The Fatal Structure in ‘Medicare for All’ No One Mentions
In September, The Los Angeles Times announced “Medicare for All is Back on the Front Burner and A Dem Majority Can Get It Passed”.
NPR headlined “‘Medicare for All’ message attracts midterm voters buckling under medical bills”.
The Hill trumpets “Medicare for All support soars to 66 percent in 6 years”.
What is M4A?
Medicare for All is the biggest restructuring of American medicine since the Affordable Care Act. M4A, also known as single payer, is a form of universal healthcare that concentrates control in a single federal agency.
There are several versions but here are the features in most plans and the one popularized by Sen. Bernie Sanders. M4A would:
- Abolish private insurance for covered services (some versions allow supplemental plans)
- Roll everyone into one federal plan and expand it to all ages
- Authorize government, meaning federal agencies, to negotiate or dictate what providers get paid.
- Eliminate premiums, copays, deductibles for most care
- Fund the plan through taxes and/or deficit spending
What’s good about it?
There’s a reason M4A is popular.
In 2026, employers pay an average of $28,303 for family coverage and workers shoulder $7,471 of those premiums. By offering everyone “free” universal coverage the plan would eliminate medical bankruptcies, pre-existing condition games, and coverage gaps if you lose a job.
And there are genuine savings, though not as much as is assumed. The US spends more per capita on administration costs than any peer nation. By eliminating insurer overhead, billing, and the bureaucracy associated with prior-authorization, we eliminate multiple payers and forms. The government becomes the single payer. This is a serious cost reduction.
As the single payer, the US has enormous leverage over what they are willing to pay for drugs and procedure and providers would have to accept. Other countries do exactly this and pay a fraction of US prices.
What M4A advocates don’t mention
- Unmanageable costs
- Wait-times and rationing
- Innovation risk
- Gatekeepers
- Political weaponization
Costs
The cost is brutal. The US spends more than $5 trillion a year on healthcare. The US government would absorb all of this, every year. Even with savings, the tax burden is enormous. Every nation that did this has been forced to ration healthcare to control costs and the US would be no different.
If you think billionaires will pay for it, the math doesn’t work. If you liquidated the total net worth of all billionaires on the Forbes 400, you would have enough cash to pay for about 18 months of M4A. At that point their assets are gone, and you are on your own.
Wait-times
The wait-times are more than inconvenient. Between April 2024 and March 2025, at least 23,746 patients died in Canada while waiting for surgeries or diagnostic procedures. The same would happen in the US with 10X the population.
Canada, the UK, and others have similar programs and lengthy waits for specialists, imaging, and elective procedures. When price is zero, demand explodes, the supply doesn’t.
Innovation risk
The US market funds the lion’s share of global pharma R&D through high prices. Squeezing pharma slows the development pipeline. It takes years for the slower development to hit people personally, so most won’t see the risk until it’s too late.
Gatekeepers
With a single payer you have one entity or department deciding what’s covered, what’s “medically necessary,” and who qualifies for benefits. That means a single government institution has control over life-and-death decisions. This brings us to politics.
Political weaponization
A single federal payer creates a single point of leverage. That means whoever controls it can control your behavior through coverage decisions, payment rates, and access rules. We know from the COVID-19 experiences the federal government is already biased and politicized. The M4A leverage point is too tempting to be ignored.
M4A’s fatal structure nobody talks about
The revolving door between federal agency employees and pharma is well documented.
EX. During the COVID pandemic, Doran Fink was a medical officer in the FDA’s Office of Vaccines Research and Review. He took part in the final decision to license Pfizer’s and Moderna’s vaccines. He completed his FDA role in December 2022. Two months later he landed a job at Moderna.
There are dozens of stories like Doran Fink’s. Here’s why it matters.
- FDA officials almost routinely leave government for jobs at the companies they once regulated. Former commissioners, deputy commissioners, and review staff cycle into pharma and back.
- Center for Medicare and Medicaid Services (CMS) is the agency that would run M4A. They are staffed at senior levels by the same people who came from insurers, PBMs, and hospital systems.
- The National Institute of Health (NIH) funds the basic research which private firms then commercialize for profit. The government takes the risk; industry takes the reward.
The people who licensed these products and approved their funding end up on the payrolls of the very companies that profited from their decisions.
Revolving door employees don’t get punished for their conflict, they get paid for it with lavish salaries at the very companies they were supposed to be watching over.
