Medicare for All (Or At Least More): Will It Mean Political Campaigns Based on More Knee Replacements?

Democratic Representative John Conyers, Jr., from Michigan has introduced a bill that would allow anybody, of any age, to buy into Medicare.  The theory is “everyone loves Medicare,” so why not let people buy into it if they want to.  Last year Hillary Clinton proposed letting people over 55 buy into Medicare.

Megan McArdle explained the problems with this idea.  Among others, there was this:

“If we followed Clinton’s plan, and lowered the Medicare eligibility age, one effect would be to take some pressure off Obamacare’s exchanges, by moving the sicker and older patients out of the pool.  But that cost has to go somewhere, and where it’s likely to end up is in hospitals, as their patient load shifts dramatically toward lower-reimbursed Medicare patients.

… I doubt that hospitals could simply turn around and jack up rates to private payers.  On the other hand, I do kind of wonder what the hospitals would do to cover the now gaping holes in their budgets.  Hospital profit margins are in the low-to-mid single-digits. which is probably not enough to absorb a large loss. …

[T]hey also might refuse to handle so many Medicare patients (a phenomenon you see among doctors, though doctor opt-out is nowhere near as bad as it is with Medicaid, which basically tries to pay doctors in cigar bands).  Of course, you can’t turn away someone who’s having a heart attack.  But you could, say, decide that you’re only doing so many Medicare-funded knee replacements a year.  That would fix the budget problem.  But all those folks with bad knees are apt to get pretty cranky while waiting for a hospital bed.”

I find her suggestion in the last paragraph, “you could … decide that you’re only doing so many Medicare-funded knee replacements a year”, especially interesting because it is what happens in other countries.

In New Zealand, parties actually run for office on the basis of how many more knee operations or cataract surgeries they will fund.  In 2005, when then-Prime Minister Helen Clark was seeking re-election (which she won), her Labour Party promised 7500 extra cataract surgeries¹ and 10,000 more joint operations – and made this promise one of its seven major campaign pledges.  Labour tried again in 2008 (this time they lost), promising to spend an extra NZ$160 million (over four years) for “elective surgeries.”²

If Representative Grayson and former Secretary of State Clinton have their way, is this our future, too?  Will promises more knee operations or cataract surgeries be another way for politicians to try to buy our votes?
------------
¹ It was not clear whether this was 7500 patients or 7500 eyes.  Sometimes a patient needs both eyes done, so if this was 7500 eyes, it would have been fewer than 7500 patients.
² Audrey Young, “Leaders dangle carrots for the grey voters,” The New Zealand Herald, August 17, 2005 (printout from website); Martin Johnston, “Labour’s $160m injection for health,” The New Zealand Herald, May 19, 2008 (printout from website).