Medicare For All? Hang Onto Your Wallets.

By James C. Sherlock

Information useful for keeping up with the state of medical care is published daily by Beckers. It often provides real-life stories that cause readers to ponder healthcare policy.

An article arrived this morning that tells the story of Robbinsdale Hospital in Robbinsdale Minnesota, a suburb of Minneapolis.

Minnesota is governed by Tim Walz, the freshly-minted Democratic vice presidential candidate. The governor is busy, so the story will be told here.

Sen. Bernie Sanders reintroduced the Medicare for All Act in May 2023. Sen. Kamala Harris co-sponsored the 2017 version of the legislation. This story will not prove encouraging to fans of that approach.

Nationally, private health insurance covers twice as many people as public insurance. But inpatient care, driven by older patients, is paid disproportionately by government programs: 96% of hospitals in 2022 had 50% of their inpatient days paid by Medicare and Medicaid, and more than 82% had 67% Medicare and Medicaid inpatient days.

Minnesota is already number two in the country for Medicaid spending behind only Massachusetts. Minnesota Medicaid still manages to underfund the program. Root cause: it covers far too large a slice of the population.

Sixty seven percent of hospitals and health systems in Minnesota lost money in the first half of 2023. Robbinsdale Hospital predicts it will lose $124 million this year. As the article tells it:

“losses (are) related to government programs in 2024 due to a financial crisis brought on by the payer mix in its service area… 74% of patients are covered by Medicaid and Medicare programs, meaning that for 74% of patients seen, the hospital is reimbursed only around 70 cents to the dollar for patient care costs.

Medicare and Medicaid began in 1965. There were 7,156 hospitals in the United States in 1975. There are 6,120 today. There may be something to that government payments thing.

Minnesota neighborliness. Governor Walz has said that one person’s socialism is another’s neighborliness.

Minnesota Democrats control the offices of governor, secretary of state, attorney general, and both chambers of the state legislature. They make hospitals take Medicaid patients and then pay them far less than it costs to treat those patients.

That is apparently considered neighborly.

Hospitals like Robbinsdale are begging the legislature to increase Medicaid payments. Minnesota requires a balanced budget. It will have to move money from somewhere else, raise taxes or stand by while hospitals shut down.

Or they could tighten eligibility. Those kicked off because they make too much money could buy their own insurance or get it through work like most Americans. But that will never happen in Minnesota.

Of the Robbinsdale population of 14,646, 17.7% are of Medicare age. That is 7% higher than the national average. Nothing else in the census bureau profile of Robbinsdale jumps out as unusual. No information is available as to what percentage of patients come from outside of the town.

Most people reading the profile data on income and jobs will find it hard to understand why so many Robbinsdale Hospital patients are qualified for Medicaid.

But most are unlikely to be as neighborly as Minnesota Democrats.

A neighborly national forecast based on past performance. Democrats, led by newly-elected President Harris, will want the federal government to provide medical insurance for everyone, including illegals. Sen. Sanders and Ms. Harris offer no discussion yet of the cost of reimbursing the shareholders of the insurance companies destroyed in the process.

Here is how, based on previous experiences, it may go:

Sen. Schumer will suspend the filibuster to pass that dream into law. Medicare’s predicted insolvency date, currently 2036, will jump to the day after Medicare for All legislation is passed. So trillions will be borrowed to pay for it.

The new program by design will kick out the private insurance leg of the stool that keeps most hospitals afloat.

That legislation will prove neighborly only if your neighbor doesn’t need a hospital or if your 401k doesn’t own shares in United Health.

Democrats will wait a year or so, suddenly discover the actual costs of the program and declare greedy hospitals and doctors to be the “root causes”.

President Harris will declare a state of emergency and try to seize hospitals by executive order.

She will be turned back by the Supreme Court.

Senator Schumer will again suspend the filibuster to pass a law to buy 5,000 hospitals by eminent domain.

The bill will lower the salaries of every medical professional with hospital privileges, but not the cost of medical school. Medical school loans will be increased and forgiven in the same legislation.

More trillions will be borrowed as an “investment in America’s future”.

Problem solved.

What could go wrong?