Wrong For Iowa And America

Medicare for All is a catchy title promising a utopian system of free health care with easy access to any hospital or physician. Despite its appeal, support plummets when people learn about the inevitable rationing, waiting lists, soaring taxes, and loss of current health coverage.

A proposal being debated in Iowa’s U.S. Senate race would put all Americans on a government program that would be a twin of Medicare for All, via TRICARE. That’s the Department of Defense’s health care program serving 9.6 million active duty and retired service members, family members and survivors. TRICARE uses a worldwide system of government-owned and -operated military hospitals and clinics, augmented by civilian providers and facilities.

The Congressional Budget Office analyzed the impact of a nationwide program in which all medical providers would be paid Medicare payment rates, which are similar in many areas to TRICARE rates. CBO says that “Setting payment rates equal to Medicare rates under a single-payer system would reduce the average payment rates most providers receive—often substantially.”

This “could lead to a shortage of providers, longer wait times, and changes in the quality of care, especially if patient demand increased substantially,” the CBO reported.

Physicians and hospitals participating in TRICARE want to take care of our nation’s heroes. They can accept TRICARE’s lower payment rates because their practices also receive payments from private payers that fill the gap and keep their practices afloat.

Without this mix of payments, many practices and facilities would fail, especially in rural areas.

We know where government-run health care plans end up: The government tries to save money, it continues to ratchet down payments to providers, and ultimately care is rationed and waiting lines ensue. The most vulnerable patients would be the most severely impacted as they try to navigate a complex, bureaucratic system to get the care they need.

In fact, some military families already can face significant wait times under TRICARE. A 2018 survey conducted by the Military Officers Association of America (MOAA) found that 28% of military families reported being “very satisfied” with TRICARE, but 22% were either very or mostly “dissatisfied.” More recently, MOAA reported that TRICARE beneficiaries “continue to voice dissatisfaction with the cost of their care, and many are experiencing access to health care issues more frequently as more military treatment facilities are reducing services.”

Health care is simply too personal and complex for one big government-run program. Families should be in charge of their own decisions with more choices of plans and providers competing to offer the best value for the best price to consumers who are empowered to make her own choices.

Any reform plan must support the most vulnerable and others who need assistance in affording health insurance. And we need rules to make sure consumers are protected—such as guaranteeing that their policies can be renewed and affordable, especially when a patient has a pre-existing condition. We have offered a plan to do that.

Instead, TRICARE for All would mean a government takeover of health care the United States. Medicare and Medicaid would end. In Iowa, for example, more than 1.8 million people would lose their private health plans, and everyone would be forced onto this massive new government program. Many private health insurance companies would close and their nearly 140,000 employees would have to find other ways to support themselves and their families.

The goal is to give everyone the same or better coverage as TRICARE with a choice of the plans and health care arrangements that suit them best—with extra help for the most vulnerable. TRICARE for All is not the solution.