# What are the arguments against Medicare for all? **URL:** \ **Category:** Great Debates\ **Created:** [June 29, 2018, 3:13pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997 "2018-06-29T15:13:17Z")\ **Posts on this page:** 20\ **Page:** 23
**Author:** ![nelliebly](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nelliebly/32/5422_2.png) [@nelliebly](https://boards.straightdope.com/u/nelliebly)\ **Post date:** [September 5, 2018, 3:19pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/441 "2018-09-05T15:19:53Z")
> [@survinga](#): > > Medicare is single-payer for the over 65 population in the US. If you don’t like Medicare, or have issues with it, or have suggestions on how to improve Medicare, that’s fine. I’m no huge fan of it myself. But it is single-payer. It’s single-payer for a _narrow segment_ of health care. It doesn’t cover doctor visits, prescription drugs, tests, physical therapy, or really anything other than hospitalization/rehab/nursing home care. Furthermore, it only covers the first 60 days of in-patient care, so inpatient stays beyond that: are $335 per day or 60-90 days, and a whopping $675/day–$20,000 per month–after that. So let’s call it what it really is: single-payer limited hospital/rehab/nursing home coverage. Calling it single-payer healthcare is inaccurate and misleading. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [September 5, 2018, 3:31pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/442 "2018-09-05T15:31:00Z")
> [@Scylla](#): > > People talk about Sweden and other countries with single payer, but these are not without their issues and drawbacks as well. I read a report yesterday (sorry, not on the internet, but can’t cite) that the average wait in Sweden for someone to see an oncologist after they’ve been diagnosed with prostate cancer is now 270 days. Sweden is dealing with a crisis of scarcity. This is more or less happening everywhere. Too bad you don’t have a cite, because I have a lifetime of experience with single-payer in Canada and no such phenomena have occurred in my direct or indirect experience, because the critical determinant in successful health care is triage so that treatment is provided commensurate with the degree of urgency, and in my experience it always has been, and always with an abundance of caution when the level of urgency is unknown. Also in my experience, when one hears about these kinds of wait times from critics – and wait times do exist – the critics always seem to forget to mention that the procedure in question was elective and non-critical. I have no idea about the specific situation you’re referring to in Sweden, but my guess is that since some types of prostate cancer are frequently very slow growing – indeed so slow that in some cases the best recommendation is not to treat it at all – that this anecdote is a mischaracterization of that type of situation. In any case, there are wait times of some kind everywhere, and it’s only a function of funding level and not something intrinsic in single-payer. What single-payer UHC does do is make health care accessible to everyone. That’s a feature, not a bug. I don’t know about you, but I don’t want to live in a country where I get slightly faster access to non-critical care because other people with more critical needs don’t get access at all, and die because of it. > [@Scylla](#): > > Another issue with single pay is that those countries that implement it are being subsidized in a very real way by our health care system. Almost all of the innovation, the new drugs, the new techniques come out of our system. There is little incentive to innovate and advance medicine under single pay. That’s total bullshit, and it’s bullshit on several levels. First of all, there’s absolutely nothing about the fact that the government is paying for or subsidizing public health care that has anything whatsoever to do with the market for medical goods and services. As a matter of fact, it tends to increase the size of that market. It’s true that many medical innovations come from the US, but that’s just because the US is a large country with a strong technology base – it sure as hell has nothing to do with the private health insurers, who are basically useless parasites. The other level on which this is bullshit is that pharmaceutical and medical technology innovations come from all over the world, and some of the most prominent innovators in many of these areas are not American. For example, [here are the largest providers](https://www.hospitalmanagement.net/features/featuremedical-imaging-technology-diagnostic-device-manufacturers/) in the field of advanced diagnostic imaging in the world – things like MRI machines and related technologies – and their nationalities: 