A recent conversation with my aunt brought to light a possible flaw with some of the Democratic candidates’ “Medicare for All” pitch. Medicare is beloved, true, and folks look forward to reaching eligibility age for it, also true. They can get excellent care from American physicians at a low cost thanks to workers’ Medicare taxes. Wouldn’t it be wonderful if we could all just be on that plan right now? Yes, yes it would. However, how good would it be if you had universal coverage but no providers?
Let me explain my concern. Medical school sucks; my brother-in-law is a surgeon down in the Carolinas, and I watched the exhausting rigors that he endured in medical school, residency and even now as a practicing surgeon. It was eight years or so of exhaustion, struggle and worry. To top that off, he has hundreds of thousands of dollars of medical school debt, now. Why would anyone suffer through all of that, you ask? In many cases, it may come down to one major factor: money.
Currently, American doctors can earn a very good living (or more), which goes a long way toward making up for the misery of med school and can pay off the mountains of debt. Now, imagine those earnings all go away and, with it, the incentive to pursue a career in the field. Many Sanders or Warren supporters right now will quip that their preferred candidate will erase my brother-in-law’s debt, so all should be good, right?
For him, maybe, but what about future doctors who are still in primary school? Again, supporters will retort that their candidate will make college free to all. That may happen, yes, but they aren’t proposing to make all colleges free. Many of our excellent medical schools are private, so they won’t be included in the ranks of the free path.
I fully agree that we need health coverage for absolutely everyone as a basic human right. I do think, though, that flipping the switch to Medicare for all is not as well thought-out as the candidates make it sound. We need doctors to make Medicare for all desirable, potential medical students need a reason to dive into the deep end of med school, and state medical schools probably won’t solve the issues.
Heck, if you make education free for all to any state school, you also take away the schools’ monetary incentives to exist. This is a rabbit hole, to be sure. I have yet to hear Bernie or Elizabeth explain their plan for how to solve this riddle. Maybe, just maybe, they could start looking at complete loan forgiveness for all public-oriented service-type careers, such as doctors, social workers, teachers, etc.
Just a thought.
Matt Williams
New Haven