NO CHOICE, NO EXIT The Left’s Plans for Your Health Care edited by MARIE FISHPAW and ROBERT E. MOFFIT, PHD More praise for NO CHOICE, NO EXIT The Left’s Plans for Your Health Care Big government is especially pernicious when asserting control over an individual‘s health care. A bill which received an all-day hearing in a House of Representatives committee would do just that, resulting in a complete government takeover of health care. This book provides a go-to source as we continue the difficult debates about the federal presence in health care. —REP. MICHAEL C. BURGESS (R-TX-26), MD No Choice, No Exit: The Left’s Plans for Your Health Care cuts through the rhetoric to explain the consequences of proposals purporting to save a family money by raising their taxes and limiting their health care choices. The publication is timely as health care will be part of the debate for the presidential campaign and into the next Congress. Americans who wish to understand this debate should read this book. —SEN. BILL CASSIDY (R-LA), MD Health reform remains a top priority for Americans. They’re concerned about high costs, access, and choice. This book explicitly shows how the Left’s plan for your health care fails to address those concerns. —JOHN GOODMAN, PHD, FATHER OF HEALTH SAVINGS ACCOUNTS AND CO-AUTHOR OF BEST-SELLING BOOK PATIENT POWER This important collection cuts through the Left’s rhetoric on health care to highlight the danger of over-centralization and government control. American health care faces real problems, but the Left would only double down on them. —YUVAL LEVIN, PHD, DIRECTOR, SOCIAL, CULTURAL, AND CONSTITUTIONAL STUDIES AT AMERICAN ENTERPRISE INSTITUTE AND EDITOR IN CHIEF, NATIONAL AFFAIRS It has never been more important than now to understand what a single-payer system would mean. This is a “must read.” —GAIL WILENSKY, PHD, ECONOMIST AND SENIOR FELLOW, PROJECT HOPE NO CHOICE, NO EXIT The Left’s Plans for Your Health Care edited by MARIE FISHPAW and ROBERT E. MOFFIT, PHD © 2020 by The Heritage Foundation 214 Massachusetts Ave., NE Washington, DC 20002 (202) 546-4400 | heritage.org All rights reserved. Printed in the United States of America. ISBN: 978-0-89195-173-5 CONTENTS FOREWORD From the President of The Heritage Foundation .................................. vii KAY C. JAMES INTRODUCTION Government-Controlled Health Care: Rhetoric Versus Reality ..................... 1 MARIE FISHPAW and MERIDIAN PAULTON SECTION 1: Public Option: The Trojan Horse to Government-Controlled Health Care Introduction ........................................................ 13 CHAPTER 1 The “Public Option”: Government-Run Health Care on the Installment Plan ............................................. 15 NINA OWCHARENKO SCHAEFER and ROBERT E. MOFFIT, PHD CHAPTER 2 The Public Option: Single Payer on the Installment Plan ............ 19 NINA OWCHARENKO SCHAEFER and ROBERT E. MOFFIT, PHD SECTION 2: Leading House and Senate Bills Introduction ........................................................ 41 CHAPTER 3 House Democrats Unveil Plan to Bring Total Government Control Over American Health Care ........................................ 43 ROBERT E. MOFFIT, PHD CHAPTER 4 Total Control: The House Democrats’ Single-Payer Health Care Prescription ........................................... 47 ROBERT E. MOFFIT, PHD CHAPTER 5 Government Monopoly: Senator Sanders’ “Single-Payer” Health Care Prescription ........................................... 71 ROBERT E. MOFFIT, PHD CHAPTER 6 Sacrificing Public and Private Health Insurance for “Medicare for All” ............................................... 97 DOUGLAS HOLTZ-EAKIN, PHD, and ROBERT E. MOFFIT, PHD CHAPTER 7 New “Medicare for All” Bill Would Kick 181 Million Off Private Insurance .............................................. 101 ROBERT E. MOFFIT, PHD SECTION 3: Framing the National Debate Introduction ....................................................... 107 CHAPTER 8 The National Debate over Government-Controlled Health Care ....109 ROBERT E. MOFFIT, PHD, CHRISTOPHER POPE, PHD, and WHIT AYRES, PHD CHAPTER 9 No Choice, No Exit: The Truth About “Medicare for All” Proposals .......................................131 ROBERT E. MOFFIT, PHD SECTION 4: Britain and Canada: Lessons from Their Experiences Introduction ....................................................... 137 CHAPTER 10 London Calling: Don’t Commit to Nationalized Health Care .......139 TIM EVANS, PHD CHAPTER 11 How Socialized Medicine Hurts Canadians and Leaves Them Worse Off Financially ...........................153 PETER ST. ONGE, PHD CHAPTER 12 Lessons from the Canadian Health Care System ................... 