Medicare for all - long overdue

Jack Bernard

Guest Columnist

“I mean, if you want to have a single-payer health care system, be my guest.” -Senator Graham

I support some of the things that Senator Graham says and does, but not all. Mostly, I like the fact that he is honest and one of the few Senators willing to speak his mind and not play with words, whether I agree with him or not.

He was being sarcastic when he made the above statement during the disastrous GOP push to repeal the Affordable Care Act (ACA). But, he was correct.

We should all want single payer, Senator Graham. Medicare for all (single payer) is the solution to our worsening health insurance cost and access problems.

Every private provider would be paid the same amount for specific services, as Medicare does now. Inefficient hospitals, nursing homes and others that could not control costs and deliver a quality product would go out of business.

Effective ones with high quality and low expenses would do well. That is capitalism, not socialism, as the right wing constantly states when Medicare expansion is proposed.

The government would also have the clout to drive pharmaceutical pricing down to the levels seen in other developed nations … but markedly NOT here. We have the highest drug prices in the world by far, impacting both our budgets and our health status.

Politicians on the right constantly repeat the refrain that our healthcare system is “the best in the world,” but according to every objective international study (for example, see the Commonwealth Fund reports in 2016 and 2017) that is just not true. Morbidity and mortality are worse in our nation than the rest of the developed countries. And, the cost is much greater here, while 30 million of us are still uninsured.

The GOP repeal effort has failed miserably, but millions have already lost insurance due to Trump’s stated policy of placing roadblocks in front of Obamacare. Many of these people were Trump voters and may well be alienated in 2018 and 2020, voting against him.

The GOP had a world of difficulty coming up with a reasonable plan to keep everyone insured and still do away with the ACA. They have given up. But, there is a way: House Bill 676 or the similar Medicare for all Senate bill introduced by Senator Sanders

If you look around the world, there is already a proven way to have access for everyone and control cost … a single payer system like universal Medicare. Canada copied our Medicare system in the early 1990s, but expanded it to include all ages. I visited several Canadian provincial hospital associations in 1996. They were all happy with their system and all thought it vastly superior to ours.

In 2016, with everyone covered, Canada’s cost per capita was just $4,506 versus $9,024 here according to the Organization for Economic Co-operation and Development (OECD). Almost all of Europe is lower than that; for example, Italy’s per capita cost is one-third of ours with better health results than we have.

Question: Why do we not already have this single payer system which has been shown in Europe, Canada and elsewhere to have much lower costs than ours? Answer: Because big insurance and big pharma lobbying money has: a. bought off both parties and b. scared the public with inaccurate portrayals of Medicare for all as socialism.

A recent Modern Healthcare column cited two studies purporting to show that single payer is costly. However, there are other studies done by nationally known experts on single payer (see the website of Physicians for a National Health Plan, which show the exact opposite.

From both a political and policy standpoint, the President should have the respected non-partisan Congressional Budget Office (CBO) examine the feasibility of phasing in single payer health insurance under various scenarios (for example, expansion in 5-year increments until everyone is covered). Bringing younger, healthier people into the Medicare pool will stabilize the program financially.

He should also reaffirm his pledge not to cut Medicare and Medicaid. Specifically, he must rebuke Speaker Ryan’s attempt to abolish Medicare and Medicaid as we know them via privatizing Medicare via vouchers and making Medicaid a state block grant.

Medicare will have its 53rd birthday this year. Let’s not wait another 53 years to have it cover those under 65.

Jack Bernard was the first Director of Health Planning for Georgia and served two terms on the Jasper County Board of Health. He retired as a Senior Vice President with a national healthcare corporation. He is now a widely published, nationally known expert on healthcare reform.