Medicare for All?

We seem to be in a continuous political fray with health care at the center. The current call is Medicare for All, whatever that means, which if one takes Sanders et al at face value it is free health care no matter. Now CMS has given data for 2017. They note:

U.S. health care spending increased 3.9 percent to reach $3.5 trillion, or $10,739 per person in 2017. Health care spending growth in 2017 was similar to average growth from 2008 to 2013, which preceded the faster growth experienced during the 2014-15 period that was marked by insurance coverage expansion and high rates of growth in retail prescription drug spending. The overall share of gross domestic product (GDP) related to health care spending was 17.9 percent in 2017, similar to that in 2016 (18.0 percent).

Thus making a reasonable assumption we are looking at $12,000 per person, sick or well, in 2020. Where is that to come from? Mainly because many of these people, more than half, make no money at all. One cannot get blood from a stone. Also if one takes the Marxists at their word it will come from the ultra rich, that class of people whose funds currently support entrepreneurial growth via their investments, and just think what will happen there.

This is another invention coming what are allegedly economists, Boston University educated economists one surmises. Details count, and as we have seen over the last fifty years those details have meant the death of many proposals.

Now there is another interesting fact, those damn facts. You see in the US specialist training is supported by Medicare, that Medicare that we all pay for and hopefully get when we reach a certain age. Thus urologists, immunologists, cardiologists etc are trained with medicare money, our contributions. Medical students are not. Also there are more medical schools opening training MDs but since the specialist resident schools are limited by Medicare in number, many of these MDs will fall in the market with no further training, no internists, no oncologists.

Four years of medical school and a year of internship can make a great physician assistant, but it takes a great deal more in today's complex world if one expects competent health care. Your local GP can go just so far, especially if they are dealing with dozens of patients a day.

So we are seeing a perfect storm occurring. Those who can afford the best care will be able to buy it, the rest will suffer the problems of national health care. Thus in the UK and Canada it may easily take 6 months to get an MRI. If you have a resectable tumor when examined by the time you get the MRI, and worse to the surgery, you might as well skip that and buy your urn!