As the Democrat presidential contenders vie for top billing in the primary season, health care, especially Medicare for All, is a top issue.

Kaiser Health News reports that every analyst interviewed for its story on the health-care debate shared concerns regarding a Medicare for All system.

• How would people respond to losing the option of private insurance — a likely consequence of Bernie Sanders’ proposal
• What level of tax hikes would be necessary to finance such a system, particularly if it covers a big-ticket item such as long-term care?
• What would be the financial impact for hospitals, often large employers in a community, or for the private insurance industry jobs that would likely disappear?
• How would it affect union members, for example, who have given up higher wages in exchange for better employer-sponsored health insurance?

In a speech to Congress in September 2009, President Obama started the push that culminated in the enactment of Obamacare in early 2010. In his September 2009 address, Obama described the basic features of the plan that ultimately got enacted:

The plan I’m announcing tonight . . . will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. . . . Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. . . . Now, if you’re one of the tens of millions of Americans who don’t currently have health insurance, the second part of this plan will finally offer you quality, affordable choices.

Francis Menton, in the Manhattan Contrarian, points to his favorite line from Obama’s speech that night.

I am not the first President to take up this cause [of universal health care], but I am determined to be the last.

Since each of the 20-something Democrat candidates seems to have forgotten that line, Mr. Menton thought a little report card on Obamacare would be useful:

• Approximately 17 million new enrolled Medicaid beneficiaries are in the “expansion group” defined by Obamacare, according to the Kaiser Family Foundation.
• The number of people covered by policies purchased on Obamacare exchanges for 2018 was 8.8 million.
• Cost? Bloomberg in May 2018 estimated annual Obamacare spending for individual and insurance company subsidies at $55 billion per year. Add to that the portion of Medicaid spending that results from the Obamacare expansion. Since the 17 million new enrollees are approximately 23% of Medicaid beneficiaries, therefore about 23% of Medicaid spending ($68 billion) is attributable to Obamacare. The total of these two numbers is $123 billion per year.
• According to Census data, by 2017, some 28.5 million people, or 8.8% of the population, continued to not have “health insurance.”
• The average price of a policy on the HealthCare.gov exchanges more than doubled from when the exchanges opened in 2013 through the 2018 open enrollment period.
• Life expectancy in the U.S. began a decline in 2014, which continued through 2017 (latest data). It’s only 0.3 years total (from 78.9 to 78.6), but still rather shocking given all the additional government spending on “healthcare.”

“In short, Obamacare didn’t come anywhere close to accomplishing its goals,” Francis Menton writes.

Obamacare Has Been a Disaster

Indeed, if you think (as I do) that the most important metrics are health outcomes (best proxy being life expectancy) and cost, then Obamacare has been a disaster.

You spent a lot more money on your health and you died younger. How is it possible to spin that as something even remotely positive?

Whatever program comes next, be it “Medicare for All” or some cut-rate facsimile, is sure to be another 1000+ page behemoth, again full of infinite complexity touted as being the final solution to the problem of “universal access” to healthcare. How long — and how many trillions of dollars — before it fails and we’re on to the next one that will really, really work this time?

Read more here.