1. Fujifilm Holdings - Japan 2. GE Healthcare - headquartered in the UK 3. Siemens Healthcare (Germany) 4. Philips Healthcare (Netherlands) 5. Shimadzu Corporation (Japan) 6. Toshiba Medical Systems (Japan) 7. Carestream Health (US) 8. Hitachi Medical (Japan) 9. Hologic (US) 10. Esaote (Italy) Among the top 10 diagnostic imaging innovators, only two are American (or three if you count GE’s UK subsidiary), and except for GE they’re mostly small players in this market. > [@Scylla](#): > > Our system sucks, and there is not a quick fix and single pay is not the answer. So you say. Much of the world says otherwise. > [@Scylla](#): > > A first question then, is healthcare a right or a commodity? If it’s a right, than we should all have free access to multimillion dollar procedures that might extend our lives slightly when we face grave, likely fatal illness. Thanks to the advancement of medecine this is becoming an increasingly common issue. People want that for their loved ones. > > It’s not realistic that this can be provided by society. Why is it not realistic? I’ve often described the single-payer health care system where I live as providing unconditional payment for all medically necessary services on the fee schedule, regardless of cost. Which is a critically important aspect of health care, because a system that denies payment when you need it the most is not a working system at all. So why, then, is our system not bankrupt from multimillion dollar procedures? It’s not hard to guess the answer. Because the system is supported universally by the entire population, and most people are reasonably healthy, and those with conditions that are very expensive to treat are proportionately very rare. Ironically, it’s the private insurer, whose entire business is geared to minimizing medical payouts by scrutinizing individual claims, who is likely to balk at a costly medical payout. Single-payer structurally doesn’t do this at all. > [@Scylla](#): > > Food and electricity are not treated like rights. They are treated like commodities that everyone has reasonable access to at reasonable prices. We need to treat healthcare like that. Well, how about that, that isn’t true either! Which is to say, for most of us they usually are commodities, but if the lack of either causes undue suffering, or has any risk of becoming life-threatening, then civilized societies can and do come to the aid of the afflicted. Civilized societies don’t let their citizens starve to death in the midst of plenty, and they don’t cut off electricity in the dead of winter, or at any time when it may cause hardship due to poverty without offering assistance and alternatives. Health care, moreover, is unique because costs aren’t predictable, and some of us who are less fortunate may have very costly needs due to disease or accident, and so it makes sense for reasons of both civilized compassion and cost-efficiency to treat all medically necessary health care as a public service, funded from some combination of tax revenues and common community-rated premiums. Each and every one of your points sounds like it was dredged up from AHIP propaganda rather than a balanced assessment of how health care systems really work. ---
**Author:** ![EscAlaMike](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/escalamike/32/4177_2.png) [@EscAlaMike](https://boards.straightdope.com/u/EscAlaMike)\ **Post date:** [September 5, 2018, 3:32pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/443 "2018-09-05T15:32:35Z")
> [@k9bfriender](#): > > Then we have this, which interprets the constitution as the pipe dream of some stoners. Correct, they were called Anti-Federalists. Patrick Henry is probably the most famous of them. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [September 5, 2018, 3:33pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/444 "2018-09-05T15:33:30Z")
**survinga** , are you saying that Medicare covers everyone over 65, and that there is no coverage provided by other services, such as VA or private insurance? Because if there are other payers for those over 65, Medicare is not single payer. It is a payer for a broad range of people, but it would just be one payer amongst others, not single payer. ---
**Author:** ![eschereal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eschereal/32/18939_2.png) [@eschereal](https://boards.straightdope.com/u/eschereal)\ **Post date:** [September 5, 2018, 4:02pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/445 "2018-09-05T16:02:47Z")
> [@Scumpup](#): > > Good thing, then, that nobody suggested something as absurd as worship of The Constitution. What do you think of the idea that we actually follow the fucking thing and, if we don’t like that, we use the processes in place to make changes to it? Please elucidate, then: what part or parts of the Constitution speak to the issue of health care? ---
