Coping with "Medicare for all"

Most of the Democrat members of Congress ran on a platform of “Medicare for all”. The national government is divided now so it probably will not happen there for a while. But in far left states like my home state of California where the Democrats won by a total rout it’ll probably happen soon. The new governor elect, Gavin Newsom, ran on a platform of Medicare for all including illegal aliens.

This is not a thread on the wisdom of this action. Instead, I think it would be useful for us to discuss how to cope with it.

It obviously depends on your current situation. Those of us on traditional Medicare have one situation while younger people on their employer’s Health Insurance have another situation.

Nevertheless everyone will have to cope with big changes. In particular, there will probably be a huge increase in the number of people trying to use the Medical System. To exacerbate the problem, the state government will probably put price controls on the amount doctors can charge. This will lead some of them to leave the state and others to take up boutique practices.

So the first effect will be difficulty finding a doctor. One solution would be for those of us like the people on this board who have money to sign up for a boutique practice if the state allows them.

What will happen to Medicare payments is an interesting question. The state will probably try to get the Federal government to pay the state run system but that may not happen. It could be a real mess.

Any way those are some of my thoughts. Again this is not a thread on the wisdom of this plan but on how to cope with it.

edit 12/14/18: Heard an informative discussion on future of California medical system on radio. The interviewee is Craig Gotwas, a lawyer who makes his living advising companies on how to cope with government regulations for their employees’ medical insurance. Scroll forward to about the one minute mark to get over the show opening stuff.

Youtube audio
See Post 37 for some comments

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I think it’s inevitable the country will migrate, state by state, to a universal health care system. I also believe that it will lead to a bifurcated health care system: pubic for the masses and boutique for those who can pay for it. Just like it has in most other places with socialized medicine.

Even with Obamacare, there are still millions of uninsured. If they all receive a health care entitlement, there will be provider and facility shortages. There will be wait times for some procedures and, perhaps, differing offerings for end-of-life care.

Maybe it will be like social security. A bare-bones safety net? Catastrophic coverage?

O-care for me is certainly less than affordable. My cost next year (single) will be $1400 / month with an HSA.


It looks to me that you might be a winner once it happens. You could drop your current coverage, sign up for Medicare for All (MFA) and bank the premiums. Then if you need better care, sign up with a boutique practice using the saved premiums.

Obviously huge YMMV depending on how it is implemented.

For now, the best we can do is decide if we can tolerate MFA. If not, start looking for a way to bail out to another state once it gets implemented.


I think it will become more like Medicaid for all - nonprofit clinics and doctors starting out their practice or those who have graduated from offshore medical schools providing most of the services. Already many doctors don’t accept Medicare or only accept it for existing patients, and many doctors are missing from Obamacare EPOs. Which in my opinion is just fine - hip replacements and other elective surgeries may take time, one may need to travel out of the way to see a clinic doctor, and one may not get the most recent drugs, but 95% of medical ailments and accidents will be treated at minimal cost to the patient.


You seem to misunderstand what Medicare is.

It is a federal program. States can’t force someone onto Medicare without meeting federal guidelines. Medicare is already price controlled. No practice negotiates with Medicare, they take it or leave it.

States are welcome to set up their own health plans and/or subsidies, but they are not Medicare.



I think it will become more like Medicaid for all [/quote]

That’s a good point. In CA, about 1/3 of all people are already on Medicaid or MediCal as they call it here.


Your seem to misunderstand what Medicare is.

Medicare for All is just the Left’s marketing to sell it to voters. The reasoning is that people are familiar with Medicare so it is easier to sell than socialized medical care. The actual implementation will not be anywhere near current Medicare.


Coping with doubling the income tax rates to pay for it would be the main problem. There will still be private doctors, if you can afford them, so you don’t have to wait a long time or get mediocre care. Medicare just for old people isn’t funded and will need more taxes within ten years, let alone massively expanding it.

North Carolina’s tale is only the latest example of single-payer dreams crumbling after confronting reality. Last year, California State Assembly Speaker Anthony Rendon, a Democrat, pulled the plug on single-payer legislation passed by the state Senate after deeming it “woefully incomplete.” Even that was an understatement – the bill was silent on how it would raise the $400 billion needed to fund single-payer each year.

In 2014 in Vermont, then-Gov. Peter Shumlin – a long-time single-payer advocate – gave up on a single-payer plan after he learned it would cost $4.3 billion annually. That amount was equivalent to 88 percent of the entire state budget. He reluctantly concluded that the proposed funding mechanism for single-payer – a 12.5 percent state payroll tax and a sliding-scale individual tax of up to 9.5 percent of income “might hurt our economy.”