In 1995 when Purdue’s OxyContin was approved, FDA employee Curtis Wright “allowed that he might have” written the labeling that made the product appear to have less misuse potential. That key passage allowed Purdue’s marketing to gain wider distribution. Surprise…after leaving the FDA Wright took a $379,000 a year job with Purdue.
These agencies and players comprise the institutions that decide those behavior-changing life and death medical decisions.
M4A is dangerous because it hands a single politicized institution total authority over your life and death health decisions handing them absolute control over your behavior.
What they control is frightening - M4A consolidates this control
- These are the people who control which drugs, devices, and vaccines reach the market and which get buried. They design the trials that make or break products, decide which products get fast-tracked, and which adverse effects are flagged or which are casually dismissed as only anecdotal. (Think of the damages from the COVID vaccines we are still exposing.)
Most are not aware of or can even imagine the enormous power compromised people wield.
- As we saw in the Curtis Wright example above, these employees control the labeling that can make a mediocre or even dangerous product marketable. They define off-label use, and create the standards of care use.
(This is how hydroxychloroquine and Ivermectin were forbidden and Americans forced into accepting Remdesivir and the COVID jabs.)
- These are the people who delay or bury negative studies, discredit whistleblowers, deny access to study data, and trivialize patient harms.
(Think of the disappearing negative studies on vaccine dangers, the missing data on the Amish vaccine study, and the ignored VAERS reports.)
- They decide which procedures get paid for, the payment rate, prior authorization rules, and what defines a “medical necessity.”
(Think of the increased payments for labeling hospital stays “COVID” related, or the times insurers have rejected a claim. Now it would be a government employee doing the rejecting and no patient recourse.)
- These conflicted people become the ‘experts’ who decide what gets taught in medical schools as the truth, continuing education is funded by the same industry experts that shape what your doctor prescribes.
- They decide who are the ‘experts’ that declare which science is settled, who are the dissidents that are de-platformed, stripped of licenses and credibility. They decide which patient voices to listen to and which to ignore.
- Their retired colleagues become the ‘independent authorities’ agencies cite, reporters quote, and we see on newscasts and talk shows. They define and control the narratives that become the rules by which society bends.
(Think the entire COVID pandemic medical response mirrored in your new ‘free’ healthcare plan. )
The compromised decision makers do more than sign approvals. They control what's tested, what's approved, what's covered, what's taught, what's suppressed, and who's allowed to ask questions about any of it.
M4A consolidates and permanentizes this control.
Sacrificing people for the system
An October 2026 UK Board of COVID Inquiry discovered that 43,000 elderly care-home residents were sacrificed to save NHS during the pandemic. According to the report, “the virus was allowed to ‘spread like wildfire’ through care homes…”
Some 43,000 care home residents died from Covid between March 2020 and July 2022. Ministers, including Matt Hancock, the health secretary at the time, are accused of focusing on protecting hospitals, while treating social care as ‘something of an afterthought’.
When any government system becomes unsustainable, the bureaucracy will sacrifice individuals to save the state. If M4A is enacted, eventually, it will happen here.
We can stop this
Robert F. Kennedy, Jr. and Jay Bhattacharya are working to remove the politics from HHS and clear the way for actual science. Entrenched employees, compromised ‘experts’, internal operatives, and biased judges make it tough, but they are making headway. We can’t stop now.
Today the Democrat Party is intent in harnessing Kennedy and passing Medicare for All. Their promise of free healthcare and the false equality of socialism is an easy sell.
2026 is not a typical Democrat versus Republican race of differing approaches but similar concerns for our nation. Its outcome will fundamentally alter the trajectory of America’s culture.
With campaign deception and melting promises who do you vote for? Lex Greene wrote an apt piece called This One’s Easy To Figure Out. He asks one deceptively simple question… “Who wants you to vote, and How?” He gives answers. I recommend reading his article before voting.
Lex Greene
This One is Easy to Figure Out
Unfortunately, politics has become a 24/365 every year event. Before this election cycle ends, the next one begins. Every day, every year, including in off-election years, the political machine is working non-stop to gin up votes for the next election. There’s no break from the exhausting negative nonsense…
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20 hours ago · 22 likes · 5 comments · Lex Greene
Truth Monster John Anthony is a national speaker, researcher, founder of the Sustainable Freedom Lab, and an expert on HUD and property rights infringements click here to subscribe to his must-read Substack. The Truth Monster is a reader-supported publication. To receive new posts and support its work, consider becoming a free or paid subscriber.