**Author:** ![Scumpup](https://avatars.discourse-cdn.com/v4/letter/s/ce73a5/32.png) [@Scumpup](https://boards.straightdope.com/u/Scumpup)\ **Post date:** [September 5, 2018, 4:29pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/446 "2018-09-05T16:29:15Z")
> [@eschereal](#): > > Please elucidate, then: what part or parts of the Constitution speak to the issue of health care? None of them. If we want the document to address that, it will have to be ammended. There are processes in place to do just that. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [September 5, 2018, 4:33pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/447 "2018-09-05T16:33:12Z")
> [@nelliebly](#): > > It’s single-payer for a _narrow segment_ of health care. It doesn’t cover doctor visits, prescription drugs, tests, physical therapy, or really anything other than hospitalization/rehab/nursing home care. Furthermore, it only covers the first 60 days of in-patient care, so inpatient stays beyond that: are $335 per day or 60-90 days, and a whopping $675/day–$20,000 per month–after that. > > So let’s call it what it really is: single-payer limited hospital/rehab/nursing home coverage. Calling it single-payer healthcare is inaccurate and misleading. This is not accurate. Medicare covers doctor visits (Part B), prescription drugs (Part D), tests (Part B), physical/occupational/speech therapy (Part B), and has very little coverage for nursing facilities. There is extensive cost sharing in all parts of Medicare. That part is unfortunately true. ---
**Author:** ![PastTense](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pasttense/32/14550_2.png) [@PastTense](https://boards.straightdope.com/u/PastTense)\ **Post date:** [September 5, 2018, 8:35pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/448 "2018-09-05T20:35:58Z")
> [@Scylla](#): > > A first question then, is healthcare a right or a commodity? If it’s a right, than we should all have free access to multimillion dollar procedures that might extend our lives slightly when we face grave, likely fatal illness. No. An analogy would be does every child have a right to free K-12 education? The answer in the U.S. is overwhelmingly YES. However this does not mean there are not budget constraints on the amount of money spent on this education. It’s quite fine for me if there is also a private medical system where you can buy this multimillion dollar procedure to extend your life a few weeks (or a supplementary insurance policy where you buy coverage for this). ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [September 5, 2018, 8:50pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/449 "2018-09-05T20:50:38Z")
> [@wolfpup](#): > > I have no idea about the specific situation you’re referring to in Sweden, but my guess is that since some types of prostate cancer are frequently very slow growing – indeed so slow that in some cases the best recommendation is not to treat it at all – that this anecdote is a mischaracterization of that type of situation. In any case, there are wait times of some kind everywhere, and it’s only a function of funding level and not something intrinsic in single-payer. What single-payer UHC does do is make health care accessible to everyone. That’s a feature, not a bug. I don’t know about you, but I don’t want to live in a country where I get slightly faster access to non-critical care because other people with more critical needs don’t get access at all, and die because of it. Thanks for saving me lots of typing. You are correct about Sweden. From [here](https://www.ncbi.nlm.nih.gov/pubmed/28443490). > [@](#): > > The reported long waiting times for cancer patients have mostly been related to prognostic outcome and less to patient-related experience to outcome. We assessed waiting times for patients with cancer of the breast, prostate, colon or rectum in Sweden. > METHODS: > > The median time from referral to start of treatment was assessed using data from clinical cancer registers for patients who received curative treatment during 2011, 2012 and 2013. > RESULTS: > > The median overall waiting time in different counties ranged from 7 to 28 days for breast cancer, from 117 to 280 days for prostate cancer, from 27 to 64 days for colon cancer and from 48 to 80 days for rectal cancer. For the entire nation, the median time from referral to start of treatment remained unchanged from 2011 to 2013 for each cancer diagnosis. So 270 days is the very top of the range and only applies to prostate cancer. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [September 5, 2018, 9:10pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/450 "2018-09-05T21:10:07Z")
