"Medicare-for-all" is the newest Democratic Party talking point.
Gubernatorial candidate Andrew Gillum has adopted the favorite line of democratic socialist Sen. Bernie Sanders.
But it's wildly unrealistic and would do little to deal with the high costs of health care without rationing.
The first reason "Medicare-for-all" is unrealistic is that it would have to scrap the entire health insurance system in the country.
The Patient Protection and Affordable Care Act, "Obamacare," was designed to deal with those uninsured Americans not covered by employer health insurance, Medicare or Medicaid. It's a relatively small number of Americans, but under the previous system, some uninsured Americans were threatened by bankruptcy with high health care bills. This is the segment that needs affordable health insurance.
There are reasonable proposals in Congress to deal with the uninsured and make "Obamacare" work better, but they haven't been able to gain wide support.
At issue is the incredible complexity of U.S. health care. The United States actually has several different health insurance systems:
— Employer-provided insurance, funded in part with federal tax incentives.
— Medicare for those 65 and older.
— Medicaid, which covers certain low-income people.
— Military systems, including the Veterans Administration and TriCare for active military.
— Individual policies in which people often don't receive the advantages of mass discounts and negotiation.
A "Medicare-for-all" proposal was considered in Sanders' home state of Vermont, but the proposal was dropped because it was too expensive.
The cost of "Medicare-for-all" has been estimated at $30 trillion over 10 years, which would require a doubling of federal taxes.
Beyond the gigantic tax increase, proposals resume a drop in expenses. For instance, reducing provider fees would cause a drop in access.
The real problem with U.S. health care is that high prices are baked into the system. Cutting prices means a cut in someone's profits.
Here are some facts from The Wall Street Journal:
— Health care overtook retail as America's largest industry. That equates to a powerful lobbying force for the status quo. The only segment big enough to challenge the health care industry is business itself.
— Prices for health care started rising faster than inflation in the 1960s. Drug prices have risen the fastest. In response, some large companies have started their own insurance networks and drug providers.
— Lack of transparency frustrates the effort to control prices. A consumer, faced with a diagnosis of appendicitis, does not have time to solicit bids and analyze treatment alternatives.
However, as much as 40 percent of care could allow for shopping, such as with joint replacements or nonemergency MRIs. But what seems more practical is to give physicians the price and quality information and to give them bonuses for recommending tests and procedures that save money.
REPRINTED FROM THE PANAMA CITY NEWS HERALD