Our country’s cyclical debate on how to best reform health care is in full swing. A fresh slate of presidential candidates and debates in Congress have unrolled a new set of plans, some of which were intensely on display in the recent debates. The challenge for us as Iowans is to distill debate rhetoric into the real impacts. The problem is, none of the proposed solutions to transition our private health insurance system to one controlled by the government would serve Iowans or the country well. In fact, these systems would only undermine our ability to offer high-quality care.
This type of reform can be an easy sell. But I encourage Iowans to educate themselves on these one-size-fits-all proposals, rather than merely taking in what’s being said on T.V. in front of debate monitors and prepared talking points.
Consider this point: Medicare for All is a popular slogan. But when the discussion goes deeper, the perception quickly changes. A new national poll shows that only one in 10 registered voters want the equivalent of Medicare for All if it means abolishing private health insurance plans — and that’s exactly what the proposal does.
Understanding the role private insurance plays in the health care marketplace, and its relationships to other programs, is important. In reality, public programs such as Medicare rely on private plans to remain afloat, because their costs have not kept up with inflation. Nor do they have the same flexibility and responsiveness of private or employer-type plans.
When health care providers are restricted, they will be detoured from participating in “assigned” medical costs. For example, the Mayo Clinic and providers across the U.S. do not accept Medicare assigned charges; thus, a person could potentially have to pay significant dollars out of their own pocket if Medicare for All is the only plan available. Under this concept, do we really think the same quality of health care in our country will continue?
Medicare and Medicaid are important. However, they can’t expand beyond their scope without consequences. While deductibles and copays would be eliminated, under Medicare for All significant taxes would be imposed, including a 4% tax on nearly all households and a large increase in payroll taxes.
While not necessarily one and the same, a Medicare public option would inevitably put our system on the same path. Ostensibly, a public option would be introduced in the market to “compete” with other plans. In reality, competition would be virtually nonexistent as government-run insurance could “artificially” set prices. That means essentially unlimited resources as well as the ability to rely on taxpayer bailouts, even if not successful. This isn’t a catchall system — we’d have longer delays, challenges with access, and more unaffordable services — reducing options until only a government option remained. This is not to suggest that we shouldn’t reform health care. Our current system offers a vast array of plans and coverage options to meet highly individualized needs, including new alternative plans that were a result of inaction. While these plans may not be a perfect fit for everyone, we should be focusing on expanding options, not reducing them.
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Unfortunately, there is no telling what would be covered under Medicare for All or a public option — nor how effectively they would work. What good is having more people covered if everyone is under the same ineffective option? The government isn’t exactly effective at controlling health care costs — or negotiating them for that matter.
No matter what you call it — Medicare for All, a public option, or single payer — would inevitably balloon out of control and crowd existing plans out of the market. Not only would they fail to address our number one concern — rising health care costs — they would end up raising taxes, inflating premiums, and lowering the quality of care.
Rather than trying to capture headlines via disruption or T.V. sound bite, politicians and local leaders should focus on making practical, realistic reforms to benefit the health insurance marketplace. Tackling healthcare’s realities is much more effective — and long lasting — than perfecting a tagline.
Keith Hennessey of Urbandale is a longtime agent for Farm Bureau Financial.