False Premise, False Promise: The Disastrous Reality of Medicare for All

by Sally C. Pipes

American health care is at a crossroads. Health spending reached $3.5 trillion in 2017. Yet more than 27 million people remain uninsured. And it's unclear if all that spending is buying higher-quality care. Patients, doctors, insurers, and the government acknowledge that the healthcare status quo is unsustainable. America's last attempt at health reform -- Obamacare -- didn't work. Nearly a decade after its passage in 2010, Democrats are calling for a government takeover of the nation's healthcare system -- Medicare for All. The idea's supporters assert that health care is a right. They promise generous, universal, high-quality care to all Americans, with no referrals, copays, deductibles, or coinsurance. With a sales pitch like that, it's no wonder that seven in ten people now support Medicare for All. Doctors, especially young ones, are coming around to the idea of single-payer, too. Democrats, led by the progressive wing of the party, hope to capitalize on this enthusiasm. In 2017, they introduced companion legislation in the House and Senate that would establish Medicare for All. They have already promised to do the same when the next Congress convenes in 2019. More than 70 House Democrats have joined a new Medicare for All Caucus. Senator Bernie Sanders is effectively already on the presidential campaign trail, making his case for single-payer. If Democrats take the White House and Senate in 2020, and hold onto the House, a Medicare for All bill could be among the first pieces of legislation presented to the new president for a signature. In this book, Sally C. Pipes, a Canadian native, will make the case against Medicare for All. She'll explain why health care is not a right -- and how progressives pressing for single-payer are making a litany of promises they can't possibly keep. Evidence from government-run systems in Canada, the United Kingdom, and other developed countries proves that single-payer forces patients to withstand long waits for poor care at high cost. First, she'll unpack the Medicare for All plans under consideration in Congress. She'll explain how radical they truly are. Medicare for All will not save $5 trillion, as some of its proponents claim. It will cost about $32 trillion over 10 years, according to analyses from the Urban Institute and the Mercatus Center. It will outlaw private health insurance. It will raise taxes by trillions of dollars. It will cut pay for doctors to the rates paid by Medicare and thereby exacerbate our nation's shortage of physicians. And it will ration care. Then, Sally will detail the horrors of single-payer. She'll start in Canada, whose single-payer system most closely resembles the one progressives have in mind for the United States. Analyses of the government-run systems in the United Kingdom and a few other developed countries will follow, with particular focus on the problems that these systems pose for patients and doctors. To substantiate her indictment of single-payer, Sally will marshal both quantitative and qualitative evidence. She'll highlight how Americans fare better than their peers in Canada and the United Kingdom on the health outcomes that are directly linked to the quality of a healthcare system, including survival rates for patients with cancer and cardiovascular issues. She'll also explain why the health outcomes where the United States performs poorly relative to other nations, like infant mortality and life expectancy, tell us little about our healthcare system. Sally will pepper her text with heart-wrenching stories of the human costs of single-payer -- of people who were injured, were forced to remain in pain, or even died because their government-run healthcare system delayed or denied care.

Genres: Politics, Nonfiction

154 pages, Kindle Edition

Published January 7, 2020

Reviews

[Amora · Rating 4 out of 5]

This book is more of a critique of single-payer systems than Medicare for All, in my opinion. It’s really only one chapter where Pipes focuses on various versions of Medicare for All and what the implications of each is. That aside, this is a good critique of single-payer systems. Pipes argues that single-payer systems around the world have the common theme of wait lists, rationing, and out-of-date technology and pharmaceutical drugs. This is one of Pipes’ shortest books, but it was a nice read.

[Prashanth · Rating 1 out of 5]

Right wing propaganda that cherry picks exceptional cases while ignoring important context, and generalizing that to the whole concept of universal healthcare.

The explanation on why healthcare was not a basic right was awfully unempathetic. Books like these serve as mouthpieces for propagating and legitimizing exclusionary thought.

[Chris White · Rating 1 out of 5]

I legitimately can't, in one review, express just how hilariously garbage the arguments made in this book are. Three highlights from the first chapter-and-a-half:
* Sally tries to make a false equivalence between current Medicare and "Medicare for All" (so named because it's a familiar name, not because one program is even tangentially related to the other).
* She claims healthcare is not a right after a gallon of word soup containing semantic arguments based on how "nobody can truly define" what a right to healthcare would be.
* She managed to put the idea that "many will lose their job in the insurance market" and "the government will have to hire thousands to work on M4A" two sentences apart without managing to connect the dots.

The entire final 3/4 of the book is a parade of arguments from emotion, cherry-picking people who had unfortunate experiences in Canadian and UK healthcare, ignoring that both countries' programs are largely loved by their populations; nobody claims that the healthcare systems in those countries are perfect and her exaggerations rarely seem to coincide with stories about how US healthcare is better than either in any way. It's the conservative ideology of not believing things deserve regulation unless they can be 100% perfect at its finest, and a hilarious ignorance of the literal millions of similar and worse stories you could find within current American healthcare simply by checking twitter for a minute.

This is a tangled mess of arguments, false equivalences and philosophical dreck that presents such terrible information that it would require an entire other book to debunk sufficiently.

[Claire Humphrey · Rating 1 out of 5]

I was disturbed and disgusted to find my mother, Anya Humphrey, quoted in this book as if she was an opponent of the Canadian health care system.

While our family had a tough experience with lack of palliative support for my dad, this experience did not at all make anyone in the family disillusioned with the Canadian system. On the contrary, my mother spent the next decade as a palliative care advocate helping to improve patient experience here. She would not have signed off on her words being used in this way.

When you have to misquote random strangers to make your argument, it's a sign that the argument is pretty weak. And it's especially gross when the subject is someone's unavoidable death and the grief around it.

The author and publisher should be ashamed of themselves. Avoid this book.

[Will Atkins · Rating 2 out of 5]

A bit disingenuous in most of the arguments. Only provided direct comparisons of Canadian/UK single payer programs with the US when the US “won.” In most cases, she just said how bad certain stats were for UK/Canada without mentioning that the US was even worse. In other cases, she made vague arguments while implying that it was due to single payer. An example: she discussed how Canada had an EpiPen shortage in 2018 and implied that this was because of sub-standard healthcare, but never mentioned that the shortage was caused by production delays in Missouri or that Americans were buying Canadian EpiPens due to the American healthcare system allowing them to be sold for thousands of dollars here as opposed to dozens of dollars in Canada. Overall just a biased and disingenuous book.

[Darren Gray · Rating 5 out of 5]

Many will be unhappy with the results and conclusion within this book. However the author has been smart to back up all her claims with the book containing 36 pages of citations! As a public health student I personally understand both sides of the argument. I personally think that a 100% single-payer “Medicare-for-all” system would come at a great cost to the American population. In addition she also address the counter arguments. Regardless of your stance this is a great book outlining some of the issues of single-payer systems with focus on the UK and Canada! Overall great read!

[Stan Sienkiewicz · Rating 5 out of 5]

While the individual stories provide an example of various points in the book. The opposition view could do the same. Also can find one case opposite any opinion. I’m not criticizing the author but want to state a fact.

The book does show at a macro level how much of the media has misinformed the public. What we need is more open discussion of the facts and not statements to elicit emotional reaction.

I would love to see a five page talking points of this book.

[Don · Rating 1 out of 5]

So bad.

[Kiri Dawn · Rating 4 out of 5]

Fascinating ideas to consider but a bit anecdotal at times.