First of all I admit that the following post is not specific to Massachusetts and not statistics based. I write about Medicare because there is a very weak argument for Medicare for All and against the effort in the U.S. House of Representatives to repeal the Patient Protection and Affordable Care Act of 2010 that is circulating as of January 18 on the Internet among a group of bloggers and journalists. Only what I believe to be the "root" source of the weak argument is linked to above but the meme appeared on five or more blog posts within hours of it appearing at this link. And I'm sure the count has increased dramatically since that time because these bloggers are a superset of the journalists that got together in December to mislead their readers about what happened to healthcare insurance premiums in Massachusetts after the passage of Romneycare.
Just as I wondered in December whether any of these journalists had ever been to Massachusetts or read anything about Romneycare (if they had they surely would have known that healthcare insurance premiums went through the roof after Romneycare), I wonder in January if the bloggers and journalists that push "Medicare for All" have asked their parents and grandparents how it works. I suspect not.
The overall meme is that things like employer-sponsored insurance (ESI), Medicare/Medicaid/"free care pool," state insurance regulations, and COBRA are "non-market" (and therefore healthcare insurance is not a "free market"). In fact, these and other aspects of buying healthcare insurance are just market dynamics to which individuals adapt in the process of protecting themselves against catastrophic health care expense (and insurers adapt to in the process of selling such protection). That does not make the market unfree.
But Medicare for All as they envision it would be such a closed market. The illogic of that idea got me thinking particularly about Medicare and the claim that "single-payer" Medicare for All would somehow save the day. As someone about the go on Medicare and who also lived outside the US during my working career in a country that had single-payer healthcare at the time, I can tell you that Medicare is the furthest thing from single payer.
On my 65th birthday, having transitioned to so-called "single-payer" Medicare, it looks like I'll go from dealing with one healthcare insurance company to dealing with four counting the CMS group in the US government (CMS plus an insurer for Medigap, one for drugs. and a possible fourth or more for vision and/or dental). In addition basic Medicare -- what I am forced to get whether I want it or not -- has all kinds of time limits, deductibles, and nasty other fine- print items that would make Wellpoint of California blush.
(Note: I am sensitive to the request of its proponents that the PPACA not be called Obamacare. In my day job -- see my web site on Information Technology Investment Research -- I have always taken the tack when describing enterprise software and other technology products that "it's your baby and you get to name it whatever you want" no matter how odd or undescriptive or propagandistic the name is. The only exception to the PPACA vs. Obamacare rule I make is for blog-post headlines.
(On the other hand, I never heard Mitt Romney object to Chapter 58 of the Acts of 2006 of the Great and General Court of the Commonwealth of Massachusetts as amended by Chapter 305 of 2008 and Chapters 122 and 359 of 2010 -- not sure of the last two numbers -- being called Romneycare. Thank god because no one would know what you were talking about if you used Romneycare's real names.)
-- Dennis Byron