By Meagan Day and Bhaskar Sunkara
The New York Times, Opinion Today, August 10, 2018
A growing majority of Americans agree: Health care shouldn’t be a business. They’re finally coming around to the idea that it can and should be a public good instead — something we can all turn to when the need arises.
The favorite right-wing argument against Medicare for All — the most popular approach to universal, publicly financed heath care — is that it’s too expensive. More on those costs in a moment. But first, we should note that our current health care system is actually the most expensive in the world by a long shot, even though we have millions of uninsured and underinsured people and lackluster health outcomes.
This is partly because a lot of that money doesn’t go directly toward keeping people healthy. Instead it goes to the overhead costs required to keep businesses running. These include exorbitant executive salaries, marketing to beat out the competition, the labor-intensive work of assessing and denying claims and so on. None of these would be a factor in a single-payer, Medicare for All system. Taiwan and Canada both have single-payer systems, and both spend less than 2 percent of total expenditures on administrative costs — and so does the United States’s current Medicare program. By contrast, private insurers in the United States spend as much as 25 percent on overheads.
But the most important way Medicare for All would save money isn’t by slashing administrative costs. It’s by using the power and size of the government, like other countries around the world currently do, to negotiate favorable terms with drug companies and service providers. There’s a reason a CT scan costs $896 in the United States, but only $97 in Canada.
And what about the sticker shock factor — the dramatic rise in government spending to accommodate such a program? Medicare for All would transfer all payment responsibility to one public agency (as opposed to a bunch of private companies), and that act of combination produces the big price tag that conservatives use as a cudgel. But while this would be more expensive for the government, it wouldn’t be for ordinary Americans. The money would be raised through progressive income and corporate taxes and end up costing most people less than their current health care. And coverage would be comprehensive and universal, meaning nobody would ever be unable to afford the care they need.
Pursuing Medicare for All would come with its own set of dilemmas: Eliminating an entire industry won’t be easy, and we’ll face plenty of political resistance and calls for half-measures. But if we want actual universal coverage, and we want it to be affordable and high-quality, Medicare for All is the only way forward.
This is our fifth and last newsletter; next week Quinta Jurecic of Lawfare will substitute for David Leonhardt. We’ll leave you with a few suggestions for further reading:
How Medicare Was Won by Natalie Shure, The Nation
Single-Payer or Bust by Adam Gaffney, Dissent
“Medicare-for-all” Means Something. Don’t Let Moderates Water It Down by Tim Higginbotham and Chris Middleman, Vox
Even Libertarians Admit Medicare for All Would Save Trillions by Matt Bruenig, Jacobin
“It Was About the Insurance Fix” by Meagan Day, Jacobin
The full Opinion report from The Times follows (at the link).
David Leonhardt is on a break from writing this newsletter until Aug. 27. While he’s gone, several outside writers are taking his place. This week’s authors are Meagan Day and Bhaskar Sunkara of Jacobin, the socialist magazine. You can sign up here to receive the newsletter each weekday.
By Don McCanne, M.D.
Today’s Opinion Newsletter distributed by the New York Times provides a nice, concise statement on why America needs Medicare for All, along with links to references. It should be useful to share with friends, associates and others who still have questions about how we can afford to spend that much on health care (when we are already doing so).
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