• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!

Again, why Medicare for All would never work

Here are some claims I believe to be true:

1) U.S. healthcare is insanely expensive.

2) Americans, as a group, are not healthy.

3) Most insurance plans are terrible - high deductibles, surprise bills, and claim denials are the norm.


Now imagine flipping a switch: healthcare is suddenly “free.” No co-pays, no deductibles - just walk in. First come, first served.

What happens next?

Everyone shows up.

People who’ve been putting off checkups, procedures, and diagnostics flood the system overnight. Not just the sick, but everyone. Because when something expensive becomes free, demand doesn’t just rise - it explodes.

Hospitals would be swamped. Doctors would be way overbooked.

The next step is waiting lists.

The NHS has 6 million patients on waiting lists.

In Canada, the average wait time from initial visit to treatment is over six months.

Our system would be 5x times larger than the NHS. Socialist institutions work worse the bigger they get.

Btw, can you guess what increased demand does to the price of a service like healthcare? It sends it up, up, up. That means the crazy taxes they imposed to pay for medicare for all aren't going to be nearly enough.

Medicare for All would bankrupt the country.

Medicare isn't even close to free.
To have the same healthcare as we did before 65 we pay over 8000 per year in premiums for us both. And there are still deductibles and copays.
 
4) Medical debt is the #2 cause of bankruptcy in the U.S., right behind losing your job.
Actually it’s not medical debt. Studies of people who declare medical bankruptcy reveal that medical debt made up a very small portion of their overall debt.
It’s the loss of income due to being sick which causes the majority of medical bankruptcies.
Maybe demand explodes. So we go through an initial period of high demand that tapers off. Or we taper M4A in, which would be pretty easy.
Medical demand won’t explode. Most people without insurance are relatively healthy.
The government would set the price, like they do for Medicare now.
There is the run. Medicares price is often less than the cost of care . Without higher reimbursement from private insurance companies many facilities would close.
Countries don't go bankrupt.

By all serious calculations, M4A would provide better care overall for less money.
No. It would create less care for less money. There is no free lunch here. You cannot get the savings you plan on getting without addressing reimbursement being lower than the cost of care.
The government already pays for the most expensive to insure. You can subtract the insane costs of the insurance bureaucracy - for the insured, who still pay for at least a portion of their insurance, for the doctors who have to hire staff just to deal with insurance companies, and for the government, who subsidizes insurance policies and pays for Medicare Advantage - with more money going to actual healthcare, and still come out ahead, probably far ahead.
No. Because government insurances can be the worst to deal with. Particularly if you plan on getting this massive savings.
Most people would have more money in their pockets, even with slightly higher taxes. Companies wouldn't need to shoulder their share of the insurance burden. Workers would no longer be tied to their jobs to keep their insurance. And the populace, including the workforce, would be healthier (a fair assumption, I think). All of this would be great for the economy - more demand, lower costs for businesses, and healthier people. And far fewer bankruptcies. I don't think many people appreciate the economic destruction that bankruptcies cause.
Bankruptcies would remain about the same.
And the economic would take a huge hit as the medical industry collapsed.
Simply cutting out a very expensive and counterproductive middleman would do wonders for healthcare, and for costs.
Not for healthcare . And not for reimbursement.
As for the transition, if we simply taper in M4A and fold current Medicaid recipients into a better, more comprehensive healthcare plan, I don't foresee any big problems with the healthcare industry ramping up to meet what I would hope is greater demand for healthcare in general. Certainly, any transitional problems are not a sufficient reason to keep plowing ahead with the current system, which we all agree stinks.
The problem is that the current reimbursement by Medicare is causing hospital closures and fewer physicians NOW .
 
Medicare isn't even close to free.
To have the same healthcare as we did before 65 we pay over 8000 per year in premiums for us both. And there are still deductibles and copays.
Which would mean you have modified adjusted income of roughly 500000 to 750000 if finally jointly.
Not sure that qualifies as “ most” people.
 
Americans are very unhealthy.

Health insurance sucks.

Paying cash is extremely expensive.

