Flawed logic won't fix care

Abdul El-Sayed, the Democratic candidate for Senate in Michigan, has a simple pitch to voters. Imagine, he says, a health-insurance plan with "no premium, no copay, no deductible — just healthcare when you need it." El-Sayed and other proponents call the idea "Medicare for All."

Free, on-demand care for everyone sure sounds good.

There's just one wrinkle: The proposal bears little resemblance to how Medicare actually works. Even under generous assumptions, it would shift trillions of dollars in healthcare spending onto the federal budget while potentially slashing quality and restricting access to care.

No doubt, the current system — beset by soaring costs, corporate misconduct, opaque pricing and perverse incentives — needs fixing. Yet a more pragmatic reform agenda would serve Democrats better in the midterms and serve Americans better over the long term. ...

Another approach involves a universal guarantee against catastrophic financial losses after an income-based deductible. Such coverage would protect consumers from financial ruin while scaling back insurance for routine care — with the goal of creating a genuine market to lower costs.

That's a less extravagant ambition than Medicare for All. It's also far more likely to help.

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