To start, the bill would spend $370 billion to expand Medicare
benefits for hearing, vision, and dental – benefits that Medicare
beneficiaries already have access to at no additional cost to
taxpayers through Medicare
Advantage plans. In fact, Medicare Advantage plans already
attract more than 40 percent of Medicare beneficiaries.
But, Medicare Advantage plans are private insurance products that
compete with each other to deliver benefits to willing seniors under
Medicare’s oversight. To Sen. Sanders and his allies, that looks too
much like a free market, and they don’t like it. They believe adding
new benefits will move people from this more competitive, efficient,
and consumer-friendly option into traditional, government-centered
Medicare – even though it would mean higher premiums for
beneficiaries, higher costs for taxpayers, or both.
The plan would also expand Obamacare in two flawed ways.
First, it would offer Medicaid directly to individuals in states
that chose not to participate in the Obamacare’s Medicaid expansion.
Because Medicaid pays doctors far less than even what Medicare does,
they are far less likely to accept Medicaid patients compared to
patients with private health insurance. This drastically limits who
Medicaid recipients can see and their access to care.
Medicaid is also terribly wasteful. In just two years it reported
$143 billion in improper payments. Even
more concerning is that Medicaid often provides substandard care,
with a major study concluding that the program "generated
no significant improvement in measured physical health outcomes."
Americans already spend more than $600 billion a year on this
wasteful and ineffective program. Yet Sen. Sanders thinks we should
expand it. That is not the way to improve it.
Second, the plan would make permanent the increased Obamacare
subsidies that were part of Covid relief, with much of that aid
going to those who do not need it. A recent study conducted by
health care expert Brian Blase, PhD, found that under this proposal
"a family of four with a 60-year-old head of household and income of
600 percent of the federal poverty level (FPL), or $159,000 a year,
would qualify for an annual [Obamacare subsidy] of $16,845."
Furthermore, the Congressional Budget Office says the
vast majority of this new spending would go to those who already
have insurance, providing a huge incentive for some private
companies to push employees off their company-sponsored private
plans and onto the Obamacare exchanges. The
result would once again be more Americans on government-run health
care and a shift in cost from the private sector to taxpayers.
There is a pattern here.
And of course,
what wasteful Washington budget would be complete without a
special-interest giveaway? In this case, a gift to the unions in
the form of $400 billion to expand adult in-home and day care
through Medicaid. In many states, these workers are designated
"public employees" because Medicaid pays them, so they must join a
union. This is special interest pork-barreling at its worst and it
decreases choices for these workers.
One way Sen. Sanders proposes to pay for all this is to allow the
government to fix the prices of prescription drugs. It sounds like a
simple solution. But one only has to look to European nations with
similar policies to see that allowing the government to set price
controls inevitably leads to drug shortages and fewer new cures and
therapies, effectively inserting the government directly into your
If the Covid pandemic taught us anything, it is that the way to get
Americans quicker access to more life-saving drugs and treatments is
to remove governmental obstacles and empower innovators. But price
fixing does the opposite by deterring investment into research and
development. As a result, vulnerable patients, including those
waiting on cures for rare and complex diseases, will suffer most.
Congress needs to reject this government health care takeover
masquerading as an infrastructure plan. We have serious health care
issues in this country, and they can be addressed through personal
options for health care that give people more choice and control
over their own care. But, surreptitious efforts to move Americans
off the private health plans they like onto government systems will
only make matters worse.
In spite of the enormous intervention of government into healthcare
and the governmental protectionism afforded to the giant health
insurance companies, hospitals, unions, and pharmaceutical
companies, new entrepreneurial solutions are developing. The last
thing that we need to do is shut them down or crowd them out by
further protecting the giant market incumbents and enlarging the
role of government in healthcare. More choice, more freedom, is an
Dr. Kathleen Brown practiced dermatology for 21 years in Oregon
and founded Oregon Coast Dermatology in 2011 as an alternative to a
broken healthcare system. She and her husband currently live in
Montana and now run Montana Dermatology.
Dr. Kathleen Brown