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The big healthcare fight Democrats keep dodging

The real lesson of Abdul El-Sayed’s latest pseudo-scandal.

Abdul El-Sayed is among America’s most prominent proponents of Medicare-for-all.

The frontrunner in Michigan’s Democratic Senate primary literally wrote the book on that policy (or at least, a book on it). In El-Sayed’s view, Medicare should cover “all necessary healthcare” for every American — without co-pays, premiums, or deductibles — and be “accepted everywhere.”

• American healthcare is expensive largely because our hospitals, doctors, and drugmakers charge unusually high prices.• American physicians earn about twice as much as Canadian doctors and four times as much as Swedish ones.• To make Medicare-for-all affordable, we need to push down many doctors’ salaries, which is politically difficult.• Expanding the supply of doctors — by funding more residencies and easing barriers for foreign-trained physicians — would lower costs and make universal coverage more feasible.

Alas, despite his many years of advocacy, El-Sayed has seemingly failed to persuade his wife of that last point: According to a recent report from the Washington Free Beacon, El-Sayed’s partner, the psychiatrist Sarah Jukaku, does not accept Medicare as a form of payment at her private practice.

This bit of gossip is of little importance, in and of itself. The Free Beacon’s story does nothing to refute the case for El-Sayed’s candidacy or his healthcare plan (his wife’s business is, well, her business). As hit pieces go, it’s weak tea.

Nevertheless, the tension between El-Sayed’s healthcare proposals and his wife’s business practices is real. And it is illustrative of a major challenge facing anyone who wishes to reform our nation’s misbegotten healthcare system: To meet the medical needs of all Americans, reformers will need to defy the interests of most doctors — and in many cases reduce their compensation.

And that won’t be easy. Few people feel a deep fondness for insurance companies. But El-Sayed is far from the only American who loves a physician.

The biggest obstacle to Medicare-for-all

To understand why Medicare-for-all would be bad news for many doctors — and how the Free Beacon’s story illustrates that point — we must first dwell on one fundamental fact about America’s healthcare system: It’s a rip-off.

The US spends about twice as much per person on medical goods and services as other wealthy countries. And yet, all that money does not actually buy us much more care. Compared to our peers abroad, Americans are less likely to see a doctor, secure a long hospital stay, or access a timely appointment for medical treatment. On the other hand, we do have the privilege of paying radically higher healthcare prices.

To take just one telling example: In the United States, a coronary bypass surgery will typically cost more than $89,000; in Australia, it costs just $17,741.

Such exorbitant prices are the chief obstacle to any version of universal healthcare. Even with one-third of working-age Americans uninsured or underinsured — and thus, consuming too little medical care — the bill for America’s health sector ran to $5.7 trillion in 2025.

In El-Sayed’s........

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