Improved Medicare for all: it's the answer

Who does not have a family member or a friend that has not been able to access or afford the medical care that they need? In those individuals, what harm came their way because they could not access or afford the care they needed? Who knows someone who went bankrupt in large part due to health care bills? 

Who has had to change doctors or has had to go out of network and pay much higher prices for care because the doctor they needed or wanted to see was not in their insurance’s network? Who has given up on a business idea or stayed in a job that they dislike because that job provided health insurance? 

Who has struggled to pay their escalating health insurance premiums, their co-pays, and their growing deductibles? Who postpones or just does not seek health care due to cost?

We can eliminate the above issues. The fix is “Improved Medicare for All”. 

As a family physician, now in my 34thyear of health care provision in the Adams County area, I have witnessed too many of these examples, each one of which causes pain and suffering for the individual and loved ones involved. 

I was born and raised in York County as a moderate Republican. I think more like an independent, but I work diligently to try to understand both sides of an issue and then form my opinion. 

Since 2007, I have become totally convinced that the mission of health care in the United States has lost its way. The mission should be to provide affordable, accessible, high-quality health care to all Americans. Instead the mission seems to be more and more about maximizing the profit margins of the health insurance industry, the pharmaceutical industry, the medical device industry, and health care systems throughout America. 

As Thomas Paine penned “Common Sense”, a pamphlet that inspired many colonists spread throughout 13 colonies in pre-revolution North America, John Geyman, M.D., has written “Common Sense about Health Care Reform in America”, a pamphlet now available and a must read for all Americans that desire affordable health care for their families. His purpose is to provide “simple facts, plain arguments, and common sense”. Dr. Geyman’s goal is “to have the American people gain freedom from corporate interests in our medical-industrial complex that take their exorbitant profits on the backs of sick Americans, their families, and taxpayers”.

Dr. Geyman lists and explains today’s crisis in health care including the soaring costs of care, the increasing unaffordability of care, restricted access and choice of care, the large numbers of uninsured and underinsured, an inadequate primary care base, disparities of care, unacceptable quality of care, marginalization and criminalization of mental illness, an inadequate safety net, the decline in physicians’ clinical autonomy and increasing burnout, and massive, inefficient bureaucracy. 

He provides lessons from previous reform failures. His arguments include: the market and consumer directed health care have failed to control health care spending, the private health insurance industry is obsolete and should be abandoned, deregulated health care markets have failed the common good, privatization does not work, it is inefficient and gouges us for profits, health care is not just another commodity for sale in an open market, but it is an essential human right, today’s market-based health care system is falling apart and is not sustainable without fundamental financing reform. 

Dr. Geyman states “we need a larger role of government to reform the system”. 

“Improved Medicare for All” will provide national health insurance to all Americans. It will cut current administrative costs five-fold. The savings at the onset will be $616 billion. This will come from marked reduction in administrative costs as well as negotiated annual budgets with hospitals, other facilities and negotiated fees with physicians. $113 billion will come from negotiated prices on out-patient prescriptions. This savings will be folded right back into the system to provide universal coverage for all of us. 

This is not socialized medicine, that being providers owned by the government. Funds will be given to those who lose jobs in the present system to retrain them for the jobs created in the new system. 

Who are the winners? We as patients will receive much more care for less cost. Employers will no longer be burdened by the costs of providing health insurance to their employees. The administrative inefficiencies of the present system will be markedly reduced for both hospitals and physicians. 

How do we pay for “Improved Medicare for All”? HR 676, the present bill in the US House of Representatives, would provide a progressive funding formula. Someone earning $50,000 a year would pay $1500 for his or her family’s health care, one making $100,000 would pay $6,000, and one making $200,000 would pay $12,000. As of 2017, the average family of four was paying over $28,000 a year. 

How can we make this happen? Dr. Geyman contends, “Trump Care will disappoint Trump’s original supporters when they see that it makes his rhetoric, “a wonderful system that will take care of everyone” just another empty promise”. 

I believe “Improved Medicare for All” will happen when the political will of the people supports it at the voting booth. We as concerned citizens must make health care a priority in the upcoming election as well as in future elections. It is time to stop voting for politicians who hide behind empty promises. I will not vote for any politician who supports block grants for Medicaid, who supports changing Medicare to a voucher system, or one who suggests that we can no longer afford social security in its present structure. All of these positions will tear at the safety net of our nation. These politicians are bowing to the “dark money” that feeds their campaigns or meme-based ideology. 

As a family physician, as a father and husband, as a concerned citizen, and as a taxpayer, I have followed with great interest the debate on health care finance reform. I will continue to do so in my attempt to understand and then to facilitate health care as a human right in our community. Please vote health care in November. 

Dr. Dwight Michael is a local physician and member of Gettysburg Democracy for America.