Hence it is reasonable to presume a rather pent up demand.
Not really.
North Korea makes public food production work. As does Cuba.

Does this sound like an argument for public control over the means of producing food?

I should hope not.



Sure, but it's all got to be paid for, and with all this demand means prices go up, not down.
No. Because the government is already driving reimbursement down. Which of course is causing hospitals to close.
An astute observation, but if I recall correctly, medicare accounts for about 20% of all healthcare spending. Things would look drastically different if it covered 100%.



Insurance companies are not the problem. Their profits were essentially capped by obamacare.
Insurance companies are definitely the problem.
Profits get turned into salaries and buying other insurance companies etc.

As far as capping profits Obamacare doesn’t cap profits , it caps percentage of profit vs expenses on medical care.
 
Which would mean you have modified adjusted income of roughly 500000 to 750000 if finally jointly.
Not sure that qualifies as “ most” people.
Per month
185 for part B
190 for part G
50 for part D

So actually 5100 per year for 1 person. But yes there are cheaper options than G. But I wanted to keep the same level as when I was working including the flexibility.
 
Not really.

Yes, really. The current healthcare system sucks.

No. Because the government is already driving reimbursement down. Which of course is causing hospitals to close.

Closing hospitals is a further restriction on supply, which means higher prices.

Insurance companies are definitely the problem.
Profits get turned into salaries and buying other insurance companies etc.

The government already pays for about half of all healthcare spending. Do you really believe the "solution" to the healthcare mess is to have the government pay the other half as well?

As far as capping profits Obamacare doesn’t cap profits , it caps percentage of profit vs expenses on medical care.

That's true, I should have been more precise, but it's still makes the situation worse:

 
Per month
185 for part B
190 for part G
50 for part D

So actually 5100 per year for 1 person. But yes there are cheaper options than G. But I wanted to keep the same level as when I was working including the flexibility.
Part g is a private plan , it’s not Medicare.
 
Yes, really. The current healthcare system sucks.
One no. Healthcare does not suck, healthcare insurance sucks.
Two demand won’t likely go up because the people without health insurance are generally healthy.
Closing hospitals is a further restriction on supply, which means higher prices.
No because hospitals don’t set prices . Insurance does.
The government already pays for about half of all healthcare spending. Do you really believe the "solution" to the healthcare mess is to have the government pay the other half as well?
Nope. But let’s be honest when we talk about it
We do have a healthcare insurance and government insurance issue and we are heading toward have crappy actual healthcare and not having insurance to pay for it.
Both sides of this issue are full of bs. And we need serious and informed discussions not pie in the sky “ Medicare for all will be wonderful “
And “ the free market will cover everyone cheaply including the guy with cancer”
That's true, I should have been more precise, but it's still makes the situation worse:

The government did nothing of the sort.
Pairing demand for healthcare. ( old people)
With insurance to pay for it is why we have
Some of the best healthcare in the world . It’s why new drugs , new procedures and better techniques and treatments are developed and introduced here first.
 
One no. Healthcare does not suck, healthcare insurance sucks.

You don't need insurance to walk into a hospital and get medical care. But when you get the bill, you'll understand why health insurance isn't the problem.

Two demand won’t likely go up because the people without health insurance are generally healthy.

Do you have any evidence to support that assertion?

No because hospitals don’t set prices . Insurance does.

Then how do DPC and cash only clinics determine how much to charge?

Some of the best healthcare in the world .

No, it sucks, bad.

As it happens, one of my oldest friends has breast cancer and I've been spending hours and hours and hours with her in hospital waiting rooms while doctors and nurses stand around in groups drinking coffee and bullshitting. The "service" is worse than the DMV, and these are hospitals in lower fairfield county CT, the wealthiest county in a wealthy state.

Furthermore, medical errors are the third leading cause of death in the US.


Terrible service and terrible quality, and we pay a fortune for it. This shitshow is what you get from regulated capitalism.
 
