By Eagan Kemp and his colleagues at Public Citizen
February 4, 2019
From the Introduction
These facts are not in dispute: The United States spends the most per person in the world for health care while leaving a much greater share of its population uninsured and experiencing the worst health outcomes of any wealthy country.
There is nothing inherent to the United States that consigns us to having poor health outcomes and high care costs. As recently as 1980, our health care spending was close to that of other wealthy countries and our life expectancy was about average. Since then, we have fallen to the bottom in life expectancy of these countries, while our spending has soared far beyond that of any other comparable country.
The authors of the Affordable Care Act (ACA), otherwise known as Obamacare, sought to improve our dismal state of affairs while retaining the fundamental structure of our health care system. Although the law has achieved important progress, such as significantly decreasing the number of people who lack health insurance, it has not provided access to affordable care akin to what other wealthy countries provide to their residents.
Rising out of the ashes of this bleak landscape are increasingly optimistic prospects to improve and expand our most popular health care program—Medicare—to cover all Americans. This proposal, often referred to as Medicare-for-All, has long been recognized by most policy experts as a method to provide access to affordable health care to all Americans while reaping tremendous savings by streamlining our fragmented system.
Despite its allure on policy grounds, many policy makers have previously shied away from pursuing Medicare-for-All legislation for fear of challenging the many powerful special interests that profit from our current health care system. But the ongoing challenges of our health care system along with attacks on the ACA, Medicare, and Medicaid have helped garner mainstream support for reform.
Public Citizen advocates for the broadest and most-inclusive plan possible. There should be no premiums, deductibles, or co-pays for necessary medical services or prescription drugs. Moreover, the plan we advocate for would expand Medicare to include vision and dental care, and vastly improve access to mental health care. The private insurance plans administered by Medicare, named Medicare Advantage, should be eliminated because they squander resources on overhead and private profits that would much more wisely be applied to providing actual health care.
An abundance of supporting research reveals that such a program would accrue tremendous savings, because of its scale and simplicity. A particularly vivid example of this—and a metaphor for the inefficiency that ails our system—would be ridding ourselves of the byzantine billing system that sometimes requires multiple people to handle remittances for a single doctor.
Meanwhile, ensuring that everyone in the United States has access to affordable care through all stages of their lives would prevent many debilitating health conditions. In addition to improving quality of life, it would reduce uncompensated care, a significant source of increased costs for both the public and for health care providers, under the current system.
Numerous studies have concluded that Medicare-for-All would yield significant cost savings. But there is also a very simple exhibit to turn to: Medicare, itself. Although Medicare’s costs have increased over time in real dollars, they have risen much more slowly than the cost of care for Americans covered by private health insurance. Since 2009, Medicare’s costs (adjusted for inflation) have actually fallen.
This accomplishment is all the more remarkable because Medicare primarily treats elderly patients with more chronic and complicated health conditions than the population as a whole. Medicare coverage in its current state is not as generous as the plan we envision but represents a strong foundation on which Medicare-for-All would be built.
We are at a rare moment in time, in the window of what might be a once-in-a-century opportunity to boldly reshape our health care system to expand and improve access to care such that we could potentially leap-frog the countries that currently outperform us in health outcomes. Such a clear surge in support for Medicare-for-All that our nation is experiencing holds the promise of taking us from worst-to-first when it comes to providing guaranteed access to health care. In this report, we highlight research from a variety of scholars and researchers to answer the key questions about Medicare-for-All and lay out a path for finally achieving health care coverage for everyone in the United States.
Link includes a two minute video on 5 myths about Medicare-for-All:
Full report – 69 pages:
By Don McCanne, M.D.
This highly credible and well documented report on the case for Medicare for All (the bona fide single payer version) can serve as a valuable resource to answer many of the questions that people still have about the proposal.
Although the report is 69 pages long, it is concise and quite readable. Just the table of contents alone asks and answers several pertinent questions.
It would be especially valuable for individuals who are intrigued by the concept but want to learn more. It is also valuable to keep as a reference to provide answers to some common questions people have about the proposal.
The report would also be very helpful in informing those who are guided by the rhetorical memes that have been designed to mislead the public about Medicare for All. But that could be a difficult audience if they have closed their minds and refuse to reopen them. Nevertheless we should keep on trying to get through. The health of the nation depends on it.
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