By Lydia Ramsey
Business Insider, November 2, 2108
Dr. Steven Corwin knows what he does is expensive.
Corwin is the CEO of NewYork-Presbyterian Hospital. Surgeries, intensive care, and other costly procedures are constantly taking place within its walls. Hospital care cost about $1.1 trillion in 2016 — that’s 32% of health spending in the US.
“We do a lot of very expensive things,” Corwin told Business Insider. “We have to figure out how to reduce our costs.”
“We have to have universal coverage,” Corwin said. “Let’s forget the mechanism of getting universal coverage, but I think everybody’s gotta be insured.”
While Corwin doesn’t support Medicare for All, it’s a concept he has on his mind, in part because of how much simpler what is known as a single-payer system would be on the administrative side of the hospital. Instead of worrying about the variability in different plans, hospitals would have only one plan to keep in mind.
But to him, there are two big questions around Medicare for All:
Logistically, what’s the tax structure the US would need to support that?
Does Medicare for All makes sense for the US as a country?
“I think we should have that debate,” Corwin said.
A group of students at Weill Cornell and Columbia explain why their CEO is wrong to oppose ‘Medicare for All’
Business Insider, Letter to the Editor, November 26, 2018
In a recent article, NewYork-Presbyterian Hospital CEO Dr. Steven Corwin commented on rising healthcare costs. He stated that “We do a lot of very expensive things…We have to figure out how to reduce our costs.” In the same article, he stated that he opposes “Medicare for All,” but that “We have to have universal coverage,”
As medical students training at the institution Dr. Corwin leads, we agree: we do need it – and we need it urgently. Unlike Dr. Corwin, we, along with a growing number of hospital leaders, believe “Medicare for All” is the only solution for universal coverage and cost reduction.
Medicare for All is a universal, comprehensive single-payer system in which healthcare is financed by one public agency but privately delivered. It would cover all medically necessary services and eliminate co-pays, premiums, and deductibles, leading to improved financial security when individuals or families get sick. It would also give patients the freedom to choose their doctor.
HR 676, a bill introduced in the US House of Representatives with 123 Democratic co-sponsors last year, and the NY Health Act, a state bill that has passed the New York State Assembly in each of the past four years, would both establish such a system.
In his interview, Dr. Corwin first asks “what’s the tax structure the US would need to support [Medicare for All]?” Both HR 676 and the NY Health Act have well-defined funding mechanisms. Each proposes a progressively graduated payroll tax paid by employers and employees, as well as a progressive tax on non-employment income such as capital gains. HR 676 also includes an increase in personal income taxes on the top 5% of earners and a small tax on stock and bond transactions.
While many recent headlines claim that Medicare for All comes with a hefty price tag for taxpayers, it is vital to understand that this increase will be more than offset by the elimination of co-pays, premiums, and deductibles, resulting in net savings for 95% of U.S. households. Studies on the fiscal feasibility of HR 676 and the NY Health Act predict that the proposed funding mechanisms will sustain a Medicare for All system while saving billions of dollars annually.
The business community is also warming up to the idea of Medicare for All. Employer spending on healthcare continues to rise dramatically: the average employer contribution to premiums per worker has risen nearly 70% in the past decade.
Despite repeated claims of government inefficiency, Medicare currently operates at roughly 2% overhead cost, compared to 12.4% overhead for private insurers. These lower administrative costs, along with reasonable limits on drug prices, procedures, and devices will result in billions of dollars of savings for businesses and consumers that can be redirected into the private sector.
Dr. Corwin also asked “Does Medicare for All make sense for the US as a country?” We believe it does—as do 70% of Americans, including 84.5% of Democrats and 51.9% of Republicans.
Medicare is a national treasure: before age 65, when most Americans are insured by private companies, the U.S. has the worst mortality rates of any comparable countries; shortly after 65, when Americans become eligible for Medicare, the U.S. shoots to the top of the rankings. Additionally, Medicare beneficiaries have much higher satisfaction rates than those insured by private companies. Medicare for All will expand these benefits to the entire country.
Medicare for All is something all Americans can get behind, because it is for all Americans. It is bigger than any one hospital, insurer, or patient. As future physicians, our goals align with Dr. Corwin’s: we want universal healthcare coverage and we want to reduce costs. Medicare for All will do both. Is it time for Medicare for All in the U.S.? Dr. Corwin said “I think we should have that debate.” We wholeheartedly agree.
William Ford, Emilie George, Alex Irace, Rachel Madley, Graham Wehmeyer, and Michael Zingman; Students at Weill Cornell Medicine and Columbia University Vagelos College of Physicians & Surgeons, Members of Students for a National Health Program (SNaHP)
A personal message:
By Don McCanne, M.D.
The future of health care in America rests with the nation’s students in medicine and in the other health professions. When you read the letter above written by members of Students for a National Health Program (SNaHP) you can be assured that the future is in very good hands.
Those of us at Physicians for a National Health Program (PNHP) who worked with Nicholas Skala were very impressed with “his incisive mind, wide-ranging knowledge and formidable skills of argument that were devoted entirely to bringing about a better world for everyone.” He was “an extremely witty and compassionate human being, and a great source of inspiration and encouragement.” He was so gifted that I personally thought that his name someday would be widely associated with the single payer Medicare for All program that would eventually be enacted. We are still reeling from his loss due to a cardiac event. We remember his legacy through multiple programs, including the Nicholas Skala Health Activist Award, Memorial Fund, and Student Scholarship Program.
On Giving Tuesday it seems appropriate to consider the contributions of Students for a National Health Program, and I am doing so through a contribution to the Nicholas Skala Student Activist Scholarship Fund. Before you decide that you are receiving too many requests today, do just one thing. Click on the following link, look at Nick’s portrait, and then just try to say no. I couldn’t. I hope you’ll join me.
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