> [@Scylla](#): > > I didn’t say that, did I? You implied that Medicare is very expensive, and low quality, so I was asking compared to what? Having no or very bad insurance? Maybe. But my Medicare payments are about 1/5 my COBRA payments from before I turned 65, and those benefited from having the advantage of being negotiated by a very big company. And my benefits are better. And COBRA was a lot cheaper than what I could have gotten from the marketplace. I personally put a lot into the Medicare system when I was working, but it is still a bargain. > [@](#): > > But, just for the sake of argument, I suppose it could be, if it worked like a renewable life insurance policy that you started when you were young. Would your force young people to buy this? If not, it won’t work. If so, you have private Medicare, which would not have the clout to enforce good prices - and which would be subject to providers going broke. > [@](#): > > But I don’t care about insurance or who is insured. That’s really not the issue, is it? The actual issue is access to quality healthcare at a reasonable price. That’s what I care about. > > People talk about Sweden and other countries with single payer, but these are not without their issues and drawbacks as well. I read a report yesterday (sorry, not on the internet, but can’t cite) that the average wait in Sweden for someone to see an oncologist after they’ve been diagnosed with prostate cancer is now 270 days. Sweden is dealing with a crisis of scarcity. This is more or less happening everywhere. They fail with access to. The wait time in the link I just gave is for treatment, not for seeing an oncologist. [Here](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608402/) is the data for Canada, which is a lot shorter. I can’t find similar data for the US - but remember, there are plenty who might avoid treatment because of cost. The rest of this \*\*wolfpup \*\* covered. I don’t know if Medicare is really single payer or not (looks that way to me) but as far as I can tell it works great. It would work even better if we got the costs down in the rest of the system which isn’t single payer. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [September 5, 2018, 9:12pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/451 "2018-09-05T21:12:50Z")
> [@wonky](#): > > This is not accurate. Medicare covers doctor visits (Part B), prescription drugs (Part D), tests (Part B), physical/occupational/speech therapy (Part B), and has very little coverage for nursing facilities. > > There is extensive cost sharing in all parts of Medicare. That part is unfortunately true. However most of the rest of the cost of hospital stays can be covered by Medigap policies, which are not all that expensive even for the best. I’ve paid under $20 for drug copays in a year and a half (I take cheap ones, luckily) and nothing for doctors visits, including my cardiologist. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [September 5, 2018, 11:00pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/452 "2018-09-05T23:00:26Z")
> [@Voyager](#): > > However most of the rest of the cost of hospital stays can be covered by Medigap policies, which are not all that expensive even for the best. I’ve paid under $20 for drug copays in a year and a half (I take cheap ones, luckily) and nothing for doctors visits, including my cardiologist. The most popular Medigap, Plan F, averages over $300 a month. The second most popular, C, averages over $400 a month. Medicare Part B premiums are at $134 a month. The median income on Medicare was $26,200 a year, or about $2200 per month, in 2016. Medigap does not cover prescription drugs. I don’t think they are even grandfathered in from when they were last available to be sold. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [September 6, 2018, 12:43am UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/453 "2018-09-06T00:43:41Z")
> [@wonky](#): > > The most popular Medigap, Plan F, averages over $300 a month. The second most popular, C, averages over $400 a month. Medicare Part B premiums are at $134 a month. > > The median income on Medicare was $26,200 a year, or about $2200 per month, in 2016. > > Medigap does not cover prescription drugs. I don’t think they are even grandfathered in from when they were last available to be sold. That’s odd. Why is C more expensive than the better F? And my premiums for plan F are $149 a month. Medicare Part B is just what you say. Medicare Part D is $32 a month, btw. Compare that to the $861 a month I was paying COBRA. Which had higher copays. The really poor can still get Medicaid. I agree that a single payer UHC system funded by general revenue, like Canada, would be better. But given the cost of healthcare and insurance in this country Medicare is still a bargain. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [September 6, 2018, 2:07am UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/454 "2018-09-06T02:07:27Z")
