Sens. Michael Bennet (D-CO) and Tim Kaine (D-VA) recently reintroduced their signature Medicare X Choice Act, which would create a public health insurance option through Medicare.
Democrats argue that Medicare X “would help achieve universal health care by making coverage more affordable and accessible,” especially in rural communities.
Democrats claim that they just want to offer another health insurance choice. But Medicare X would simply nudge us along toward the Democrats’ endgame: a complete government takeover of the health insurance system.
Medicare X would force healthcare providers that participate in Medicare and Medicaid to accept and treat the new health plan’s beneficiaries. But it wouldn’t pay market rates for care. Instead, it would cap provider reimbursements at 150% of Medicare fee-for-service payments, less than what private insurers pay.
With this cost advantage, Medicare X could offer patients lower premiums and cost-sharing than private health plans.
From there, the road to government domination of the health insurance marketplace is straight. Patients would drop their private plans in favor of the cheaper public option. Providers, meanwhile, would raise the rates they charge private insurers in order to compensate for the influx of people with low-paying public coverage.
Private insurers would respond by raising premiums. And yet more people would quit their private plans for Medicare X. And the cycle would repeat. Eventually, an Uncle Sam-issued health plan would be the only option.
A 2019 study from FTI Consulting projected that 70% of state health insurance marketplaces would drop all private plans by 2050 if the federal government established a public option.
Medicare X would also exacerbate America’s doctor shortage. Practicing providers might choose to retire early or pursue other lines of work, rather than swallow the public option’s low payment rates. And the best and brightest young people might think twice about pursuing careers in medicine; they’d likely have more remunerative options elsewhere.
Universal health coverage through Medicare shouldn’t be a goal. Countries with single-payer systems are grappling with doctor shortages and lengthy waits for critical care. Britain’s National Health Service, for example, is currently dealing with a backlog of 7.57 million appointments. Staff shortages prompted by the system’s constant dearth of funds stop 1.4 million operations a year.
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Or consider Canada, where wealthier patients are paying private providers out of pocket in an attempt to avoid staggering wait times for publicly insured patients.
Medicare X will not “decrease the number of uninsured Americans, control the cost of health care, and increase competition in the health insurance market,” as its proponents claim. The road to single-payer is paved with such talk.
Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on X, formerly Twitter, @sallypipes.
