The health care debate: Be full of fear, friend
As we read and watch the news, as we watch or hear the claims of our president and our presidential candidates, as we listen to the interpretation of their statements by our news commentators, the healthcare debate becomes very confusing. How do we improve our system which presently leaves 28 million uninsured, 40 million underinsured, and is the most expensive and complicated healthcare system on earth?
Authors, James G. Kahn, M.D. and Elliot Marseille, Dr.P.H., recently penned an article for “The Hill” on 8/14/19 entitled Medicare for All: Fears and Facts. They have provided an excellent comparison of the healthcare options expressed by our presidential candidates thus far.
They have succinctly explained Improved Medicare for all:
“Medicare for all (single payer) provides coverage for life, regardless of health, wealth, or work status. Everyone has a comprehensive benefit package, accepted by all doctors. A public agency directly pays doctors and hospitals’ negotiated rates. Medicare for all combines superb coverage with lower costs. How? By simplifying every aspect of insurance, from enrollment to coverage to billing.”
In 2007, after much frustration dealing with the bureaucracy of our healthcare system, I carefully reviewed a considerable volume of literature that assessed our healthcare system. This research convinced me that our nation can and should do a much better job of providing affordable, accessible, high quality healthcare to all Americans. Twelve years later I remain convinced that “Improved Medicare for All” (IMFA) is by far the best option and probably the only affordable one to achieve this goal.
Although the Affordable Care Act has provided new important protections against previous insurance industry abuses and has allowed many more Americans to have health insurance, it has not provided any cost control.
Back to our fears, fears that the “educated” press tells us should frighten us from supporting IMFA.
Will we be able to keep our insurance? Truth be told, no matter what job we have, our employers have been forced to pass more of the expense of healthcare back on their workers’ shoulders including higher deductibles, co-pays, and shared payment of premiums. Many jobs do not provide health insurance. If we lose or change our job, we potentially lose our insurance. This is one major benefit of IMFA. Under IMFA, whether we have a job or not, all Americans will have health insurance, Improved Medicare.
Will we lose access to care? If you listen to the pundits, you will hear that if we move to a single payer system, our care will be rationed, and we will wait longer for needed care.
Are we not rationed now when we have no insurance, when we cannot afford our premiums, deductibles or co-pays and therefore postpone care, or when we cannot see the doctor or provider because they are not in our insurance network?
Will we pay more tax? Please understand that the proposed funding formulas do include a new progressive tax that will pay for our healthcare. But we will no longer pay our share of premiums, co-pays, and deductibles. Unless we are very, very wealthy, we will pay significantly less for our healthcare than under the present system. Opponents of IMFA, the industries that stand to lose profit when IMFA is enacted, are doing everything possible to scare us on this issue. I would like to pay as little as possible in taxes, but at the end of the day, if the taxes I pay are much less than the premiums, co-pays, and deductibles I presently pay for my healthcare, this outcome is a financial win for me and the large majority of Americans. Please understand, when IMFA is enacted, there will be no more insurance premiums, deductibles, or co-pays for you to pay.
Will we lose our freedom of choice? If anything, our freedom of choice will be much better. Do you want to choose your doctors, hospitals, and therapy centers, the people who actually provide your care, or do you want to choose from one of several insurance companies that tie you in to a narrow network of providers? Look out if you do not use those providers! IMFA will allow you to go to any doctor or hospital that you choose unless they do not participate with the one payer.
Presently, we spend nearly 18% of our gross national product on healthcare. At last count this was $3.2 trillion a year. Improved Medicare for All is projected to save $400-500 billion a year in reduced administrative costs. By negotiating drug prices as a nation with the pharmaceutical industry, the projected savings are another approximate $188 billion a year. With these savings, we can afford to provide healthcare for all Americans and still reduce future cost increases. The PERI group projects this savings at 5.1 trillion dollars over 10 years.
As you hear candidates discuss the public option and Medicare Advantage for All, please understand that these 2 options maintain the present complexities of our system and therefore maintain the huge administrative costs our country’s citizens presently pay in contrast to other industrialized nations. We will not see significant cost savings with the public option expansion or with Medicare Advantage for All.
This is a complicated subject. I develop heartburn when I hear politicians and pundits misinform our public regarding our healthcare system. I believe that most of us care about others, not just ourselves. If we care about our loved ones, grandparents, parents, children, grandchildren and our communities, then we should care about this issue.
As you try to decide what you believe and how you act on what you believe, please search for the truth.
Dr. Dwight Michael is a member of the Gettysburg Democracy for America Healthcare task force.