The probable pitfalls that ‘Medicare for all’ proponents must address

First is the most globally threatening issue of the medical research and development. America leads the world by a longshot, producing 44 percent of the globe’s medical R&D despite comprising just 4.4 percent of its population. As it stands, the federal government only funds one-fifth of the nation’s $171.8 billion medical R&D bill, with private industry footing the overwhelming majority of the bill. On top of the raw costs of the system, would the government be willing or able to replace private R&D funding?

If we failed to do so, we’d be at the mercy of China, the next highest spender on medical R&D.

Then there’s the matter of the immediate international effect that eliminating our private system would posit. Despite accounting for only a quarter of the world’s income, we pay for three quarters of its pharmaceutical profits. Sure, some of Europe’s wealthier countries could afford the instant effect of us ceasing to subsidize their medicines, but could the poorer ones? Could the developing ones? And none of this even addresses single payer’s effect on non-profits. We currently spend $33 billion and $22 billion annually on health organizations and international affairs, respectively. We couldn’t possibly maintain that level of charity given the level of taxation that “Medicare for all” would require.

This, of course, brings us to the most obvious problem: cost.

For argument’s sake, let’s ignore all the other price tags I’ve pointed out and just address the $32.6 trillion elephant in the room. The federal government is projected to acquire $3.422 trillion in tax revenue and incur a deficit of more than $1 trillion for fiscal year 2019. “Medicare for all” would roughly require doubling our tax revenue to even remotely pay for it.

Theoretically, this could be done across the board, but the United States only just brought our corporate tax rate to a globally competitive rate. Single payer supporters have relied on
Magical
Modern Monetary Theory to explain how they can afford to incur endless debts and print endless cash to fund “Medicare for all.” While the American government can borrow a great deal without defaulting and sparking an international financial crisis of a magnitude unknown in human history, there is a limit. That limit would decline severely with the erasure of our economic growth that would be expected in such a case.

The federal government collected just half of its revenue from income taxes in fiscal year 2017. We’d have to more than triple our income taxes then, rendering impossible to insulate the middle and working classes of the country from massive tax increases.

All of the latest Democratic tax plans meant to target the wealthy couldn’t remotely fund “Medicare for all.”

The wealth tax touted by Sen. Elizabeth Warren, D-Mass., would earn the federal government just $2.75 trillion over its first decade. The top marginal tax rate increase floated by Rep. Alexandria Ocasio-Cortez would raise less than $1 trillion. The estate tax plan proposed by Sen. Bernie Sanders, I-Vt., would accumulate $2.2 trillion, but over an unspecified amount of time because, as a Sanders staffer delicately put it, “it would only take effect once they die.”

Fine, you may say. Everyone would be okay with effective income tax rates eating up half or more of your pay. After all, it’s a small price to pay for better healthcare. But would it be better?

The $32.6 trillion valuation assumes that health care providers would be willing to accept reimbursement rates 40 percent lower than the current private average. In the long-run, the idea that this can be done without affecting the quality of care is simply insane. Why would new, young people put themselves to the trouble of going through medical school and accumulating so much debt?

“Stop the fearmongering,” I can already hear you say.

But we already see mass exoduses of physicians in France and Romania as well as shortages in patient care in socialized system across the world.

In a survey of eleven developed nations, nearly half of all Americans reported being able to obtain medical care within 48 hours. Only four in ten Canadians claimed to do the same. Of all the nations surveyed, Canada has the worst emergency room and referral wait times, with the majority of the country waiting more than a month to see a specialist.

Seven in ten Americans reported that their insurance paid for their medical care. In France, 74.5 percent reported the same. Only 15 percent of Americans reported spending a lot of time on paperwork or disputes related to medical care, while nearly twice as many French reported doing the same. Most alarmingly, even more French than Americans cited having “serious problems” or being unable to pay their medical bills.

To recap, single payer would require doubling or tripling our current income taxes for less and worse health care, all while leaving the future of medical R&D and charity to the Chinese.

If Democrats have actual solutions to these pitfalls, I’d legitimately love to hear them. But until then, anyone touting “Medicare for all” without addressing them is peddling a fantasy.