Medicare for All plan makes economic sense.
Lawrence Caird, an opponent of Improved Medicare for All, said one thing in his Sept. 20 guest viewpoint that I, an advocate of IMFA, agree with - almost. IMFA would cost nearly the same as our current system, even as it provides more care to more people.
We are projected to spend $49 trillion on health care in the United States over the next decade. Most of this will be tax-funded - 48 percent of the total for direct programs (Medicare, Medicaid, Veterans Administration, etc.), 6 percent on federal, state and local government employee health care, and 2 percent on research. Employer-purchased health insurance is tax free, a taxpayer subsidy amounting to another 10 percent. This totals $27 trillion to $32 trillion in taxes over the course of a decade.
Opponents have recently claimed that Improved Medicare for All will cost our country $32 trillion over the next decade. If only! Saving 35 percent - $17 trillion - would be great!
The average of serious estimates suggest a single-payer system will save 4 percent early on. Direct savings are substantially larger, but IMFA will provide health care for all with no financial barriers, leading to more care for more people. The net savings over a decade could be as "little" as $2 trillion, but due to decreased medical inflation, will likely be greater.
While savings are important, most important is that with IMFA there will be no financial barriers to care, so fewer people will die because they put off preventive or diagnostic care. Also, anxiety about affording necessary care will go away, health care will not be a perennial time and goodwill sink in labor/management negotiations, no one will be tied to a job just to get health benefits (indirectly promoting entrepreneurship), U.S. businesses will be more internationally competitive, unpleasant wading through complicated insurance plan choices will be eliminated, and enrolling and determining eligibility will be greatly simplified.
Most of the rest of Caird's column made questionable speculations, intended to scare people and support his claim that IMFA "would likely be a huge failure."
While it will be politically challenging to change to a universal system such as IMFA, people have designed and implemented such systems in every other economically advanced country. Those who are served like their systems better than we like ours, they spend far less money per capita, most get better medical results, and no one dies or goes bankrupt because of financial barriers to care. These countries are not more capable - it is up to us to rise to the political challenge!
Caird dubiously stated that malpractice claims would go away because you cannot sue the government. Medicare patients can sue now, and IMFA patients will be able to do so as well. Most health care providers will remain privately employed.
Caird claimed the stock market would tumble if most private health insurance policies were no longer sold, because insurance companies have large investments. Insurance companies and those that invest in them are not financially stupid - they would not risk huge losses by selling all at once. A major reason for the Great Recession was the paucity of high-quality investments, encouraging the manufacture of bogus high quality investments. Demand will remain for high quality investments held by insurance companies.
Caird claimed that hospital stocks would suffer. Only 18 percent of hospitals, providing 15 percent of beds, are investor owned. Sen. Bernie Sanders' proposal allows for-profit hospitals to remain, while Rep. John Conyers' Expanded and Improved Medicare for All proposal phases them out over 15 years.
While it is expected that better prices for drugs and medical equipment will result in savings under IMFA, most prices need not be reduced precipitously.
Other than for health insurance companies and some drug companies, the effect on stock prices will likely be mild and drawn out.
Health insurance companies will still have a role in IMFA, albeit diminished - selling supplemental insurance and providing some services, as they do now to entities that self-insure (including most large companies and many government programs).
Caird says we would probably lose the Affordable Care Act. Of course we will! But everything good the ACA does will be retained or improved. Because of efficiencies due to simplifications in enrollment, eligibility, and billing and insurance related activities, Improved Medicare for All will provide more care to more people and still cost less.
Visit Health Care for All Oregon (hcao.org) to learn more. Eugene's group meets at 6:30 p.m. on the first Tuesday each month at the First United Methodist Church.
Charlie Swanson of Eugene is the legislative action committee chairman for Health Care for All Oregon.
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|Title Annotation:||Guest Viewpoint|
|Publication:||The Register-Guard (Eugene, OR)|
|Date:||Oct 2, 2017|
|Previous Article:||Missing the point.|