You don't need insurance to walk into a hospital and get medical care. But when you get the bill, you'll understand why health insurance isn't the problem.
True. But that bill is based on insurance companies and based on how healthcare works . How much demand is there for ventilators do you think? Do you think every ventilator is being used by the hospital every day? If course not.
So if that ventilator had to be paid for by only people that need the ventilator … no one could afford it. So all those costs of the hospital have to get passed on to everyone to some degree that uses the hospital.
If not? Hospitals wouldn’t have most of their equipment for extreme issues.
Hospitals have to generate a bill of course. But each insurance company they work with pays only a portion of that bill depending on its allowables. Insurance A will allow so much for a colonoscopy, but less for a biopsy . Insurance B will pay more for the biopsy but less for the colonoscopy.

Therefore to ensure the hospital can survive financially the hospital has to make sure that its charges are always above everyone’s allowables .
Do you have any evidence to support that assertion?
Common sens. If you are really ill generally you can’t work which means you qualify for Medicaid and Medicare.
Then how do DPC and cash only clinics determine how much to charge?
Well DPC basically set up their own insurance company and charge their monthly fee as high as they can above their costs.
This though usually means they cannot provide care at the level of a hospital because having things like ventilators and surgical suits etc and medical radiation and dialysis costs too much and most people in the dpc don’t use it.
( kinda the idea of a dpc)

Cash only clinics charge as high as they can above their costs and only provide services that they can make money on in a cash basis.
Which leaves a lot of care out.

No, it sucks, bad.
No it doesn’t. In fact your friends chance of surviving her cancer is among the best in the world . One of the advantages of our system but one of the reasons it costs more.
The reason by the way they could spend time “ bs ing” by the way is likey because they were very well staffed . And so a nurse could have one three patients and two were out getting tests so she only had to answer the call bell for the third.


A bit of fiction there.
Terrible service and terrible quality, and we pay a fortune for it. This shitshow is what you get from regulated capitalism.
Yeah no.
 
Here are some claims I believe to be true:

1) U.S. healthcare is insanely expensive.

Because the US government refuses to negotiate prices.
2) Americans, as a group, are not healthy.

A lot of that is due to the fact that we don't have accessible and affordable healthcare.
3) Most insurance plans are terrible - high deductibles, surprise bills, and claim denials are the norm.

Which would be solved with universal healthcare.
Now imagine flipping a switch: healthcare is suddenly “free.” No co-pays, no deductibles - just walk in. First come, first served.

What happens next?

Everyone shows up.

People who’ve been putting off checkups, procedures, and diagnostics flood the system overnight. Not just the sick, but everyone. Because when something expensive becomes free, demand doesn’t just rise - it explodes.

Hospitals would be swamped. Doctors would be way overbooked.

The next step is waiting lists.

The NHS has 6 million patients on waiting lists.

In Canada, the average wait time from initial visit to treatment is over six months.

Our system would be 5x times larger than the NHS. Socialist institutions work worse the bigger they get.

Btw, can you guess what increased demand does to the price of a service like healthcare? It sends it up, up, up. That means the crazy taxes they imposed to pay for medicare for all aren't going to be nearly enough.

Medicare for All would bankrupt the country.
And how many Americans are on a waiting list right now?
 
Because the US government refuses to negotiate prices.
Not true at all . The us government Medicaid , ca and Medicare have consistently lowered what they pay for treatments procedures and doctors visits.

Medicare does not negotiate on pharmaceuticals but the both the va and Medicaid do negotiate on pharma.
A lot of that is due to the fact that we don't have accessible and affordable healthcare.
We do have that. Not health insurance.
Which would be solved with universal healthcare.
Not likely. There is no free lunch here.
And how many Americans are on a waiting list right now?
Average IN THE US is 28 days for elective surgery.
“As the following chart also shows, waiting times for non-emergency surgeries also varied widely from one country to another. In 2023, the average waiting time was lowest in the U.S. and Switzerland (28 days),”

In Canada the median time is 30 WEEKS

“In Canada, the average wait time for elective surgery can vary significantly, with some procedures having longer waits than others. The median wait time for a referral from a general practitioner to treatment is 30 weeks according to the Fraser Institute. However, this is just a national average, and wait times can vary significantly by province, specialty, and the specific procedure”
 
Not true at all . The us government Medicaid , ca and Medicare have consistently lowered what they pay for treatments procedures and doctors visits.