> [@Voyager](#): > > That’s odd. Why is C more expensive than the better F? And my premiums for plan F are $149 a month. > Medicare Part B is just what you say. > Medicare Part D is $32 a month, btw. > > Compare that to the $861 a month I was paying COBRA. Which had higher copays. > The really poor can still get Medicaid. > I agree that a single payer UHC system funded by general revenue, like Canada, would be better. But given the cost of healthcare and insurance in this country Medicare is still a bargain. Premiums for MediGap vary by state (and even county). Without MediGap, you pay 20% of all charges - with no OOP max. To avoid that, Medicare Advantage can be quite a bit cheaper or no cost at all - but you are turning over control to an insurance company. You are usually faced with narrow networks and specialist pre-approvals and all the joy of an insurer getting to control your treatment instead of your physician. ---
**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\ **Post date:** [September 6, 2018, 3:10am UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/455 "2018-09-06T03:10:52Z")
> [@survinga](#): > > It’s the response you’ve earned and that you deserve. So, I’ll treat you the way you deserve to be treated. > > We’ve gone in circles in this thread, with you pretending to be bothered by “ad hominem” attacks, and then accusing me of being selfish and being a liar. You ask questions, which I answer multiple times, and then pretend I haven’t answered. You talk about me “waving my hands”, when you’re the one who’s doing that. > > Pretender. > > I’ll remember this as we engage on future threads. I’ve figured out your act. …I didn’t pretend to be bothered by your ad hominem attacks. I didn’t accuse you of being selfish. I most certainly didn’t accuse you of being a liar. I asked you a specific question: you still haven’t answered it. I won’t remember you when we engage in future threads. I can barely remember people I’ve interacted with in real life. But its awesome that apparently I now have my own personal nemesis. I’ll do my best to live up to my new status as “arch-villain”, even though “when we meet again” I won’t have a clue as to who you actually are. ---
**Author:** ![PastTense](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pasttense/32/14550_2.png) [@PastTense](https://boards.straightdope.com/u/PastTense)\ **Post date:** [September 6, 2018, 3:57am UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/456 "2018-09-06T03:57:21Z")
> [@jasg](#): > > Premiums for MediGap vary by state (and even county). They may also vary by age: > [@](#): > > There are three ways that a Medicare Supplement plan charges: Attained-Age rated, Issue-Age rated, and Community rated > **[Medigap: Attained-Age vs. Issue-Age vs. Community Rated - Senior65](https://www.senior65.com/medicare/article/medigap-attained-age-vs-issue-age-vs-community-rated)** > > Now that you're enrolled in Medicare and decided on a Medigap policy, you should know the 3 ways your insurer can charge you for your policy. ---
**Author:** ![Red\_Wiggler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/red_wiggler/32/13190_2.png) [@Red\_Wiggler](https://boards.straightdope.com/u/Red_Wiggler)\ **Post date:** [September 6, 2018, 12:37pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/457 "2018-09-06T12:37:11Z")
> [@Banquet\_Bear](#): > > …I didn’t pretend to be bothered by your ad hominem attacks. I didn’t accuse you of being selfish. I most certainly didn’t accuse you of being a liar. I asked you a specific question: you still haven’t answered it. > > I won’t remember you when we engage in future threads. I can barely remember people I’ve interacted with in real life. But its awesome that apparently I now have my own personal nemesis. I’ll do my best to live up to my new status as “arch-villain”, even though “when we meet again” I won’t have a clue as to who you actually are. I have a “50 First Dates” joke lined up but I don’t know if that flies in this forum. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [September 6, 2018, 9:04pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/458 "2018-09-06T21:04:13Z")
> [@Banquet\_Bear](#): > > …I didn’t pretend to be bothered by your ad hominem attacks. I didn’t accuse you of being selfish. I most certainly didn’t accuse you of being a liar. I asked you a specific question: you still haven’t answered it. I answered you on post #419. Do you ever read even one response to your nonsense? ---
