Medicare-for-all sounds great, until the bill comes due

During the debate — including a government shutdown — that led up to the passage of the Affordable Care Act, we remember hearing a millennial’s plaintive cry about the unfairness of the “individual mandate.”

“Why should I pay for something I don’t need?” That palm-to-the-forehead realization of a basic misunderstanding of the term “insurance” is bound to be repeated this election cycle, as the “Medicare-for-all” plank is inevitably nailed into the platform of the Democratic Party.

There’s some value in examining whether health “insurance” is actually insurance at all. Perhaps it’s better thought of as pre-payment for something that “will” happen — the need for medical care — rather than actual insurance against something that “might” happen, such as an accident.

A nonpartisan Kaiser Family Foundation survey sheds some light on the coming battle over the MFA issue, and the points that will have to be hammered home in order to defeat the concept.

Asked whether they support “Medicare-for-all” as first championed by Sen. Bernie Sanders in 2016, respondents favored the concept 56 to 42 percent, and that climbed to 71 percent when they were told it would guarantee health insurance as a right and 67 percent when told it would eliminate premiums and reduce out-of-pocket costs.

But when they were told a government-run system would lead to delays in getting care or higher taxes, support dropped to 26 percent and 37 percent respectively.

Those factors are hard to quantify since some studies estimate government spending would increase $25-35 trillion over a decade, but others estimated cost savings would cut the increase to $1.1 trillion in new taxes in the first year of the program.

A couple of other ideas found wide support in the survey, one which would allow people ages 50-t0-64 to buy into Medicare, the other to allow uninsured to buy into their state’s Medicaid program.

Another private survey found that the uninsured rate among U.S. adults rose 13.7 percent int he last three months of 2018, and has climbed 2.8 percent overall since 2016, translating into about 7 million more uninsured adults.

The issue is bound to come home for Nebraskans, who voted to expand the state’s Medicaid coverage under Obamacare, which has been thrown into question as a result of court rulings potentially gutting it because of the elimination of the individual mandate.

The Kaiser Health Tracking Poll was conducted Jan. 9-14 and involved random calls to the cellphones and landlines of 1,190 adults. The margin of sampling error for all respondents is plus or minus 3 percentage points.