Universal Coverage: Check Your Freedom at the Door

Today, the Cato Institute releases a study by attorney Kent Masterson Brown titled, “The Freedom to Spend Your Own Money on Medical Care: A Common Casualty of Universal Coverage.”  Brown addresses a dark side of universal coverage that proponents tend to de-emphasize:

Most people would agree that a patient should always be able to spend his own money on the health care services he desires. Yet that freedom is often threatened or denied when government tries to provide universal health insurance coverage, as in the U.S. Medicare program, which provides health insurance to seniors and people with disabilities. Over the past 20 years, the Medicare bureaucracy—and to a lesser extent Congress itself—has limited the freedom of Medicare beneficiaries to purchase medical services with their own money. Those limitations violate beneficiaries’ right to privacy, undermine a tool that could reduce the burden Medicare imposes on taxpayers, and may deny care to Medicare beneficiaries outright, or deny them access to the highest quality care available.

Brown was the lead attorney in Stewart et al. v. Sullivan (1992) and United Seniors Association et al. v. Shalala (1999), two cases challenging Medicare’s efforts to eliminate beneficiaries’ freedom to spend their own money as they wish.

Note that New York Times columnist Paul Krugman, presidential candidate Dennis Kucinich, and others want “Medicare for All,” while Hillary Clinton wants to open Medicare or a similar program to all Americans.

This debate is going to be fun.