Medicare-for-all would be costly

Medicare-for-all is not socialism. Think Britain's National Health Service. Not even Bernie Sanders has suggested all medical providers become government employees.

But also ignore all their cost projections, for a couple of reasons. First, if you have Medicare or employer-provided insurance, you are only paying 20% of the premium to start with, so your employer or the government reaps most of the savings. Someone's taxes will go up, and it'll affect more people than you may hope.

Second, they're ignoring Economics 101; Supply and demand. By making health care free to the consumer at the point of purchase, they will want more. Demand goes up. But what about supply? There are already providers who refuse Medicare patients due to low reimbursement rates. Others who balance their practices' income with higher-paying private insurance and uninsured patients will be economically encouraged to find something else to do. Supply goes down.

What happens next should be part of the current debates and differentiate the candidates

Can't do much about demand, as the starting premise is that health care is a right and should be free at the point of sale. We could just make more providers of care, but that takes a few years to ramp up. Short term, you would see longer wait times, i.e., rationing of health care. Or reimbursement rates have to go up to encourage current providers to stay in the market.

Maybe those advocating the expansion of the Affordable Care Act are on the right track.

Tim Hein

Palatine