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Italy Shows That Medicare for All Is No Cure for Coronavirus

Italy Shows That Medicare for All Is No Cure for Coronavirus
An isolation and containment room at the new COVID 3 level intensive care unit for coronavirus COVID-19 cases, at the Casal Palocco hospital near Rome. (AFP via Getty Images)
 

By Wednesday, 18 March 2020 08:28 AM Current | Bio | Archive

The Democratic presidential race may be pretty much over, but the party's fight over health care isn't. "This coronavirus pandemic exposes the incredible weakness and dysfunctionality of our current health-care system," Senator Bernie Sanders said at Sunday's debate. Former Vice President Joe Biden replied that Italy's alarming experience suggested that Medicare for All "would not solve the problem at all."

Fans of Sanders's health-care plan are furious about Biden's comment, and his campaign surrogates have continued to criticize it after the debate. But while Biden isn't known for rhetorical precision, he got this point exactly right. He didn't say that Italy's high death rate shows that Medicare for All won't work. It shows only that it's not a solution to this problem.

Sanders offered two reasons for thinking that his health-care plan would make the U.S. better equipped for a pandemic. He said people who are sick would be more willing to seek testing and treatment if Medicare for All had made nearly all health care free at the point of service. So more people would get the care they need, and — he left unsaid, but surely was thinking — fewer people would be spreading the virus.

Medicare for All would also, he argued, make it easier to plan for pandemics because it would make for a more efficient health-care system delivering more care for each dollar. Our current system spends much more than other countries, he said, yet we don't have enough doctors, hospitals and medicine.

Sanders's first point is his strongest one. But as Biden observed, it can be answered without going all the way to Medicare for All. We can make coronavirus testing free for all — as my former Bloomberg Opinion colleague Megan McArdle has advocated — without outlawing private health insurance.

His second point is dubious. Sanders claims that administrative expenses and profits explain the high cost of American health care. But some administrative expenses bring costs down, by preventing fraud. Profits are a small share of health expenses.

A big driver of the difference in health costs among countries is that medical providers in the U.S. charge more. Medicare for All legislation attempts to save money by cutting doctors' pay. If we go that route, though, we should accept that fewer people are going to spend the time and money it takes to become doctors in the first place. The idea that we can transition from our current system to one with more doctors and lower costs, just by putting the federal government in charge of more of it, is implausible.

The promise of savings also runs up against another effect of Medicare for All: raising demand for medical services by making it free at the point of service. Common sense tells you it would have that effect. So does Sanders's own first argument, noted above, which is that charging people discourages them from getting tested and treated.

Then there's the obvious point: Italy disproves the idea that a country that finances most health care through the central government and spends less than the U.S. does will therefore build a system that handles a pandemic well. Which, again, is the point Biden was making.

The truth is that no health-care system is optimized for handling a once-in-a-generation pathogen. It would be irrational to have one that was so optimized. It would mean devoting enormous amounts of resources to create standby capacity that would barely ever be used.

And there's a more important truth for this unusual moment. The reason South Koreans have fared better than Italians against the coronavirus probably has more to do with differences between the countries' median ages and behavioral responses to the epidemic than to those between their systems of financing universal health care. The most important thing elected leaders can do to improve public health right now is not overhauling insurance coverage. It's closing the bars.

Ramesh Ponnuru is a Bloomberg View columnist. He is a senior editor of National Review and the author of "The Party of Death: The Democrats, the Media, the Courts, and the Disregard for Human Life." To read more of his reports — Click Here Now.

© Copyright 2020 Bloomberg News. All rights reserved.

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RameshPonnuru
The truth is that no health-care system is optimized for handling a once-in-a-generation pathogen.
italy, coronavirus, medicareforall
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2020-28-18
Wednesday, 18 March 2020 08:28 AM
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