President Trump lit into the Democrats’ “Medicare for all” plan in a USA Today op-ed this week that itself has been panned for several Trump inaccuracies. “Medicare for all” was part of Bernie Sanders presidential platform in 2016 – when he was one of the few politicians willing to back the idea. But since then, health care has emerged as a more potent political issue, in part because of Republicans’ repeated efforts to kill the Obama-era Affordable Care Act, which about half of Americans now support (with 40% disapproving). Health-care costs also continue to rise by more than inflation, taking an ever-bigger bite out of the family paycheck, with no solutions in sight. Democrats are making better health care a top campaign theme in this year’s midterm elections, with some of them touting “Medicare for all” as the answer. But this is more of a slogan than a plan at the moment, since there are several pieces of legislation that would expand Medicare beyond those 65 and older, and the details vary considerably. Trump referred to a Sanders-style plan in which all private-sector insurance — including employer-provided insurance, which is how half of Americans get coverage – disappears, with everybody being covered by a government-run plan resembling Medicare. There is no chance this will happen any time soon, because it would completely upend nearly everything about health care in the United States. Besides, Republicans run Congress and the White House, and there’s probably not one of them who would vote for the idea. Even though there are several Democratic bills to expand Medicare, Trump was referring to the Sanders plan—which is the most extreme—when referring to the “Democratic proposal.” Trump argued that the Sanders plan would “take away benefits that seniors have paid for their entire lives.” It wouldn’t. Medicare for seniors would remain as is. It is true that a full-blown government-run health plan would involve trade-offs, which might include longer waits for doctors and stricter access to some care. But since the Sanders plan is politically unfeasible, it’s nothing but fearmongering to label any effort to expand Medicare as a threat to seniors. Story continues [See why Medicare for all could save businesses trillions.] Trump also said Medicare for all would cost “an astonishing $32.6 trillion during its first 10 years.” That figure comes from credible research published by Charles Blahous of the libertarian Mercatus Center at George Mason University in August. The price tag might sound like a stratospheric figure, but it’s not crazy at all once you account for all the money saved, as well as spent. Sen. Bernie Sanders. (AP Photo/Chris O’Meara, File) Blahous, a former public trustee for Social Security and Medicare, forecasts that total spending under Medicare for all would amount to at least $4.47 trillion in 2022, almost all of it federal money. But without Medicare for all, total U.S. spending on health care from all sources—including the government, private-sector companies and individuals—is likely to total $4.56 trillion in 2022. Let’s call it a wash and say total spending would be about the same under each scenario. But companies and individuals would spend nothing on health care under MFA–which would cover about 27 million people who currently don’t have insurance. So the nation would spend about the same, while covering many more people. That’s a lot more bang for the health care buck. Businesses currently spend about $1.2 trillion per year providing health care coverage for their workers. If you started the U.S. health care system from scratch, there’s no way you’d make it the responsibility of businesses to provide half the health care in the country. That’s why no other nation makes its business sector responsible for health care. Under Medicare for all, businesses would get out of the health insurance business completely, saving $1.2 trillion. Taxes would have to go up, to pay for the all that additional government health care, but you’d have to raise federal business taxes fivefold to equal the giant sum corporations already pay for health care. From a business perspective, Medicare for all actually looks pretty good. There would be other problems with Medicare for all, however. The government would probably slash payments to doctors and other providers, which could drive some of them out of the industry and leave a shortage of caregivers. If it didn’t slash payments, then spending would be higher than Blahous predicts. And yes, there might be rationed care managed by the dastardly government. But remember, the Sanders plan isn’t going anywhere. More plausible, however, might be a modest expansion of Medicare to people who, say, can’t get coverage through an employer and have no group purchasing power. Or, there could be a hybrid model, like in Switzerland, with basic government-provided care for everybody, and more elaborate private plans offering better access for those willing to pay for it. Lawmakers could easily expand Medicare while retaining parts of the existing system that work. Amid today’s white-hot partisanship, even a modestly expanded government role in health care is probably unlikely. But Trump would be mistaken to ignore public opinion on the topic, which seems to be shifting in the Democrats’ direction. In polls conducted earlier this year by the Kaiser Family Foundation, 59% of respondents said they favor a single-payer government-run health care system such as Medicare for all, and 75% said they favor expanding Medicare for people who might