PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

At first blush the phrase sounds great. Medicare for All. Who wouldn’t want more health care coverage?

But, upon reflection, the phrase is just that – a phrase without much detail about what it really means.

To many Democrats using the phrase, it means a fully government-run health care system that, among other things, would do away with private health insurance. Senator Kamala Harris, as she announced her campaign for president in 2020, relied heavily on Medicare for All because, like most on the left, she apparently believes the phrase will appeal to voters.

Disregard the price tag. In fact, don’t even mention the word price.

Several letters to the editor in the Wall Street Journal appear to understand that much more needs to be known before confirming support or opposition to Medicare for All. They were writing in response to piece the other day by Karl Rove that questioned the underpinnings of the new, proposed government program.

Here is a collection of points from the letters to the editor that appeared under the following headline and tag-line – and note that the letters are not just from opponents; they are from real citizens who want more information:

Let’s Think Through ‘Medicare for All’ First

It would be grossly unfair to the tens of millions of employees who have supported Medicare over decades to suddenly give it to those who have not paid anything into it.

Letter #1: Karl Rove (in the op-ed that ran in the Wall Street Journal January 31) doesn’t note that a very high percentage of those now receiving Medicare have paid for it up to 53 years through their FICA payroll deductions The payroll deduction is now a combined 2.9 per cent for employees and employers with an additional 0.9 per cent (for employees only) on wages above $200,000. Retirees continue to pay for it through a deduction from their Social Security benefits. It would be grossly unfair to the tens of millions of employees and tens of thousands of employers who have supported Medicare over decades to suddenly give it to those who have not paid anything into it.

Voters would be irate as well as terrified of the new sky-high taxes to cover the cost.

Charles Larson, Naples, Florida

Letter #2: Would you be in favor of a “Medicare for all” plan if it increased your taxes by 5 per cent? What if it also increased your wages by 15 per cent because your employer would no longer need to pay for your health insurance?

Pollsters can obtain any result they want by manipulating the survey questions. The fact is no one can accurately analyze the costs and benefits of a Medicare-For-All plan because the details of such a plan haven’t been worked out.

Would it, for example, replace Tricare, the current government health plan for military members and their families?

How would Veterans Affairs services fit in?

Would such a plan result in the extinction of private insurance companies or would they be allowed to participate, as they do now, by offering Medicare Advantage plans and managed-care Medicaid plans?

The proposal must first be described in detail so that its elements can be included in the analysis.

Robert Sommers, Ph.D., Jacksonville, Florida

Letter #3: Medicare is an 80/20 system, with the patient responsible for 20 per cent of the costs, which could be thousands of dollars for major surgery. Further, Medicare pays 80 per cent of what it considers reasonable and appropriate fees for medical services.

If the approved Medicare rate is less than what the provider charges, providers can refuse Medicare patients.

Medicare pays the doctor’s charge for your physical exams, but not the hundreds of dollars for diagnostic tests that determine if you have diabetes or high cholesterol. To protect yourself from some of those uncovered costs, you can buy a Medicare supplement insurance plan for hundreds of dollars a month, assuming such plans are still permitted under the Democrats’ proposals. Highlighting the individual costs of government-rationed health care, which it will be, will give voters a more realistic sense of the personal costs of these proposals before they vote.

Peter Coffey, Madison, Connecticut

Letter #4: Rove doesn’t explain why a single-payer equivalent of Medicare For All in Canada, Britain and other countries is affordable. He concludes by suggesting the 2020 election is a choice between “democratic socialism and free enterprise.” Democratic socialism exists happily side by side with free enterprise in countries such as Denmark. The two aren’t mutually exclusive.

Carl Eriksen, Indio, California

Letter #5: Rove claims that 10 years of Medicare for all could cost $32 trillion but neglects to mention current health-care outlays are $3.5 trillion annually now. In 2017, only 56 per cent of Americans had employer-provided health insurance—$19,600 is the national average for family plans and $6,800 for individuals.

Want to pay $20,000 a year with a $7,500 deductible for a family plan on a $65,000 salary or do you want an all-in plan where the costs are actually shared by all Americans? Give me the latter.

Richard Mertens, West Lafayette, Indiana

What these letters illustrate is that not much is really known about the catch-phrase, Medicare for All.

How would the new government program work? Could private insurance exist in any form? How much would the new program cost?

And, to borrow a phrase from former president Barack Obama as he advocated for his, “Affordable Health Care Act,” could you keep your doctor if you wanted to do so?

Who knows the answers to any of these questions? Before moving ahead on such a big-government programs, we ought to have the best possible answers. Then, with the answers, let the chips fall where they may, though I would hope that reasonable officials would work together to get the answers and make the final decisions on bases other than the sound of catch-phrases and perceptions from pollsters.