COVID-19 and Medicare for All

Dear Editor:

Question: Would a Medicare for All (MFA) system have helped Americans deal with COVID-19?

• The MFA agency would have been housed, along with the CDC, FDA and NIH, in the Department of Health and Human Services (DHHS). Supporting the health care of all Americans, this augmented department would have emphasized national health preparedness: maintenance of the Strategic National Stockpile, readiness for testing, supply chain security, production capacity, etc.

• Once the pandemic threatened, DHHS’s infrastructure and comprehensive database would have been ready to facilitate testing, contact-tracing, manpower and facility needs identification, directives dissemination, clinical trials organization, and procurement through established price-negotiation platforms. It could have quickly packaged the country’s medical, as distinct from economic, needs for fast-track congressional consideration.

• Providers’ cash flow could have been maintained as in Medicare’s Accelerated and Advance Payment Program.

• Suddenly uninsured workers would have been spared cruel choices: pricy COBRA, a chance on Medicaid or marketplace eligibility with possible loss of regular provider, “going bare.” With MFA: seamless coverage.

• Out of fear of unpredictable bills, many of the 87 million underinsured adults have no doubt avoided seeking medical advice about symptoms and kept engaging with the public. In MFA, with its minimal point-of-service costs, this infection risk would have been reduced.

• Predicted 2021 premium increases of up to 40 percent to pay for COVID-19 expenses could cause employers to stop offering coverage and marketplace enrollees to drop theirs. In an MFA system, equitable taxes would simply be adjusted over time.

I take that as a yes.

Daniel Bryant, MD

Cape Elizabeth