‘Medicare for All’ Single-Payer Bills Proposed in Congress

Published April 23, 2018

Congressional Democrats are lining up behind several bills that would create a nationwide single-payer health care system by expanding Medicare eligibility to include all U.S. residents.

In March, U.S. Rep. Keith Ellison (D-MN) became the lead sponsor of House Resolution 676, the Expanded & Improved Medicare For All Act. U.S. Sens. Jeff Merkley (D-OR) and Chris Murphy (D-CT) introduced S. 2263, the Choose Medicare Act, on April 18.

In addition to Ellison’s and Merkley’s proposals, Sens. Tim Kaine (D-VA) and Brian Schatz (D-HI) are sponsoring bills that would also institute single-payer “Medicare for all” programs.

‘Medicare Is Basically Going Broke’

Scott Ehrlich, a policy advisor with The Heartland Institute, which publishes Health Care News, says he would not support a single-payer system because, absent significant reforms, Medicare is already financially doomed.

“I wouldn’t be in favor of ‘Medicare for all,’ because Medicare is basically going broke,” Ehrlich said. “People put in of a lot more than what they get out, and obviously that’s not a sustainable financial system. It consumes a significant amount of our resources, and it’s going up as Baby Boomers retire and the population ages. The costs of Medicare are incredibly high and, obviously, adding a lot of people to that is just unfeasible, from a financial standpoint.”

Politics over Patient Care

Robert Moffit, a senior fellow with The Heritage Foundation’s Center for Health Policy Studies, says a single-payer system would put government bureaucrats, instead of doctors and patients, in charge of people’s health care decisions.

“There are certain things that will necessarily follow from the adoption of a single-payer system of health care,” Moffit said. “Government officials—not doctors, not patients, not hospital executives, not insurance companies—are going to have to make some very big decisions about who gets care, how they get care, why they get care, and under what circumstances they get care.”In this kind of a sad situation, the key decisions are almost always political decisions,” Moffit said. “What happens in effect, then, is that you basically politicize the system. The health care decisions become political decisions, … not medical decisions, and not even economic decisions.”

Ehrlich says the problems caused by Medicare have already exceeded its benefits to people, a trend “Medicare for all” would only make worse.

“While Medicare had good intentions and it dealt with a real, serious problem, it ended up causing a lot of unintended effects on the health care system for everyone else,” Ehrlich said. “The more we increase that, the more it’s going to happen.”

Recommends Regulatory Reform

Instead of trying to expand government programs such as Medicare, Moffit says Congress should loosen bureaucrats’ regulatory grip on health care providers and health insurers.

“The first thing they ought to do is to free up the regulatory regime that is driving up health care costs to the individual small-group market,” Moffit said. “The way to do that, it seems to me, is to either repeal or replace the Affordable Care Act with a system that would allow much greater flexibility in health insurance regulation.”