‘Medicare for All’ Is a Fantasy

“Medicare for All” is an enormously popular slogan, as evidenced by a slew of recent surveys. Its widespread appeal has emboldened the growing ranks of America’s democratic socialists, the more ambitious of whom see it as the entering wedge of a larger transformation of the country’s economic life. It’s also an indulgent fantasy, based on the illusion that we can simply reset the way the U.S. health-care system operates. And for those who doubt the wisdom of moving the U.S. health system further under state control, and who believe that Medicare is less the solution to its woes than a prime source of them, it’s both a warning and an opportunity. Opponents of Medicare for All must reconcile themselves to devoting more federal dollars to health expenditures in the short run—call it a bribe—to secure a saner and more sustainable health system in the long run.

The failure of congressional Republicans to unite around a coherent alternative to Obamacare is the proximate cause of the single-payer boomlet. The temptation for Republicans will be to focus solely on savaging Medicare for All, leaving the more contentious questions surrounding the pathologies of the U.S. health system to be addressed at a later date. But it would be shrewder to use the threat of Medicare for All to bring the overmighty hospital sector, bane of reformers on the left and the right, to heel.