Democrats have a unique problem on their hands with Medicare for All.  It’s not just taxes and economic reality — it comes down to property.

How are the Democrats going to treat the private property of patients and physicians?  

Democrats want to create one fair system of health care for all Americans. Others have debated the merits of forcibly removing private insurance policies from 180 million Americans. More interestingly, what about physicians? Do physicians have a right to exercise their private property in this expedition or are they to become agents of the state forced to participate in the new health care plan in the name of equity?

The Pitfalls of Existing Government-Run Health Care

Government control of the payment of physicians through Medicare and Medicaid places a tremendous administrative burden on physicians and tends to drive reimbursement downward. As such, certain physicians refuse to accept Medicare or, more commonly, Medicaid insurance plans.

It doesn’t take too much logic to realize that physicians do not want to be paid less for the same amount of work.

Is the government going to have to force them to participate?

Medicare, the government’s insurance plan mostly for the elderly, reimburses generally about 20 percent less than private insurance for the same procedure. Medicaid, the government’s insurance plan for those with limited income and resources, reimburses about 70 percent of what Medicare does.

It doesn’t take too much logic to realize that physicians do not want to be paid less for the same amount of work. And it’s generally top doctors or private institutions that are able to be more selective about who they see or how they charge patients.    

Most physicians do take Medicare, but in 2017, New York City physicians had only a 76 percent acceptance rate for Medicare patients. A 2016 survey found that 35 percent of Texas Medical Association members said they would not take on new Medicare patients. One-third of doctors simply do not see Medicaid patients.

If the government does not force physicians to participate in the new massive government insurance scheme, this will certainly create an inequity of access that will be unsettling to the new socialist order. 

A Dangerous Trend

Bernie Sanders bluntly calls for the complete elimination of private insurance. Kamala Harris embarrassed herself nationally at a CNN Townhall when she essentially called for that same elimination only to backtrack the next day.  Elizabeth Warren played high school student council-level politics when she avoided the question on Bloomberg Television. These are not Alexandria Ocasio-Cortez whoops moments, this is becoming a true policy platform. 

At some point, the national government will have to force individual physicians, real people, to participate in something against their will.Economics aside, the Left wants to promise what it can only deliver only with force: complete equity.  It sounds joyfully reminiscent of the blunder, “If you like your health care plan, you can keep it.” Part of that statement also mentioned that “if you like your doctor…you can keep your doctor.” At some point, the national government will have to force individual physicians, real people, to participate in something against their free will.

It begs the question, what else could a government of that power force physicians to do against their will? I certainly don’t want to find out.

There are some realistic considerations to this. Physicians often times learn and benefit from government-funded academic research institutions. Physicians also take the Hippocratic Oath to serve patients. There is absolutely a societal aspect to care, but a single government entity is not the only way to help people. 

Like in all socialist agendas, government bureaucrats will always have more than enough; they will always be in the upper tier. They will not be equal.

An actual debate is merited for a two-tier system rooted not in the make-believe world of equity but in the intellectually relevant conversation of Sufficientariansim. How do we give people enough? It’s worth mentioning and never forgetting, like in all socialist agendas, that government bureaucrats, like all the major Democratic presidential candidates, will always have more than enough; they will always be in the upper tier. They will not be equal.

Ted Kennedy, champion of universal healthcare, famously said: “Every American should be able to get the same treatment that US senators are entitled to.” That sounds wonderful, and I’m sure he meant it. However, in reality, Ted Kennedy exercised his private property rights (net worth between $45 million and $150 million) to bypass several local and regional healthcare centers to have brain tumor surgery at Duke University with a world-renowned specialist. Surely, I would imagine, our current Democratic presidential hopefuls believe equity would prohibit such a grand gesture.

This article was originally published on FEE.org