As a presidential hopeful, Kamala Harris was once a vocal proponent of single-payer healthcare, specifically the Bernie Sanders-Pramila Jayapal Medicare for All Act of 2023. This legislation would grant the federal government complete control over the healthcare system, encompassing financing, staffing, and medical decision-making.
If Harris were to assume the presidency, it is likely she would push for the passage of her version of Medicare for All, following in the footsteps of Barack Obama’s efforts with the Affordable Care Act. However, the idea of a single-payer system is misguided, as it would be more beneficial for patients to be in control of their own healthcare, rather than the federal government.
The Medicare for All plan is complex, but its core elements are straightforward. The federal government would provide cradle-to-grave medical care at a staggering cost of $32.6 to $40 trillion over a decade. To put this into perspective, the Affordable Care Act cost $1.76 trillion, while the US spent $4.8 trillion on medical care in 2023. Harris’s plan would account for nearly half of the world’s GDP.
Under Medicare for All, all public and private insurance plans would be abolished, except for Indian Health Service and Tricare, and replaced with a single federal plan. A national health budget would dictate payments for services and goods, with patients paying indirectly through taxes. The tax burden could potentially double for Americans, similar to Sweden’s top tax rate of 52.2 percent.
The plan would cover most Americans, with Harris intending to add approximately 11 million undocumented immigrants. However, the Medicare for All bureaucracy would dictate what care individuals receive, when, and by whom, stripping patients of their medical autonomy. This is similar to the UK’s single-payer system, where patients have limited freedom to choose their care.
The seesaw effect, which occurs when government-insured patients increase and medical services decrease, would likely result in longer wait times for care. With 333 million Americans covered under Medicare for All, wait times could extend from 122 days to years.
The federal government would also be responsible for credentialing and licensing care providers, with the power to punish those deemed non-compliant. This could lead to a chilling effect on medical innovation and freedom of speech.
From a physician’s perspective, Medicare for All could lead to a mass exodus of senior physicians, exacerbating wait times and creating a shortage of medical professionals. The plan would also induce a centrally controlled economy, where costs and spending rise without limit, and service and quality decline.
Currently, federal bureaucracy consumes 31 to 50 percent of US medical spending, taking away from funds for patient care. Medicare for All would only exacerbate this issue, leaving less money for care providers and patients.
The solution lies in returning control of healthcare spending to Americans, allowing them to shop for their care and creating a competitive market. This can be achieved by giving employees the money employers currently pay to insurance companies, removing restrictions on health savings accounts, and repealing regulations that dictate what policies insurance companies can sell. By doing so, Americans can gain timely, compassionate, and affordable healthcare, while reducing spending and restoring individual freedom.
