A recent study by three high-lev­el econ­o­mists shows some of the flaws in the cur­rent Medicare sys­tem, which means plac­ing a large bet on Medicare for All may be prob­lem­at­ic.  Main points:

  1. Medicare pro­vides more gen­er­ous access to providers and new treat­ments than pub­lic pro­grams in oth­er devel­oped countries.
  2. Three major shifts make a uni­form design less effi­cient today than when Medicare began in 1965: ris­ing income inequal­i­ty, a dra­mat­ic expan­sion of expen­sive med­ical tech­nol­o­gy and the mount­ing eco­nom­ic costs of the plan with tax financ­ing of the system.
  3. The rec­om­men­da­tion is not just a blan­ket “Medicare for Every­one,” but a base sys­tem that every­one can use (less gen­er­ous than cur­rent Medicare) with the option of “top­ping up” for a pri­vate insur­ance plan as a sup­ple­ment, with indi­vid­u­als choos­ing their own coverage.