Medicare for All remains on the congressional docket. Sen. Bernie Sanders, I-Vermont, recently reintroduced his bid for a single-payer system, claiming it would guarantee all Americans health coverage while lowering costs and saving lives.
That's a compelling sales pitch. However, the reality is that Medicare for All would outlaw private health insurance and force millions of Americans onto a single government-run plan. And contrary to what its proponents might suggest, Medicare for All would lead to worse care for patients at higher cost.
Even the idea's supporters don't seem to know what it entails. According to polling from the Kaiser Family Foundation, two-thirds of Medicare for All supporters believe they'd be able to keep their private insurance under a single-payer health care system.
Sen. Sanders's bill, of course, would ban private plans. That might not sit well with the 14 million Americans who purchase private plans through the Affordable Care Act's exchanges. Almost three-quarters of enrollees like the plan they have now.
Outlawing private insurance coverage also wouldn't go over well with the 180 million Americans with employer-sponsored coverage. More than seven in 10 are satisfied with their plans.
That makes sense. Employers compete for employees in part by offering generous health insurance. Workers benefit from the great coverage, and employers benefit by being able to attract and retain quality workers.
By forcing everyone onto the same insurance plan, Medicare for All would take that bargaining chip away from employers and employees alike.
It's no surprise that overall support for Medicare for All - which usually hovers around 50% - drops to just 37% when people realize it would eliminate private health insurance.
Support drops to just 26% when people learn single-payer would lead to delays in care.
Delays are endemic to single-payer programs like Medicare for All. That's because the government would pay hospitals and doctors below-market rates in order to deliver the savings Sen. Sanders promises.
Medicare and Medicaid pay less than private insurers do. A single-payer plan would extend those low payment rates to everyone.
Providers today charge privately insured patients more to make up for low reimbursements from public plans. They wouldn't be able to do that under Medicare for All. The result would be budget deficits for 90% of hospitals, according to one study from FTI Consulting.
Providers would have little choice but to restrict access to services - if they're able to keep their doors open. Patients would face long waits for subpar treatment.
That's exactly what happens in other countries with single-payer health care. In the United Kingdom's National Health Service, there are more than 6 million people waiting for hospital care. Thousands have been waiting for more than two years.
Similarly, under Canada's single-payer system, patients face a median wait of nearly six months from the time they're referred by a general practitioner to receipt of treatment from a specialist.
Under Medicare for All, American patients would experience similar fates. That was the conclusion of Phillip Swagel, director of the Congressional Budget Office, who recently told Congress that single-payer would increase "congestion in the health care system, including delays and forgone care."
Those delays and forgone care would cost Americans a lot of money - more than $30 trillion over a decade.
Less than 10% of the American population is uninsured. There are far more cost-effective ways to expand access to affordable coverage.
For example, the additional subsidies provided by the American Rescue Plan Act have helped more than 3 million Americans secure coverage through the Affordable Care Act's exchanges for less than $10 a month. Extending those subsidies permanently could continue to make private coverage affordable for millions.
The Affordable Care Act has also driven down coverage inequities, especially in states that have expanded Medicaid. That's a testament to the power of building on the parts of our health care system that are working.
Lawmakers should focus their efforts there - not on Medicare for All.