Tuesday, June 5, 2012

Medicare for all?

From Aaron Carroll
I don’t think I’d be betraying any confidences if I reveal here that my father is no great fan of the ACA. That said, he could not have been happier the day he turned 65. He loves his Medicare. Before that time, while he was somehow able to find insurance for himself, the plan cost somewhere around $15,000. That was before the $5000 deductible. I think I could heal the cheers all the way across the country the day he became eligible for Medicare. My mother, on the other hand, still hasn’t hit 65. She’s counting the days.
I think maybe my Canadian background is betraying me here, but why are we so scared of universal medicare in the United States?  We have already covered the most expensive portion of the population (the elderly, the disabled, and impoverished children).   Is it really the case that a higher rate of spending drives innovation more than it drives rent-seeking and low productivity? 

I think that the answer to this question gets more critical as time goes on rather than less.  But I simply do not get what the resistance to universal health care is based on.  It would do wonders to make mobility higher (moving without health care is a scary thing) and do a lot to increase competitiveness in sectors like manufacturing. 

Why is this so hated?  Can it really just be a war of the old versus the young


  1. Personally, since I have health care coverage through my employer, I'm risk-averse to any changes in the system. From my perspective there is a fixed pot of healthcare, so if others are allowed to consume more healthcare, than I will have to consume less.

    This is even though I'm somewhat enlightened, and can intellectually entertain the following possibilities: economies of scale from a single payer system, encouraging entrepreneurship by making small business more competitive, efficiencies from broader application of preventative care, and an overall increase in the productivity of the nation from improved health.

    I can intellectually entertain those possibilities, but deep down I really do figure that my health care experience will get worse.

  2. @Paul: I think the issues that you bring up are part of why it is hard to institute changes in a system as expensive as the United States. You can't promise equal or better for everyone but cost cutting is probably an explicit goal.

    In contrast, in the Canada of the 1950's, % of GDP on helath care was low enough that you could design a system where all parties came out ahead at the same time.