Medicare does not negotiate on pharmaceuticals but the both the va and Medicaid do negotiate on pharma.

If that's true, that should be a national standard for everyone
We do have that. Not health insurance.

No, we don't, otherwise going bankrupt for medical expenses wouldn't be a thing in the US.
Not likely. There is no free lunch here.

It seems to work in most other countries with universal healthcare .
Average IN THE US is 28 days for elective surgery.
“As the following chart also shows, waiting times for non-emergency surgeries also varied widely from one country to another. In 2023, the average waiting time was lowest in the U.S. and Switzerland (28 days),”

In Canada the median time is 30 WEEKS

“In Canada, the average wait time for elective surgery can vary significantly, with some procedures having longer waits than others. The median wait time for a referral from a general practitioner to treatment is 30 weeks according to the Fraser Institute. However, this is just a national average, and wait times can vary significantly by province, specialty, and the specific procedure”
First off, why are you focused on elective surgery when most people are more concerned about medical emergencies and necessary medical treatments? Second, be that as it may, Switzerland has the same wait period as the US for elective surgeries and most everyone else (who also have universal healthcare) have shorter wait times for necessary procedures at a much lower cost to the patient.

 
No, it's possible. It's just not going to be what you think/hope/wish it will be.

I laid out the argument in simple terms, feel free to attack it.
First of all it is the fault of the current system that we pay twice as much as the rest of the world for HC with worse outcomes than them. We have plenty of proven fixes to learn from too. You just have to realize that we are far behind in the administration of HC and need to learn to do better. This obsession with maintaining the bloated profits of insurers is the first thing that needs to go. They just write the checks.
 
Last edited:
This obsession with maintaining the bloated profits of insurers is the first thing that needs to go. They just write the checks.

From here:

The industry’s profit margin decreased moderately to 2.7% from 3.3%, while the combined ratio increased by a moderate 110 basis-points.

One of the main reasons we pay so much for healthcare is due to sky-high labor costs. Doctors are the highest paid profession in the country and nurses average $50 per hour.

You understand that if Trump prevents farmers from hiring cheap immigrant labor then our food prices would skyrocket, correct? If yes, then you understand that when it comes to labor, cheaper is better, with the best solution being automation, which eliminates the worker entirely.
 
From here:



One of the main reasons we pay so much for healthcare is due to sky-high labor costs. Doctors are the highest paid profession in the country and nurses average $50 per hour.

You understand that if Trump prevents farmers from hiring cheap immigrant labor then our food prices would skyrocket, correct? If yes, then you understand that when it comes to labor, cheaper is better, with the best solution being automation, which eliminates the worker entirely.
Doctors are overpaid but that is mostly because insurers profits increase as costs increase. They have a vested interest in keeping HC cost rising every year.The more we pay for HC the more the insurers make.

How much did health insurance companies profit in 2024?
The nation's largest payers have filed their fourth-quarter earnings reports, revealing which recorded the largest profits in 2024. Total net earnings in 2024 were $14.4 billion, down 35.6% year over year. UnitedHealthcare's total earnings from operations in 2024 were $15.6 billion, down 4.9% year over year.

https://berkerynoyes.com/full-year-...ends/#:~:text=2024 KEY TRENDS,to 2.5x in 2024.
 
They have a vested interest in keeping HC cost rising every year.

That's true, and the reason is because of government regulation <surprise> and I started a thread about it:

 
That's true, and the reason is because of government regulation <surprise> and I started a thread about it:

Healthcare should not be part of the free market. What price do you put on your life? HC is a right of citizenship in every other nation but ours and that is shameful. Greed has no place when people's lives are in the balance.
 
Healthcare should not be part of the free market. What price do you put on your life? HC is a right of citizenship in every other nation but ours and that is shameful. Greed has no place when people's lives are in the balance.

Using this argument food should be provided by the state as well. That has been tried many times:


 
Using this argument food should be provided by the state as well. That has been tried many times:


LOL You didn't know that we supply food for the hungry all over the world? You think it is just fine to let people starve to death?
 
