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November 21st, 2020 
Awake Goy 
We have been repeatedly told over at least four decades that the free market will fix our system’s problems of access, costs, and quality of health care. That claim has been proven false by long experience. For-profit corporate stakeholders, often investor-owned, have demonstrated their commitment to profits over the public interest. The enormous medical-industrial complex that has evolved is a powerful barrier to reform, but the common good can be achieved if positive forces for change coalesce in this nodal crisis time requiring fundamental reform.
These claims by critics and opponents of Medicare for All can be readily refuted by evidence:
We can’t afford Medicare for All; it will bankrupt us.
We can’t afford the system we have. The private health insurance industry has been bailed out by subsidies from the federal government for many years, currently at $685 billion a year, projected by the Congressional Budget Office to double in another ten years. An excellent study by the Political Economy Research Institute at the University of Massachusetts Amherst projects that Medicare for All will save the U. S. $5.1 trillion over a decade through savings from replacing our for-profit market-based multi-payer financing system. Middle class Americans will see savings of up to 14 percent, while 95 percent of Americans will pay less than they do now for health care and insurance.
Medicare for All will be too disruptive.
This scare tactic by opponents ignores how disruptive private health insurance is now, with loss of insurance with job change or loss, narrowing networks, and insurers leaving unprofitable markets. The transition to traditional Medicare in the mid-1960s was seamless, even before computers.
NHI will be a government takeover.
Quite the contrary. Under NHI, physicians and other health care professionals will be enabled to stay in private practice, with simplified billing and less paper work. Private hospitals and other facilities will be stabilized during and beyond the pandemic with stable, year-to-year operating budgets.
NHI will bring rationing.
This claim totally ignores the rationing by ability to pay that plagues millions of Americans who can’t afford care when needed, delaying or forgoing care altogether with worse outcomes later on. NHI will remedy this problem.
Patients will lose choice.
This is absurd, since they will gain choice of physicians, other health professionals, hospital and other facilities, which they value much more than choice of insurer.
Physicians won’t like it.
A majority of physicians already support Medicare for All, beleaguered as they are with changing policies of health insurers, pre-authorizations, restricted networks, changing drug formularies, and other requirements related to reimbursement. Because of these administrative problems, which take so much time from patient care, a growing number of physicians are burning out and retiring early.
While we can expect powerful opposition to Medicare for All from corporate stakeholders in the medical-industrial complex, the status quo and the ‘old normal’ are no longer tenable. With the ongoing impacts of the triple crises, 2021 is a unique political moment when health care reform can be enacted. The stakes couldn’t be higher for Americans, the economy, and recovery beyond the pandemic. Do we have the political will to move to a ‘new normal’ with Medicare for All?
John Geyman, M.D. is professor emeritus of Family Medicine at the University of Washington School of Medicine in Seattle, where he served as Chairman of the Department of Family Medicine from 1976 to 1990. His most recent publications are Struggling and Dying under TrumpCare: How We Can Fix this Fiasco (2019) and a pamphlet, Common Sense: The Case For and Against Medicare for All, Leading Issue in the 2020 Elections (2019).
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