Arnold Kling  

Medicare-for-all Fantasy

Fantasy Agendas... Memetic Suicide...

As promised, I offer my rebuttal to Jacob Hacker and others who see Medicare expansion as the way to "fix" the health care system.

According to the 2006 report of the Medicare Trustees, the unfunded liability in Medicare over the next 75 years is $11 trillion. This is the gap between the promises that the system makes to future beneficiaries and the taxes that will be collected under current law to pay for those benefits.

...Proposals to increase government's role in funding health care amount to adding passengers to the Titanic. Until someone figures out how government is going to pay for its existing promises in health care, it is not realistic to make new promises.

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COMMENTS (4 to date)
Mcwop writes:

My question for Hacker is how much will Medicare payroll taxes need to increase to cover the additional enrollees. There is no spoon, there is no free lunch, there is no such thing as free health care.

mjh writes:

It's annual enrollment time and the cost of health insurance has gone up (again). Because the cost went up, I looked at all of the options and coverages. I was able to cut my cost in half by choosing a different plan. The new plan doesn't cover as much, but it covers the basics and provides a safety net in the event of a catastrophy. I have greater responsibilities in the event of that catastrophy, but it's a catastrophy. I'm betting that it's not going to happen, and even if it does I'm covered for most of the problem, just not all of it.

So my question is this: I had an incentive to get a plan that is closer to Dr Kling's ideal for health insurance for people under 65. If we don't change anything, won't insurance companies start to charge dramatically higher for "all you can eat" plans and won't that create an incentive for people (like me) to look for lower cost alternatives?

In other words, as long as we don't do things like Mr Hacker recommends, won't the system that we have eventually create exactly the incentives necessary to become more like Dr Kling's ideal?

Is there something that I'm missing?

aaron writes:

I was just amuzed by the nightly news (I think it was NBC) which suggested giving people the same plan as congress. Where people will come up with the $1000 a month it costs wasn't addressed.

dan writes:


1) so what if there are unfunded liabilities of $11 tril over 75 years? We pay over $3.5 tril per year in healthcare costs in the US today. Some small % of that is medicare. Put the rest of it into medicare INSTEAD of into private plans and you've covered your liabilities more than 20 times over.

2) The current healthcare system is "the titanic". Costs to businesses and individuals are rising in double-digit percentages every year. We have to get off this boat. You provide no reason why simply putting LESS THAN the $4650 it costs my company to insure my family into medicare wouldn't BOTH fully fund medicare AND reduce overall costs by cuttinng out all the middle men (who add no value to the system), creating administrative efficiencies AND allowing economies of scale (including pooled bargaining power).

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