Elections 2020FederalHealthcareTaxes & SpendingBeto’s “Moderate” Healthcare Proposal Would Ban Private Medicine, Experts Say

Beto O’Rourke faces criticism about his support for “Medicare for America" as he continues his bid to secure the Democratic nomination for President.
May 14, 2019
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As former Congressman Beto O’Rourke (D-TX) works to rebrand himself in his bid for the Democratic nomination for President, the El Paso native faces fresh criticism about his embrace of the “Medicare for America” healthcare plan.

In a recent Wall Street Journal piece, healthcare expert Chris Jacobs argued that “Medicare for America” would ban private medicine. Jacobs is the founder of Juniper Research Group, a former professional staffer in the U.S. House and Senate, and a frequent contributor to the Wall Street Journal’s Think Tank blog.

Previous coverage of the presidential hopeful’s healthcare proposal has been billed as “a moderate path” by CNN and something pitched as “politically palatable” by left-leaning outlets such as Vox.

Jacobs thinks otherwise. 

But first, a quick look at the actual plan.

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O’Rourke’s support for “Medicare for America” would not immediately move every American into a government-controlled, taxpayer-funded healthcare plan as Sen. Bernie Sanders’ (I-VT) “Medicare for All” proposal would. Instead, O’Rourke’s plan would maintain the existing employer-provided insurance system and workers would have the power to leave their employer-provided plan to join the new Medicare program if they so desired.

However, those without insurance coverage, enrolled in Medicaid, or enrolled in the Obamacare exchanges, would be pushed into the new “Medicare for America” coverage. And newborns would also automatically be enrolled, effectively ensuring that everyone would eventually be forced onto the federally-controlled “Medicare for America” plans.

Sanders’ “Medicare for All” proposal would move faster, effectively eliminating existing coverage for almost every American, whether they are on the individual market, have employer-provided coverage, enrolled in Medicaid, enrolled in existing Medicare plans, or use the Obamacare exchange plans.

Only those enrolled in VA plans or covered under the Indian Health Bureau would keep their coverage in Sanders’ legislation as nearly 300 million people transition to “Medicare for All” coverage with private medicine essentially extinguished. 

Jacobs said O’Rourke’s plan would also effectively end all private healthcare for many Americans.

Describing O’Rourke’s “Medicare for America,” proposal, Jacobs said, “Doctors would no longer be permitted to treat patients without the involvement of government bureaucrats. The thousands of direct primary-care physicians currently operating on a ‘cash and carry’ basis would either have to change their business model entirely and join the government program or disappear.”

If his analysis is correct, all direct primary care clinics would be forced to close, and any ventures in the future to exclude the government from the physician-patient relationship would be stifled.

On his campaign website, O’Rourke makes no mention of eliminating private insurance, but states, “We can give every American and every business the choice to enroll in Medicare without eliminating plans that many Americans like for their families because they work for their families.”

Jacobs argues to the contrary, stating that, “Under Medicare for America, taxpayers and small business owners in Texas and elsewhere would end up paying more in taxes for fewer health care choices.”

In response to Jacobs’ post in the Wall Street Journal, a campaign spokesperson with the O’Rourke campaign said, “Beto supports guaranteed, universal, high-quality health care. He believes the surest, quickest way to get there is a proposal like the Medicare for America bill, which says that everyone who does not have insurance today is enrolled in Medicare and that everyone who has insurance they cannot afford…is free to choose Medicare.”

Just yesterday, a Texas woman (Mrs. Carolyn Jones) and resident of Beaumont, Texas was removed from life-sustaining treatment at Memorial Hermann Southwest in Houston due to a state law that empowers an ethics committee of hospital administrators to end care should a doctor deem further “futile.” The imposition of a state law combined with the slow government bureaucracy of Medicaid has worked against the Jones family.

Jacobs opined that under Medicare for America, “The inability to purchase care privately could subject vulnerable populations to government rationing, whereby federal bureaucrats refuse access to treatments deemed too costly or expensive.”

Jacobs continued, “Reducing competition, and giving people fewer options, would by definition make the options that remain less responsive to patients.”

However, progressives at left-leaning think tanks like the Kaiser Family Foundation see “Medicare for America” as a desirable compromise-step toward implementing single-payer, government-controlled healthcare as proposed by Sen. Sanders.

The Kaiser Family Foundation issued a poll that showed many Americans like the idea of expanding Medicare, though their support drops when they hear private insurance would be eliminated.

“Medicare for America would address those concerns,” said Jen Tolbert, the foundation’s director of state health reform.

David Balat, director of Right on Healthcare at the conservative Texas Public Policy Foundation (TPPF), shared his disapproval for both “Medicare for America,” and the “Medicare for All” plan backed by Sen. Sanders.

Balat said, “These plans would replace the Affordable Care Act (Obamacare), and in fact, all of these [progressive] plans are an indictment on the ACA. Rather than support and augment the current system, they are choosing to go to something else. They recognize that the ACA is broken and unsustainable.”

The O’Rourke plan would be financed by repealing the Tax Cuts and Jobs Act of 2017, implementing a 5 percent income surtax on those with adjusted gross incomes of $500,000, and increasing the Medicare payroll tax on employers.

It’s unclear if the proposed tax increases in O’Rourke’s plan would actually offset the total cost were “Medicare for America” to be implemented.

Previous cost-estimates for “Medicare for All” from the Congressional Budget Office, the right-leaning Mercatus Center, and the left-leaning Urban Institute all show exorbitant taxpayer-funded price tags ranging from $32 to $35 trillion.

And some analysts consider those figures to be conservative estimates.

According to the latest polling data, former Congressman O’Rourke is polling at 3.5 percent among Democratic primary voters, ranking number seven on the list of presidential nominees.

He is currently eligible for the first democratic primary debates in Miami, FL on June 26 and 27.

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Tony Guajardo

Tony Guajardo is a reporter for The Texan. He has been involved in politics since the fall of 2012 when he served as an intern for the now-retired U.S. Congressman Charlie Gonzalez (D-San Antonio). He is a native of Fort Worth, Texas and graduated from Texas A&M University.