Single-Payer Health Care Harms Patients, Middle-Class Families, Seniors and Small Businesses
You’ve heard all the good news and rhetoric about a single-payer “Medicare for All” system: Government-run health care will get spending under control, cut costs for middle-class families, streamline the health care system to ensure access and the best care for every American, and reduce administrative costs and complexity.
Now, THE FACTS:
Single Payer Proposals Would Be A Disastrous Financial Hit to Americans and the Economy (Higher Costs, Increased Taxes, Fewer Jobs)
- The latest assessment from the Urban Institute on Sen. Bernie Sanders proposed single payer plan estimates that national health expenditures would increase by $6.6 trillion (16.6%) over the next decade.
- As a result of transitioning to a single payer system, federal expenditures would dramatically increase by $32 trillion over the same decade, imposing a massive tax increase on American families, workers, small businesses and seniors.
- According to a separate analysis from Emory University, roughly 70 percent of working privately-insured households will pay more under a fully funded single payer plan than they do for health insurance today.
- That same report found that seniors and Medicaid beneficiaries – often individuals on fixed incomes – would see a disproportionate share of the cost increases associated with single payer.
- More than 40 percent of working Medicare beneficiaries would see cost increases under a single payer plan.
- Over 70 percent of low-income working Medicaid households would pay more for a single payer plan.
- Nearly half of young adult workers would contribute more in new taxes than they receive in benefits under a government-run single payer program.
- Research also points to a single payer plan eroding the workforce for middle-class Americans. Taking into account added costs and tax increases, a single payer system would eliminate nearly 11.6 million jobs.
Single Payer Reality: Elimination of Private Coverage, Health Care Rationing and High Costs
The most notable pain point from single payer would be the elimination of private, employer-sponsored coverage – the bedrock of the country’s insurance system – for more than 168 million Americans.
- With data showing roughly 70 percent of workers reporting satisfaction with their employer-sponsored coverage, a single payer plan “would require millions of Americans to trade something that seems to be more or less working for them for something new and uncertain, both in coverage and cost,” notes AEI researcher James Pethokoukis.
- In the United States, the Veterans Health Administration represents the country’s closest parallel to experience with single payer. A Pacific Research Institute study of a VA medical center in Phoenix found that more than 200 people died while waiting for care in 2015; more than 100 people died waiting for care over a nine-month period in Los Angeles during the same year.
- In the United Kingdom, where the National Health Service (NHS) maintains authority over the number and type of health services available to patients, the agency recently ordered more than 55,000 non-urgent operations cancelled or delayed for at least a month in order to accommodate urgent and emergency care, according to the Pacific Research Institute analysis.
- In total, more than 3 million British residents faced wait times longer than 18 weeks for surgery – a figure expected to increase to more than 5 million residents facing delays in care by 2019.
- After approving a new treatment for blood cancer in children and young adults in Sept 2018, the UK’s National Institute for Health and Care Excellence (NICE) rejected the same treatment for adults with aggressive leukemia just two weeks later, creating a misaligned rationing system across the country.
- Canada has faced exorbitant increases in health care costs, threatening to limit investment in other areas that would support economic growth.
- Total spending on health care services in Canada increased more than 110 percent more for care between 2001 and 2016.
- In total, Canadian families pay $4,000 – $12,000 in additional taxes to support the country’s health system.1
- Canadians also face steep barriers to care. According to research from the University of Toronto, “long waits for non-urgent services like hip replacements or M.R.I. scans for back pain are a genuine problem in many parts of the country…more than a third of Canadians wait more than two months to see a specialist, and 18 percent of Canadians wait at least four months for elective surgery.”
Not Only Does Single Payer Eliminate Employer-Coverage, It Threatens the Medicare Program & Destroys Medicare Advantage
After paying into the Medicare program for decades, millions of seniors will see their Medicare benefits significantly curtailed or outright eliminated, in the case of private Medicare programs designed to provide added financial protection and care coordination.
- More than 19 million seniors depend on Medicare Advantage – the private form of Medicare that provides critical financial protection, such as out-of-pocket caps on health care costs, and benefits beyond traditional Medicare.
- For these individuals, the added protection against soaring health care costs and affordable disease management and care coordination provided by Medicare Advantage can make a difference in maintaining their health and independence.
- Under a single payer plan, Medicare Advantage would be eliminated. Further, these benefits and many other critical coverage options, including Medicare supplement insurance (Medigap), would largely end, exposing seniors and vulnerable beneficiaries to gaps in care and greater financial uncertainty.
Expansion of Single Payer / Medicare-for-All Would Hurt Access to Care and Undermines Future Innovation
The Medicare program is already underpaying providers and hospitals, and the likelihood of significant cost decreases under a single payer program would lead to drastic reductions in beneficiary access to care.
- In 2015 alone, Medicare underpaid hospitals by more than $40 billion. Combined with the number of providers who have already opted out of the program or limited access – 14 percent of doctors said they would not see patients covered by Medicare and another 13 percent said they would limit the number of Medicare beneficiaries they accept – Medicare seniors would compete with millions of Americans for care, leading to longer wait times and reduced access to medical services. 
- Further, under a single payer system, health care innovators – including biopharmaceutical companies, device manufacturers, IT providers, and care management leaders – would have little incentive for innovation.
- Former Congressional Budget Office director Doug Holtz-Eakin noted that, “Making innovation and medical technology production less attractive in the United States – the world’s medical innovation superpower – will mean that the patients around the world will see cures and treatments later than they otherwise would.”
 Pipes, Sally C. “The False Promise of Single-Payer Health Care” March 6, 2018