If that's true, that should be a national standard for everyone
It is true. But if that national standard was lowered to current Medicare levels ( which is what is being proposed or even LOWER)
Many hospitals and clinics would be forced to close.
No, we don't, otherwise going bankrupt for medical expenses wouldn't be a thing in the US.
As pointed out bankruptcy is a result of loss of income. Medical bankruptcy occurs in.countries with universal healthcare insurance as well.
It seems to work in most other countries with universal healthcare .
Sure but there is no free lunch. Everyone thinks “ but but they spend so much less than the us on healthcare. But frankly that’s really not true.
For example. In America the cost of educating a medical provider such as a surgeon gets folded into the cost of healthcare. The cost of my education was directly on me and thus it gets past along to healthcare prices .
In other countries , this cost is born by their public education system .
Basically some of their healthcare cost is shifted away from healthcare and to public education. ( making their healthcare look cheaper).
Another example is malpractice insurance . It’s very expensive for me and that cost is folded into the price of healthcare. In other countries malpractice is regulated publically and handled by a public insurance system

Now that’s not all the cost. So e is the fact other countries gain in efficiency. Instead of so many independent specialists , they have fewer specialists with makes them more efficient but is one reason why generally wait times for procedures are longer.
In addition there is consolidation into regional hospitals. So tgat where in the us communities might have a local hospital , under a Medicare for all smaller rural hospitals will close in favor of larger but farther away regional centers.

In addition many universal healthcare systems do not pay for things or Medicare and even our Medicaid pay for.
In Canada, the federal government grant does not pay for pharmaceuticals, home health , durable medical equipment , or outpatient therapies like occupational therapy.

In the us our Medicare and Medicaid pay for these things.




First off, why are you focused on elective surgery when most people are more concerned about medical emergencies and necessary medical treatments?
Because that’s one of the fownsides of a Medicare for all plan.
Medical emergencies are taken care of in this country and necessary surgeries if you have insurance.
The down side of Medicare for all is greater wait times for elective surgeries. So for most people in the us ( most have insurance) Medicare for all will be worse than what they have now.
Second, be that as it may, Switzerland has the same wait period as the US for elective surgeries and most everyone else (who also have universal healthcare) have shorter wait times for necessary procedures at a much lower cost to the patient.

Well if you read your own citation , they only have shorter times for a gp. And that’s a function of tge number of gps and reimbursement in this country. We have a dearth of general practitioners in part because reimbursement is so low and Medicare for all would make it lower.

By the way it’s a function of distances and physicians for wait times in many cases .
 
Here are some claims I believe to be true:

1) U.S. healthcare is insanely expensive.

2) Americans, as a group, are not healthy.

3) Most insurance plans are terrible - high deductibles, surprise bills, and claim denials are the norm.


Now imagine flipping a switch: healthcare is suddenly “free.” No co-pays, no deductibles - just walk in. First come, first served.

What happens next?

Everyone shows up.

People who’ve been putting off checkups, procedures, and diagnostics flood the system overnight. Not just the sick, but everyone. Because when something expensive becomes free, demand doesn’t just rise - it explodes.

Hospitals would be swamped. Doctors would be way overbooked.

The next step is waiting lists.

The NHS has 6 million patients on waiting lists.

In Canada, the average wait time from initial visit to treatment is over six months.

Our system would be 5x times larger than the NHS. Socialist institutions work worse the bigger they get.

Btw, can you guess what increased demand does to the price of a service like healthcare? It sends it up, up, up. That means the crazy taxes they imposed to pay for medicare for all aren't going to be nearly enough.

Medicare for All would bankrupt the country.
People with Medicare often have co-pays. They also just cant walk-in to their Drs and sometimes the appointment for non-urgent care can be weeks. . They need an appointment.

Your argument is laughable.
 
LOL You didn't know that we supply food for the hungry all over the world? You think it is just fine to let people starve to death?
SNAP exists to feed the poor, sick, aged, and hungry in the USA, so the states does supply food to the indigent.
 
Back
Top Bottom