By Aaryana Sethi
This article was written in response to an article published in USA News.
Mr. Eichhorn and Dr. Hutchinson,
I recently read your article titled, “Why Medicare-for-all Is Not Good for America,” on USA News, and found it to be questionable in a couple respects. Thank you for sharing your opinion on the MFA Bill in that article. I am, however, urging you to read this letter and explore a different perspective in the hopes that it might enrich your own. In the following passages, I have taken your three main arguments—taxes, votes, and physician employment—and provided an alternate perspective.Let me first address your claim that taxes would increase for America’s middle class if the MFA bill were to be put in place. You say, “There are many questions about how this approach to universal care would be funded. No budget has been provided, … it would likely require raising taxes up to 70%.” However, your claim that such a budget hasn’t been provided is incorrect. Your article doesn’t specifically mention any one Medicare-For-All Bill, and since there are a multitude, I’ve chosen perhaps the most widely-cited one to address in this letter. According to that bill proposed by Senator Sanders, taxes will go up for the upper tenth of one percent of wealthy Americans—a group of people who currently control more of this nation’s wealth than the bottom 90% combined (Telford). So, not only does the bill provide insurance for the 87 million Americans who currently rate their health insurance ‘unsatisfactory’ (either because they are uninsured or underinsured by their own account), it in fact does so without increasing taxes on 99.9% of the population, let alone the middle classes (Dunham). Moreover, the 0.01% of wealthy Americans who would be taxed under this bill are also the same 0.01% that benefit most from the 1.4 trillion dollars of tax loopholes in the current system—in that way, MFA additionally assists in countering the income and tax inequality in the USA (Telford). Essentially, while the top tenth of a percent of Americans are making about $8.3 million a year, the rest of the country makes a mean of about $32,000 (Elk). However, because of the expansive tax loopholes that exist in America today, those making the $8.3 million have a much easier job of evading taxes than those making the average American salary. Actually, it’s often the case that the rich pay less tax on the dollar than the average American earner. This income inequality, in fact, has only grown since 1979, with an average increased income of 312% for households in the top 1% of the country’s earners, versus just 36% for the middle 20% of American (Amadeo). That means that those previously making the $8.3 million saw an increase of about $18 million whereas those previously earning about 30,000 saw an increase of about $11,000—0.06 times as much as the wealthy. The MFA bill, by taxing only the upper tenth of one percent of earners, helps to counter the effects of the tax loopholes mentioned above.
Your second argument about MFA being a “vote-loser” is similarly unfounded. Your unnamed (and uncited) source says, “When Americans are polled, 70% say that they approve of Medicare-for-All. However, when a follow-up question is asked, in which it is made clear that this means everybody would be required to have it, support drops to 38%.” However, according to the Kaiser Foundation, which was established over seventy years ago, and which has been tracking American public support for Medicare for All since 1998, recent years have only seen an increase in public support for the bill (Hamel et al). According to the study, this is because US health insurance firms have continued to increase their prices and make it more and more difficult for average middle-class citizens to get the coverage they require (Kaiser). This, then, means that Americans are growing more and more frustrated with their private insurance, and have therefore increased support for a version of Medicare for All.Moving to your third argument about doctors leaving the profession due to burnout—according to your article, “As many as 46% of doctors in the U.S. have suffered from burnout at some time in their careers.” This argument, while possibly valid, is entirely nonunique to the Medicare debate. The presence or absence of Medicare has no bearing whatsoever on whether or not doctors feel the burdens you mention in regards to the Dr. Drummond study. Moreover, the study you speak of itself provides no correlation between burnout/physician numbers and the potential for universal healthcare. In fact, it’s taken from a magazine called, Family Practice Management Journal, which reports not on the current employment rates of physicians in the USA, nor on how such rates might connect to Medicare for All, but instead on how to run a successful family practice. This means that not only does the study not prove any part of your argument, its source is also not credible for providing such a correlation (between employment and MFA) if one even existed in the first place. In truth, physician burnout would be countered by the implementation of Medicare for All (PNHP). According to a study by PNHP.org, one of the major contributing reasons for physician burnout is depersonalization—or the idea that under the current system, patients are always switching doctors (PNHP). However, under Medicare for All, that problem would be solved, and one of the major risk factors for physician burnout eradicated. In this way, MFA would actually only help to prevent the harms mentioned under the Dr. Drummond study.
After reading the arguments that I’ve laid out above, I hope that you will attempt to see why your article may not be entirely informed, or at least, that this analysis may have provided new insight for you.