Why would Medicare for All fail?
No, the concept of health insurance makes total sense since you can't predict what your health care needs will be in the future, so you insure your health in the future by enrolling in an insurance plan.
Of course, the larger the insurance pool, the lower the premiums and the higher the reimbursements...every insurance company has figured this out and the system isn't failing them, it's working exactly as planned for the insurance companies. They are making billions in profit by denying claims and rationing care.
There is no reason for M4A to deny a claim or ration care since the only reason to do either is to make a profit.
Is it stupid to insure people who don't want to move from their homes, despite repeated flooding? I don't know. That's not for me to decide and I don't really have an opinion on it. I guess...don't live near a river? But then that's government telling you where you can live, which is a big no-no, right?
My alternative, and I've suggested this before, is to do the following. And, yes, part of this is a sop to the existing system simply because you really can't just get rid of it--too many vested interests to have that happen.
1. You institute a national catastrophic health insurance plan. Everybody pays into this like with Medicare / Medicaid. The deductible is set at something like $10,000 or maybe a bit higher. What this covers are one-time events where you get wholloped with a huge medical expense. This doesn't cover routine medical care. It's for major one-time medical events like you need open heart surgery or something. Sure, you still have to meet the deductible, but that's payable for most people over a few years.
2. You make ALL medical expenses out-of-pocket 100% tax deductible. You get 100% back on that up to your yearly income.
3. You make an employer - employee fund system where the employer gives each employee a set amount of money for health care each year. This can be managed by what are now health insurance companies if the employer wants. The size of the fund can vary and a cap of say, $10,000 or something is put on how large the amount each employee can be given.
What this fund does, is pay up to 100% of any medical expense, whatever it is, the employee has. Submit the bill, get up to 100% paid from the fund. This covers routine medical care and a big chunk of the catastrophic plan deductible if you have to use that.
At the end of each year, any money left in the fund is split 50/50 between the employee and employer. It is taxable income except if either rolls it over into the next year's medical expense account. (more on the employee part in a minute) For the employer, this means over time they could see the money being put into this system by them diminish to a point where it is self-sustaining. That is the money they get at the end of each year is rolled over and over time builds to a point where it is sufficient to meet next year's costs.
For the employee, not being sick or using this account means a big bonus for being healthy at the end of the year.
4. An additional system is in place where each person in the US can open a medical expense account and put money into it. This money is pre-tax and withdrawals are 100% tax deductible for medical expenses as before. So, an employee with the above account in 3 can dump their left over money at the end of the year into a personal account if they wish. The advantage of this that over time, a person builds up a huge personal medical expense account that is portable. That is, they change jobs, they have coverage until they get a new job. They retire, they still have coverage. This works like a 401K or IRA for medical expenses and such accounts can be invested and managed just like those retirement accounts.
If you use this account to cover your routine medical expenses, that's fine too and you can pay up to 100% of your expenses out of it. If you have more than the catastrophic deductible in it, you are covered for that.
5. For those that are receiving government assistance, welfare, etc., they get such an account like in 4 opened for them for medical expenses. Money that would otherwise go to them from the government outside of their welfare benefits etc., gets deposited into that account instead going to them to spend. So, if they are marginally employed Earned Income Credit goes into their medical account. Tax return money goes into their medical account, etc. The object is to build them a fund for medical expenses over time.
This means that YOU manage YOUR medical expenses, not some insurance company or the government. Insurers help employers run their accounts if the employer wants that service. The government covers only catastrophic medical expenses using a non-profit system. That means all the vested interests in health insurance still get a cut of the action.
