In the Democratic presidential debate in Brooklyn, Hillary Clinton viciously attacked Bernie Sanders’ call for a single payer ‘Medicare for All’ system. She called it a “train-wreck for the poor” and stated that “it would pose an incredible burden, not just on the budget, but on individuals.”
Clinton then argued that the better approach to reach universal coverage is by expanding the Affordable Care Act to the last 10% of Americans who still don’t have insurance. She asserts: “I’m going to get us to 100 percent.”
The former Secretary of State is wrong.
Before I begin, it’s important to note that Clinton does not have a plan on how to “get us to 100 percent.” While her health care plan states that she would “encourage all states to expand Medicaid,” it’s ludicrous to assume that cruel Republicans would expand the Medicaid gap and insure millions of Americans for the sake of the Secretary. And as I’ve said repeatedly (see here, here and here), while Clinton attacks Sanders ability to pass his proposals in a Republican Congress, it is absolutely insane to assume that Republicans would support expanding the Affordable Care Act. It’s just not going to happen.
But even if the impossible became possible and the Affordable Care Act was somehow expanded to the last uninsured American, Hillary Clinton’s plan is not good at all. Here is why:
- Clinton’s Plan Doesn’t Address Underinsurance
Make no mistake. The Affordable Care Act was a great achievement. It expanded coverage to 17.6 Americans and brought the percentage of the uninsured to an all time low.
But what’s often never mentioned is that Clinton’s plan ignores the issues that those who already have insurance face. As the New York Times reports, “insurance often fails as a safety net. Health plans often require hundreds or thousands of dollars in out-of-pocket payments — sums that can create a cascade of financial troubles for the many households living paycheck to paycheck.”
Dr. Margaret Flowers and Kevin Zeese explain that the Affordable Care Act will not put an end to medical bankruptcies – 80% of people going bankrupt due to health care costs had insurance.
- Private Insurance Poses an Incredible Burden on the Economy
The United States spends 17.1% of its GDP on health care. The cost of health care is increasing at 6% per year, and at least 2.2% faster than the GDP 1. Another study shows that the percentage could increase to 25% by 2025 and would continue to rise up to 49% by 2082.
This is unsustainable.
Canada implements a single payer health care system. The percentage of health care expenditure in Canada’s GDP is at 10.4%, and has been decreasing steadily in the past four years.
Under Clinton’s plan, the United States will spend $42.9 trillion on health care over the next 10 years.
With a single payer system, the US will save $5.1 trillion over 10 years. Clinton somehow sees this as an “incredible burden“.
- Private Insurance Poses an Incredible Burden on Businesses
Health care costs are a crushing burden to businesses. Employers are finding it increasingly difficult to absorb the rising costs of Health Care 2. The average cost of family coverage according to Milliman’s Medical Index is $16,771 per employee, where $4,004 is deducted from the employee’s paycheck. As I’ve explained in my previous point, this is only expected to increase for employers and employees putting a significant strain on businesses.
High health care costs also put the United States at a competitive disadvantage globally. Autoweek reports that “Japan’s health care gives Toyota edge [over General Motors]”. General Motors could have launched 3 additional new-model programs if it didn’t have to pay for its retirees’ health care.
The middle class are impacted by health care insurance as corporations shift their health care costs to the consumers in the form of higher prices. General Motors reports that health care costs add between $1,500 and $2,000 to the sticker price of every automobile it makes.
- Clinton’s Plan Will Not Improve United States Quality of Health Care
Despite high health care costs and the availability of great doctors and facilities, the United States ranks in the bottom compared to other nations which have already implemented universal coverage. The United States ranked 37th in the world behind 36 other countries which have universal coverage. In another study comparing the quality of health care of 11 major countries, the United States ranked dead last.
Some Americans are concerned that a single payer system would limit the choice of doctors and would increase waiting times. It’s important to dispel these myths. In fact, insurance companies often limit which doctors or hospitals one can choose to maintain restrictive networks. The New York Times reports that waiting period issues “have become the norm in many parts of American medicine” and that “includes patients with private insurance.”
Clinton’s plan to expand the Affordable Care Act does not resolve these issues.
Bernie Sanders campaign claims that Single payer ‘Medicare for All’ would save families $5,173 on average. A more conservative analysis shows that it would save families from $505 to $1,823. Either way you look at it, a single payer ‘Medicare for All’ is better for individuals, businesses, the economy and the quality of health care overall.
1 W.B. Rouse and D.A. Cortese, Denis A, Engineering the System of Healthcare Delivery (2010), 87-89.
2 Ibid., 91.