**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\ **Post date:** [September 6, 2018, 9:28pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/459 "2018-09-06T21:28:18Z")
> [@survinga](#): > > I answered you on post #419. Do you ever read even one response to your nonsense? > [@Banquet\_Bear](#): > > …lets be brutally specific then. Lets address the anecdote I posted. > > What smart regulation **do you** propose be passed to ensure that anyone who needs life-saving medication that costs as much as $175.00 per week can get that medication? [Youcaring has 350,000 current active campaigns related to healthcare.](https://www.ft.com/content/b99a81be-f591-11e7-88f7-5465a6ce1a00) How do your “smart regulations” go about addressing this problem? > [@survinga](#): > > I have people in my family with asthma, type 1 diabetes, and osteoporosis. We are dealing with all of this via my private insurance through my employer, and the co-pays are very reasonable (like $25 bucks when we visit a specialist). Our medicines are less than $10. My daughter sprained her ankle, and my ER visit net out of pocket was $0. My anecdotes mean just as much as yours. > > When I say you live in a fantasy world, it’s because of your laughable, “stop making deals” nonsense. Yeah, that’ll change everything. Dems have no leverage on anything right now, because they are in the minority at every level of government. > > As for your contention that the ACA won’t get us to UHC, the Netherlands and Switzerland use very similar approaches and have achieved it. It’s politics that are blocking things, not the technical details. Given where our system is at, it would be techncially much easier than implementing anything remotely like single-payer. As for you saying that you suspect that I don’t want UHC, that’s not true. You’re accusing me of lying, I guess. And I happen to think that you’re pretending when you act as if a properly adjusted and implemented ACA can’t get UHC. …it doesn’t look like this post answers my question. Can you explain how this post answers my question? ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [September 6, 2018, 9:48pm UTC](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997/460 "2018-09-06T21:48:03Z")
> [@Banquet\_Bear](#): > > …it doesn’t look like this post answers my question. > > Can you explain how this post answers my question? It didn’t answer your question because the ACA (and I know I’m preaching to the choir), while something we should protect in the short term because it’s better than nothing, is something that needs to go away in the long term because it’s not good enough. [Even with the ACA and employer insurance, more and more people are underinsured:](https://www.axios.com/not-just-uninsured-cost-of-health-care-cdcb4c02-0864-4e64-b745-efbe5b4b7efc.html) > [@](#): > > Now that the Affordable Care Act has expanded health coverage, the percentage of the non-elderly population that is uninsured is now just under 11%, the lowest level ever recorded. But as the chart shows: > > Another 15.5% who have insurance either skipped or delayed care because of the cost or reported that they or someone in their family faced problems paying their bills in 2017. > > That brings the total percentage of non-elderly people with insurance and affordability problems to 26.2%. > > More striking: nearly half of all people in fair or poor health — 46.4% — are uninsured or have affordability problems despite having coverage. > > That includes 13.5% who were uninsured and in fair or poor health — arguably the worst off in the entire system — and another 32.9% percent who have insurance but said they or a family member have had a problem affording care in the last year. More and more people in Marketplace and employer plans are in[high-deductible plans](https://www.healthaffairs.org/do/10.1377/hpb20160204.950878/full/). > [@](#): > > A recent Henry J. Kaiser Family Foundation survey of employers shows that deductibles have increased 67 percent since 2010. Nearly one-quarter of workers are enrolled in an HDHP, up from 4 percent in 2006. Nearly half of workers are covered by an insurance plan with a general annual deductible of at least $1,000 for individual coverage. > > In the individual market, almost 90 percent of enrollees in Affordable Care Act (ACA) Marketplaces are in a plan with a deductible above the amount that qualifies a plan as an HDHP: $1,300 for an individual and $2,600 for a family (not including cost-sharing reductions) in 2015. Tweaks to the ACA are not going to do anything with this issue. [Previous page](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997.md?page=22) [Next page](https://boards.straightdope.com/t/what-are-the-arguments-against-medicare-for-all/816997.md?page=24)