Washington Examiner

Medicare for All would shutter rural hospitals

By Rep. Ron Estes (R-KS)

June 21, 2019

Support for “Medicare for all” — the marketing rebrand of government-run, single-payer healthcare — has become a litmus test for Democratic candidates for president.

One prominent progressive, Sean McElwee, founder of Data For Progress, declared, “There is no viable path to the Democratic nomination for someone who does not support single-payer health care.”

Yet when voters and America’s patients understand the devastating impacts of this policy, Democrats may rethink their support.

Consider the potential impact of “Medicare for all” on rural hospitals. Policy experts estimate that under the Medicare for All Act, reimbursement rates for rural hospitals would be slashed by 40% below current payment rates. My home state of Kansas has 83 rural hospitals — the second-largest number in the country. They are currently reimbursed at just 101% of cost. At this reimbursement rate, many rural hospitals are struggling financially to keep their doors open.

At a recent U.S. House Ways and Means Committee hearing, I asked Galen Institute President Grace-Marie Turner about how the slashing of this reimbursement rate would affect rural hospitals in my state and across the country.

She responded, “I think that the rural hospitals would be among the most vulnerable, because they often are relying even more now on Medicare and Medicaid payments and have fewer private people supporting them. … If you put all of them on these much lower government payment rates, it’s very hard to see how most of them would be able to keep their doors open.”

Turner’s warning is in line with information not only from conservatives, but from the New York Times as well. In April, the Times reported that rural hospitals “would try to offset the steep cuts by laying off hundreds of thousands of workers and abandoning lower-paying services like mental health.”

The impacts of Medicare for All would go well beyond rural hospitals and mental health services.

The bill explicitly declares that “no employee benefit plan may provide benefits that duplicate payment for any items or services for which payment may be made under Medicare” (Title VIII, Section 801 of the Medicare for All Act of 2017). This draconian provision is effectively a ban on private insurance, which one leading Democratic candidate for president, Kamala Harris, proudly endorsed.

Democrats used to claim that if you like your plan you can keep it. Now they’re promising that if you like your plan, they’re going to eliminate it.

Remember that under the Affordable Care Act (better known as Obamacare), nearly 5 million Americans were kicked off their plans. Under Medicare for All, nearly 158 million Americans could lose their private insurance. That’s hardly “progressive.”

Medicare for All, again, is all about marketing. It is portrayed as an expansion of the positive aspects of Medicare. In reality, it’s about elimination rather than expansion. It would eliminate Medicare as we know it, repeal private insurance and replace it with single-payer, government-run healthcare.

More government is not the answer. In Britain, which has a “Medicare for all” single-payer system, 1 in 5 cancer patients have to wait more than two months for treatment after being referred from a general practitioner. In Canada, which is also hailed as a shining example of single-payer healthcare, the median wait time is 19.8 weeks for patients to see a specialist after receiving a referral from a general practitioner. Canadians also have median wait times of 4.3 weeks for a CT scan, 10.6 weeks for an MRI, and 3.9 weeks for an ultrasound.

Medicare for All would be more like Medicaid for All or VA Care for All, in that it would force everyone into a system already crippled by long wait times.

Government now dominates about 80% of our health are spending. Government’s reach has expanded in the last decade. As a result, the healthcare industry has been thrown into chaos. Costs have risen, and choices have disappeared.

Instead of giving government 100% control and pushing one-size-fits-all solutions, it’s past time to empower patients with choice and access. The problem is not that the market has failed, but that a bureaucratic government has gotten in the way of quality, affordable patient care. It’s time to create innovative market solutions that will truly empower patients in all areas of America, rural and otherwise.

Ron Estes has represented Kansas’ 4th Congressional District in the U.S. House of Representatives since April 2017. He is a member of the U.S. House Committee on Ways and Means.