A popular new theme in American politics is the promise of “Medicare for All”, commonly designated as M4A. Exactly what this means precisely is still TBD as various proposals vie for the role of prototype. Placed in context, however, it’s hard to take these proposals seriously because M4A would build on a badly cracked foundation. Policymakers should fix the foundation first, before pondering additional risky reforms.
If the title is to be believed, the most bare-bones version of an M4A proposal would effectively allow every citizen to sign up for current Medicare, the financially creaky national health insurance program for America’s seniors. Some M4A proposals would instead devise a new national health insurance program, in effect a new Medicare, and force everyone including Medicare beneficiaries to join the new system.
Since M4A builds on Medicare, presumably Medicare today is in fine shape, right? No. As the Medicare Trustees’ recently released annual report reminds us, Medicare is already in deep trouble.