Senators propose Medicare for All – But is it for you?

Congressional member discusses a bill

Senators propose Medicare for All – But is it for you?

By Grant Dattilo

On April 15, United States Senator Jeff Merkley, D-Oregon, with 12 Democrat co-authors, introduced the Choose Medicare Act.  Sen. Merkley said this act is about “…legislation that would give every individual who is not already eligible for Medicaid or Medicare the opportunity to enroll in Medicare as an individual and give every employer the ability to purchase Medicare for their employees.”[1]

Merkley’s bill creates Medicare Part E, a new federal health plan. It would compete with private, commercial health insurance for individuals and offer employer group insurance.

The fact that Merkley introduced this Medicare choice bill is no surprise. There are several other versions offered in this Congress and in several states, and have been for many years. Each of these bills take an incremental step toward eventually mandating a federal government-run health care system. Whether that is good may depend on a person’s point of view, or politics.

Employers consultants like us, of course, are naturally suspicious of turning health care over to the federal government. It’s hard for us to believe, especially during these difficult times, that Americans want to trust Washington, D.C. with the tough job of administering health care for 330 million individuals.

Yet, with insurance premiums for employer-provided family health insurance averaging $21,342 in 2020,[2] an increasing number of individuals are demanding change. Somehow, sometime, someone must reduce the cost of health insurance.

But hold on. It’s not just employer consultants and conservative politicians expressing caution. The Congressional Budget Office issued a report – A public Option for Health Insurance in the Nongroup Marketplaces: Key Design Considerations and Implications – within days of Sen. Merkley’s announcement. The CBO examines all the “what if” scenarios that could develop under such a plan, which it labels a “Public Option.”

CBO explains that key to the eventual premium cost of the Merkley health plan is how much it will pay providers. If the plan reimburses providers at the Medicare rate, premiums could drop in half. While that sounds good, it also means that providers are likely to quit offering services to anyone who has the Medicare E plans, since at best, the provider will only breakeven on the reimbursements they receive.

To an individual trying to keep his or her premiums as low as possible, the idea of paying half of today’s premiums would be attractive. This would especially appeal to healthier people who seldom see a physician. The rub comes at least two ways:

First, as fewer providers will accept Medicare E patients, patient access would be dramatically reduced. Individuals will be unable to get the medical care they want when they want it.

Secondly, private insurance companies, which will be unable to compete with the low premiums of government plans, will exit the business.

The CBO evaluates several other factors that should cause concern – we will review more of them over time.

Yet, we have to find a way to reduce the price of health care.

At DCI, we prefer creating in a consumer-friendly medical care marketplace. This requires a simplified form of medical care price transparency and an easy way for patients to rate their providers. We learned a great deal from The Manual, Health Care 2020: Connecting the Dots,[3] and it is why we promote a private market reform of the medical care system.

As a medical care consumer, you will have to decide over the next several months and years whether you’re ready to trust the federal government with your health care. Or, whether you prefer buying medical care in a more transparent, consumer-friendly private marketplace. Your health and life – and pocketbook – depend on the choice you make.

Our concern at DCI is for your physical, mental and financial health. It is why we support private marketplace solutions to the high cost of health care and insurance.

[1] Merkley, J.  (2021) Merkley, Colleagues Introduce Legislation to Let Every American Choose Medicare. Government. Jeff Merkley. United States Senate, Washington, D.C., accessed April 20, 2021.


[3] Dattilo, G.; Racer, D. (2020) The Manual – Health Care 2020: Connecting the Dots. Alethos Press, St. Paul, MN.

Grant Dattilo