At this point I don’t think theres much one can do other than take a “wait and see” stance.

Its all just theoretical and speculating on the unknown right now.


I’m not so sure Medicare for All is unavoidable nationally or for many states for that matter. I don’t think the country is ready for it, just looking at how many people are suckers for tax cuts thinking it’s just free money. At best it’s a loan to yourself or to your kids, at worst a wealth-redistribution plan you may not be on the winning side of.

I’m curious to see how the experiment will pan out actually if CA goes for implementing such a system. Because I view it a bit as the situation we have with our own customers. If you talk to customers about a potential new feature or product, every one of them is excited about it and love you for it. Well until you ask them what they would be willing to pay for it because the extra features cost extra labor and infrastructure… then the response is usually MUCH more measured to put it mildly.

So everybody will love on paper Medicare for All until the question comes up of who foots the massive bill. If history is any guide, any program that gets voted on will be grossly underfunded like the Medicare and Medicaid are, and politicians will kick the can of entitlement reform (spoiler: there is no easy or painless solution) down the road for as long as they can.

Short term, I wouldn’t worry about campaign promises such as this going forward. I’m sure some may want to give it a try, if only to prove to voters that they went for it but someone else did not let it happen. But we’ll talk again when it actually gets implemented. Like some here have said, the only way to make it happen would be to impose drastic limitations on costs and then you will have a two-tier systems with many providers simply opting out.


I would encourage you all to read Bernie Sanders’ or some of the other proposals. Medicare pays for essential services, and then most recipients receive a supplement or are enrolled in a Advantage plan via a private insurance company which is a hybrid approach to socialized medical coverage. Gradually, Medicare would be expanded to younger age groups until everyone was covered.

As someone who used the ACA earlier this year and am now on employer-sponsored coverage, we have to do something. Health care costs are spiraling out of control. The insurance and pharmaceutical companies are taking advantage of the current system for all its worth and raking in huge profits while Americans are suffering. Those of us in the workforce are already subsidizing everyone else. If Medicare-for-all has the potential for bringing costs under control, then I don’t see what we have to lose. Therefore, I will not “cope” with Medicare-for-all. I plan to enjoy it.


Although I started this thread, I agree with this point although I have started to look around for other states where I can bail out if CA goes for it.

But, who knows, maybe financial sense will prevail. Stranger things have happened.

I thought you wanted this thread to not be about “the wisdom of this plan.”

You are implying that the status quo makes financial sense. I’m here to tell you that socialized healthcare is the only thing that makes financial sense. We (all of us) pay more to cover emergency care for the uninsured than we would for preventive care for all. The arguments about longer wait times, doctors moving elsewhere, and other countries having it really bad are mostly bullshit.

OK now I’m done.


We already have universal health care. Anybody who wants to can go to the ER and get treatment and then not pay for it. It might be more fair and cheaper to just expand Medicare for all.

Well, not anybody – those of us with assets will be forced to pay.

Nevertheless, we have healthcare entitlements for for the uniformed services, the underage, the poor, the working poor (in most states now), and those 65 and older.

It’s only a matter of time and whether the government will directly or indirectly (through private insurers) provide services. My guess is the next time that the House, the Senate, and the White House turn blue and there will be some sort of hefty tax to fund it.

I’m not so sure what will happen to employer-funded health care. Any ideas?

Hopefully employer funded healthcare goes the hell away. What a horrible system.

Right now my employer pays close to 40k/yr for my family’s coverage, so i do alright, but it’s still stupid.


How big is your family and how fancy is your plan? Because that sounds about 2x more than it should be.

Many countries end up banning private health insurance and care. All the good doctors end up leaving the lower paying price controlled jobs leaving few doctors and long waitlist at public facilities

In Canada they had huge wait lists for care. Then people used the private market. The socialists called this “Rich people skipping the line” and banned private practice.

That is why Canadians come to the US for care.


Source please. I want to see for myself, because I’ve heard that they like their system and don’t come to the US for care.


There’s tons of stuff on the internet but here is a quick start

Dr. Brian Day is challenging the province’s ban on the purchase of private insurance for medically necessary services that are already covered by the public system. His argument that the ban violates patients’ constitutional rights by forcing them to wait for months and even years for medical procedures will be heard at a trial that began Tuesday and is expected to last months.

Day is joined in the case by 20-year-old Walid Khalfallah, who waited more than two years for medical treatment while his spinal condition worsened.

Khalfallah was eventually treated in the U.S., but he is now partially paralyzed and moves around in a wheelchair.

Health Minister Jane Philpott told CTV’s Power Play on Tuesday that any system that allows some patients to pay to “get to the head of the line” is “not a fair system.”