Medicare for all – or more accurately a nation-wide system of some kind to provide coverage to one extent or another to every American – carries with it many possible issues and consequences, especially if the goal is to lower costs.
Here is a big one.
The American healthcare system has unique financial hydraulics, a sophisticated and opaque “Game” that depends on self-insured employers to make and keep providers whole for the perceived “underfunding” by public payers like Medicaid and Medicare. Both doctors and hospitals are completely dependent on the financial margin derived from commercial insurance. RAND studies show that on average, private purchasers are paying approximately two and a half times more than Medicare rates for hospital care (even more relative to Medicare for hospital outpatient services).