need it, while leaving the private-sector health insurance system in place. Those poll results are somewhat misleading, because they didn’t include the added costs of expanding Medicare. And if asked whether they’d be willing to pay more in taxes for government-run health care, fewer people would surely sign up. On the flip side, however, companies that no longer had to deal with the ever-rising cost of health insurance for their workers would be able to raise pay and enhance other benefits. There are wackier ideas. Editor’s note: This story has been corrected to indicate that total health spending would be roughly the same in 2022 under either Medicare for all or the current system. A prior version said Medicare for all would cost less. Confidential tip line: rickjnewman@yahoo.com. Click here to get Rick’s stories by email. Read more: Rick Newman is the author of four books, including “Rebounders: How Winners Pivot from Setback to Success.” Follow him on Twitter: @rickjnewman<doc-sep>The president of the United States said in a column in USA Today on Wednesday that Democrats who support Medicare-for-all want to “end Medicare as we know it” and, via an unclear series of aftershocks, eventually turn America into Venezuela. Donald Trump, or his ghostwriter, is sounding the alarm: Democrats have become dangerously radical leftists who want to impose authoritarian socialism on you. Be afraid — that is the subliminal message of so many Republican campaigns in the 2018 midterms. The GOP has more or less abandoned swing voters, as evidenced in the recent drama over Supreme Court Justice Brett Kavanaugh. Instead, they’re trying to stoke the most primal fears of their base. In his USA Today column, Trump conjures a new red scare. Here are a couple of the most illustrative passages (emphasis mine): In practice, the Democratic Party’s so-called Medicare for All would really be Medicare for None. Under the Democrats’ plan, today’s Medicare would be forced to die. ... The truth is that the centrist Democratic Party is dead. The new Democrats are radical socialists who want to model America’s economy after Venezuela. Trump manages to link Medicare-for-all with “open borders” socialism by the end of the column, turning back to his favorite issue of immigration. In case the fear-mongering was not transparent enough. The president also claims he “promised that we would protect coverage for patients with preexisting conditions and ... I have kept that promise” while ignoring the legislation he endorsed that would have loosened Obamacare’s ironclad protections and the lawsuit his Justice Department is joining to nix the preexisting conditions protections currently on the federal books. As for Medicare-for-all, as Vox’s Matthew Yglesias covered, Trump is tapping into a well-understood phenomenon: Older voters believe any redistribution of government resources will come at their expense. In an important 2015 paper, Vivenkian Ashok, Ilyana Kuziemko, and Ebonya Washington investigate the question of why public support for economic redistribution has not risen since 1970 despite the large increase in economic inequality. For senior citizens, however, the biggest issue is that the elderly “have grown increasingly opposed to government provision of health insurance.” The authors posit that “older Americans worry that redistribution will come at their expense, in particular via cuts to Medicare.” On the merits, none of the Medicare-for-all plans that Democrats have actually proposed would cut health care for seniors. If anything, they would improve upon the benefits that seniors currently receive. Trump is narrowly correct, in some sense, that Medicare-as-we-know-it would no longer exist — but he is borrowing the line that Democrats have used to criticize Republican plans to fully privatize Medicare. As for the nonsensical Venezuela red herring, Trump obviously isn’t interested in the structural, political, civil, and cultural complexities contributing to the problems in that country. You can read Zeeshan Aleem on Vox for that. It suffices to say that Venezuela is the right’s en vogue boogeyman for scary socialism. But almost every developed nation on Earth has a more progressive health care system than the United States. Here are the facts about Medicare-for-all and nationalized health insurance that the president didn’t mention and that cut hard against his narrative: Medicare-for-all is overwhelmingly popular with the public. Those three words have the support of nearly 60 percent of Americans, even if Democrats don’t always agree on what they mean. Medicare-for-anyone-who-wants-it, an alternative proposal from more centrist Democrats, polls even better. Most European countries that Americans wouldn’t really associate with socialism have a system of health insurance that would be considered to the left of America’s. Those range from the United Kingdom’s fully nationalized system (where the government not only covers everyone, but it also employs doctors and owns hospitals) to the German and Swiss systems that use heavily regulated private insurance to attain universal coverage. They all spend a lot less money on health care than America does. Americans also die at a higher rate from causes with proven medical interventions, compared to our peers in other countries with different health care systems. Nevertheless, a month before the midterms, Trump wants his voters to be afraid — it’s a new take on the fear-based campaigns Republicans are running across the country. “Every single citizen will be harmed by such a radical shift in American culture and life,” he warned if Democrats win in November. “Virtually everywhere it has been tried, socialism has brought suffering, misery and decay.”