No Matter the Name, Government-Run Health Care Systems Would Hurt Patients

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As a nurse practitioner, my focus is on patients, not politics. But I can’t help but notice that as the crowded field of presidential candidates debates their various health care proposals, there seems to be a lot of focus on what makes a good campaign slogan and far too little attention paid to what makes good health care policy.

While these proposed government health insurance systems – including “Medicare for all,” “Medicare buy-in,” “Medicare for America,” or “public-option” – may have catchy names, that isn’t the only thing they have in common. For one thing, these plans are short on important details, like how much they would cost taxpayers. And they would all ultimately lead to the same result: a one-size-fits-all government-run system that would hurt patients.

Having cared for patients for nearly a decade, I agree that more should be done to expand access to quality, affordable care for all Americans. And while, on the surface, these proposals sound like they would help achieve that, when you dig into their consequences, the sad reality is that these systems would not only threaten patients’ access to quality care, but could even cause hospital closures, a shortage of health care professionals and less innovation for new treatments and cures.

Under a one-size-fits-all system, nearly two hundred million Americans would lose their employer-provided and other private coverage, as would the tens of millions who rely on existing public programs like Medicare, Medicaid and the Children’s Health Insurance Program. As everyone is moved into a single, government-run system, Americans’ choice and control over their coverage would go away, and those relying on tailored public programs, like our nation’s seniors and children who often need specialized care, would also be forced into the same system as everyone else.

Also concerning is the fact that these systems would drastically cut payments to hospitals to levels that are not sufficient to cover the costs of care. Research shows that this would produce many of the same negative effects as Medicare for all when it comes to patient choice and quality care, threatening patients’ access to their doctors and treatments as they are forced to endure longer wait times. A government insurance program like this would “compound financial stresses [hospitals] are already facing, potentially impacting access to care and provider quality,” and could “force the closure of essential hospitals,” further straining access to care, especially in rural communities.

And while America today is world renowned for our great strides in medical innovation, under these systems that innovation would suffer as a government payer would be more likely to opt for generic, cheaper alternatives over pricier, cutting edge procedures. 

Although often touted as less extreme, in the end, so-called “buy-in” and “public option” proposals would have the same harmful effects, disrupting the marketplaces where Americans shop for coverage and moving everyone into a one-size-fits-all system run by politicians and bureaucrats. To put it bluntly, these government insurance programs are a slippery slope to Medicare for all.

Instead of poll-tested rhetoric, our leaders should focus on realistic, cost-effective solutions that expand Americans’ access to quality, affordable care without jeopardizing the coverage that a majority of Americans rely on and are satisfied with. For example, by finally expanding Medicaid in all 50 states, we could deliver health coverage to millions. Other sensible measures include expanding federal subsidies and using reinsurance to help stabilize premiums to increase health care affordability.

So, let’s work to improve and build upon our current system, because Americans’ health care is too important to put at risk.

Catherine Prato, Ph.D., is a nurse and nurse educator, focused on patients and students, in Las Vegas, NV.

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