WASHINGTON — Rep. Ro Khanna is once again promoting Medicare for All, claiming a government-controlled single-payer system would cover every American, save lives and reduce national health care spending by more than $1 trillion annually.
Americans have heard sweeping health care promises from Washington before.
How about no Medicare for All?
Khanna, D-Calif., cited a new analysis led by researchers at the Yale School of Public Health to argue that the United States should replace its current mix of private insurance and government programs with one national public insurance system.
“A new Yale analysis found Medicare for All would cover every American AND save more than $1 trillion a year, cutting national health care spending by 20%,” Khanna wrote Wednesday on X.
Khanna also claimed the proposal would provide better pay for doctors, nurses and other health care workers.
“We introduced the Medicare for All Act because we already knew this,” Khanna wrote. “Now Yale has the numbers to back it up. Health care is a human right. It’s time to act like it.”
The numbers deserve closer examination before Congress places nearly the entire American health care system under federal control.
The Yale analysis estimates that national health care spending would fall from $5.28 trillion to $4.24 trillion annually under a Medicare-for-All-style system. Researchers projected $1.04 trillion in savings and more than 100,000 fewer deaths each year.
However, the study is a preprint and has not undergone peer review, a fact that should accompany every political claim based on its findings. Yale School of Public Health
The projection is also built on a series of assumptions about what the federal government could force hospitals, doctors, pharmaceutical companies and insurers to accept.
Researchers attributed $377.5 billion in estimated savings to lower prescription-drug prices, $295.6 billion to paying medical providers at Medicare-level rates, $286.3 billion to reduced administrative expenses, $285.7 billion to lower fraudulent billing and $100 billion to preventing avoidable emergency-room visits and hospitalizations.
Those figures are not guaranteed savings. They are the results produced by a model based on policy assumptions.
The proposal would save nearly $296 billion by paying hospitals and other providers less than commercial insurance currently pays them. That raises a serious question about Khanna’s simultaneous promise that doctors, nurses and other medical professionals would receive “better pay.”
The researchers argue that Medicare rates would remain above Medicaid rates and that hospitals would receive additional money for care that currently goes uncompensated. But reducing provider reimbursements nationwide could still affect hospital finances, staffing, service availability and the willingness of doctors to accept additional patients.
Calling a payment reduction “savings” does not make the cost disappear. It transfers the burden to someone else.
Khanna’s pitch also brings back memories of the Affordable Care Act.
Before Obamacare became law, former President Barack Obama repeatedly told Americans that if they liked their health care plan, they could keep it. Millions later received cancellation notices because their plans did not comply with the law’s new requirements.
Americans were also promised greater choice and lower costs. Instead, many families faced rising premiums, higher deductibles and restricted provider networks. Federal subsidies hid part of the expense for qualifying households, but taxpayers continued paying the bill.
Now Democrats want Americans to believe an even larger government health care transformation will work exactly as projected.
Medicare for All would not simply allow more Americans to join the Medicare program used by seniors. Proposals championed by Khanna and Sen. Bernie Sanders would create a national single-payer system, eliminate most private health insurance and place the federal government at the center of health care financing.
Employer-sponsored insurance, Medicaid and the current Medicare structure would be replaced or fundamentally transformed. Americans who like their existing coverage would not necessarily be permitted to keep it.
That is not more choice. It is one government-approved choice.
Eliminating premiums and deductibles would not make health care free. The money would have to come from federal taxes, borrowing or both. The expense now divided among individuals, employers, insurance companies and government programs would move largely onto the federal budget.
Supporters argue that many families could pay less in new taxes than they currently pay in premiums and out-of-pocket expenses. That outcome, however, would depend on the tax structure Congress eventually adopted, the accuracy of projected savings and the government’s ability to control costs without restricting access.
None of those questions is settled by a single study.
America’s health care system has serious problems. Insurance companies should not be able to deny medically necessary care through endless paperwork. Pharmaceutical pricing needs greater transparency. Families should be able to understand the cost of treatment before receiving a shocking bill weeks later.
Congress should also protect patients with preexisting conditions, increase competition, expand access to health savings options and stop hospital systems and insurance companies from hiding prices.
But fixing a broken system does not require handing control of nearly one-fifth of the American economy to Washington.
Federal officials already struggle to protect Medicare from hundreds of billions of dollars in improper payments and fraud. The program faces long-term financial pressure as the population ages. Expanding government responsibility to every American would magnify those challenges.
Medicare was created as a promise to seniors who spent their working lives paying into the system. Congress should concentrate on protecting that promise before transforming Medicare into a national program for more than 340 million people.
Khanna says health care is a human right. But declaring something a right does not create the doctors, nurses, hospital beds, medicine or money required to provide it.
Americans deserve affordable, accessible and honest health care reform. They do not need another Washington promise that government can control more, spend trillions and somehow guarantee that everyone will receive better care for less money.
Obamacare taught the country what happens when politicians sell a massive health care law with promises that do not survive implementation.
Medicare for All would be an even larger gamble.
How about no?
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