<doc-sep>Many of these are claims we have already debunked. Presumably, the president is aware of our fact checks — he even links to two — but chose to ignore the facts in service of a campaign-style op-ed. Medicare-for-All is a complex subject, and serious questions could be raised about the cost and how a transition from today’s health-care system would be financed. Trump correctly notes that studies have estimated that the program — under the version promoted by Sen. Bernie Sanders (I-Vt.) — would add $32.6 trillion in costs to the federal government over 10 years. (He doesn’t mention that costs in theory would go down for individuals, state governments and others, so overall national health expenditures may not increase and could even decrease.)<doc-sep>
(CNN) — President Donald Trump knocked Democrats in incendiary terms ahead of the midterm elections with an op-ed decrying a proposal to establish a single-payer health care system. In the rare presidential op-ed published in USA Today, Trump claimed the proposal dubbed “Medicare for all” would “eviscerate” Medicare, the popular government program providing health care to seniors and some with disabilities. “Democrats would gut Medicare with their planned government takeover of American health care,” the op-ed reads. Championed for years by the left flank of the party, Medicare for all gained support following Vermont Independent Sen. Bernie Sanders’ bid for the presidency. Many potential candidates for the party’s 2020 nomination joined Sanders last year in filing a bill to establish the program, and former President Barack Obama referred to Medicare for all approvingly in a speech last month. Trump, in his op-ed less than a month from the November elections, claimed the plan would devastate the health care industry, undercut Medicare in its current form and “inevitably lead to the massive rationing of health care.” “In practice, the Democratic Party’s so-called Medicare for All would really be Medicare for None,” Trump said. “Under the Democrats’ plan, today’s Medicare would be forced to die.” Medicare for all would gradually phase-in all Americans to a government-run system that replaces private insurance. Trump and others have pointed to the hefty price tag projected for the plan, while Sanders and the proposal’s supporters have noted businesses and people would no longer have to pay premiums to private insurance companies. In the op-ed, Trump cites a working paper from the Mercatus Center at George Mason University, which receives funding from the conservative Koch brothers. The paper says that a national single-payer system would cost $32.6 trillion over its first 10 years. The estimate is in line with one published by the left-leaning Urban Institute in 2016, that said it would increase federal expenditures by $32 trillion. Sanders and other Democrats say the same Mercatus report claims the proposal would save Americans $2 trillion on all health care costs over the same time period. But the author of the study has said that claim is not his conclusion but based on assumptions made by Sanders. In fact, he wrote that “it is likely the actual cost of (Medicare for all) would be substantially greater than these estimates.” Medicare and other entitlements are regular battle zones between the parties, with each accusing one another of working to destroy the popular programs. Trump, for his part, campaigned on a pledge to protect Medicare, which is set to run out of funds in under a decade, and has worked to repeal Obamacare, which nonpartisan analysts said would lead to massive increases in the uninsured. In the op-ed, Trump said he’s kept his promise to lower health care premiums. While they have come down, his actions are not the reason insurers are lowering premiums. Many insurers are breaking even or have started making a profit in the individual market, and the threat of Congress repealing the law has waned. After several years of large premium increases, insurers are finally charging enough to cover the health care costs of their enrollees. More are seeing it as a viable business. Several states have also taken steps to help insulate insurers from high-cost enrollees, which is also prompting insures to reduce their rate hikes or even lower premiums for 2019. Trump paints Democrats as extreme In a statement responding to the op-ed, Sanders contrasted his proposal with Trump’s own record on health care and accused him of lying about Medicare for all. “The time is now for the United States to join every other major country on Earth and guarantee health care to every American as a right not a privilege, and Donald Trump, the insurance companies and the drug companies will not stop us,” Sanders said. The op-ed painted the Democratic Party as “extreme” for the support the proposal has received from some members of the House and Senate as well as a handful of Democratic gubernatorial nominees. Trump went on to claim that a Democratic victory this fall would lead to failed socialist policies in other sectors besides health care and pointed to the calls from some to abolish the Immigration and Customs Enforcement agency to say the party “is for open-borders socialism.” “If Democrats win control of Congress this November, we will come dangerously closer to socialism in America,” Trump said. “Government-run health care is just the beginning.