167 BACCHUS BARUA and STEVEN GLOBERMAN, PHD CHAPTER 13 What Bernie Sanders Isn’t Telling You About Canadian Health Care ......................................185 PETER ST. ONGE, PHD CHAPTER 14 Why “Medicare for All” Isn’t the Right Prescription for a Pandemic ....................................................189 ROBERT E. MOFFIT, PHD SECTION 5: Are You Better Off Financially Under Government-Controlled Health Care? Introduction .......................................................195 CHAPTER 15 In Charts, How Medicare for All Would Make Most Families Poorer .............................................. 197 MARIE FISHPAW and JAMIE BRYAN HALL CHAPTER 16 How “Medicare for All” Harms Working Americans ................205 EDMUND F. HAISLMAIER and JAMIE BRYAN HALL SECTION 6: Government-Controlled Health Care and the Impact on the Medical Profession Introduction .......................................................219 CHAPTER 17 Hello, “Medicare for All.” Goodbye, Doctor–Patient Relationship. ......................................221 ROBERT E. MOFFIT, PHD CHAPTER 18 “Medicare for All” Will Further Lower Physician Morale.............225 KEVIN PHAM, MD CHAPTER 19 U.S. Must Avoid a Single-Payer Health Care System That Stresses Doctors to the Breaking Point .......................229 KEVIN PHAM, MD, and ROBERT E. MOFFIT, PHD CHAPTER 20 How “Medicare for All” Bills Would Worsen the Doctor Shortage ..............................................233 ROBERT E. MOFFIT, PHD CHAPTER 21 Medicare Is No Model of Administrative Simplicity or Efficiency ... 237 ROBERT E. MOFFIT, PHD CHAPTER 22 How “Medicare for All” Could Block Medical Progress ............. 241 KEVIN PHAM, MD CHAPTER 23 What the Left Gets Wrong About Health Spending and Outcomes ....................................................245 ROBERT E. MOFFIT, PHD SECTION 7: False Hope: Government-Controlled Health Care Will Not Improve Lives Introduction ....................................................... 251 CHAPTER 24 Government-Controlled Health Care Won’t Help Us Live Longer ........................................253 ROBERT E. MOFFIT, PHD CHAPTER 25 Ignore Medicare for All Advocates’ Claims on Life Expectancy in the U.S.—Here Are the Facts .................................... 257 ROBERT E. MOFFIT, PHD CHAPTER 26 Health Care: The Greatest Pro-Life Political Battle of Our Time .... 261 LOUIS BROWN CONCLUSION The Truth About Government-Controlled Health Care ........................... 267 BY ROBERT E. MOFFIT, PHD APPENDICES ......................................................................283 ADDITIONAL RESOURCES ...........................................................309 ENDNOTES ........................................................................ 311 FOREWORD From the President of The Heritage Foundation KAY C. JAMES igh-quality medical care is more than just having good insurance Hcoverage. It is also about having the right medical professional who can accurately diagnose your issue, it is about getting timely access to the medical treatment or procedure you need, and it’s about having a trusted relationship with your physician where you have confidence in the help and advice she is giving you. Unfortunately, too many politicians want to insert government even further into these very personal aspects of our health care. They might dress up more government intrusion with nice-sounding terms like “free health care,” “public option,” “Medicare for All,” or “moderate” alterna- tives. But do not be fooled. When the federal government gets more say in your health care decision-making than you do, you end up paying the price—both financially and with your health care options. Even the so-called public-option plans—where the government becomes an insurer that competes with private insurance companies—are a path to “single payer” government-controlled care. Because the gov- ernment can use its regulatory power to set its prices below those of its private-market competitors, private insurers would disappear and the government plan would become the only available coverage. This book details the truly devastating impact that single-payer pro- posals would have on Americans. As seen in so many other countries, government-run health care would mean long wait times to see doctors and for surgeries. It would also mean reduced access to advanced life-saving The Heritage Foundation | heritage.org vii technologies and pharmaceuticals. Furthermore, the leading single-payer proposals in Congress would require massive tax increases that would result in most Americans paying more for health care than they do today. That is right. Ultimately, under these “free” or “virtually free” single- payer proposals, nearly two-thirds of American households would end up paying more. Yet, few politicians who support such proposals will ever admit that. When the government controls the