to the states. Of course, courts have for years argued against this logic and as Obamacare and Medicare have shown us, the federal government has plenty of tools to coerce the states into doing what it wants. I am more than sure though that if we put an NHS into place, there would be lawsuits and I’m equally sure that some of them would succeed and any ideal bill put forward would end up having parts of it overturned. That’s just how these things work. You just hope that enough provisions get upheld that the entire system doesn’t collapse.

I hope when you’re looking at downsides, you’re doing so knowing that many of those listed here are disputed. There’s a great deal of misinformation out there, due in large part to insurance companies, conservative politicians, and a certain “news” channel. There’s also some misinformation on the upsides, but you didn’t ask for that.

You should also consider that “single payer” doesn’t have a uniform definition. Canada’s system, for instance, still relies on private insurers and employer/employee contributions as well as taxes, and doctors are not government employees. (Canada spends 10% of its GNP on health care compared to the US’s 20%.) In the UK, government really does run all healthcare, and there’s no charge to consumers except for OTC meds. In Iceland, the government pays 80-85% of healthcare costs; the rest is paid mainly through service fees. In Finland, about 2.5% of taxable income goes to healthcare coverage: 1% by employer, 1/5% by employee.

One argument I hear frequently is that people have to wait for an appointment for months, especially to see specialists. This one always makes me chuckle, albeit bitterly. In some areas I’ve lived, specialists schedule 4 months out, and primary care docs schedule 3 months out. If you have to be seen sooner, you go to a walk-in clinic.

An argument I have is that we’ll need to increase the supply of medical professionals. There’s a serious shortage of PCP’s, and one reason is that the Affordable Care Act meant more people could afford to get health care. Only 2 or 3 PCP’s in my city are taking new patients. The more people covered, the more docs and nurses we’ll need.

That’s what they said about Teddy Roosevelt’s plan for ‘sickness insurance’ in the 1912 campaign.