Another nugget from Jonathan Lipow’s book Public policy for progressives.
I’ve posted on Lipow’s book three times now (here, here, and here). One thing I really like about Jonathan is that while he is progressive, he is also an economist. And he doesn’t leave his economics at the policy door.
Here’s an interesting insight about Medicare for All as a solution to healthcare spending.
He writes:
One indication that Medicare is part of the problem and not part of the solution is that no American under age 65 is on Medicare, and the U.S. spends only moderately more per person on health care for these people than other OECD countries. Meanwhile, all Americans over age 65 use Medicare, [DRH note: not quite true. My wife and I are on Medicare Part A but not on the rest of Medicare. As a federal retiree, I retained my employer-provided health insurance] and U.S. health care spending per person for this group far exceeds that [of] other OECD countries. Formally that doesn’t prove anything, but where there’s smoke, there can also be fire – and Medicare is shrouded in a huge plume of smoke.
Later he points out:
The first change the “Medicare for All” proposal would make to traditional Medicare is to eliminate all co-pays, deductibles and premiums. That would turn Medicare into a program very similar to the extravagant “all-costs paid” FFS [fee for service] insurance policy studied in the RAND experiment. Consider that the experiment found that “free FFS” insurance increased bills by 30%, while providing only negligible health benefits. Would something similar happen if we adopted Medicare for All?