By Dr. Quentin Young
FireDogLake, July 29, 2011
With media attention focused on the debt-ceiling drama in Washington, and with so many Americans rightly preoccupied with the frightening level of joblessness and bleak state of the economy, it might seem strange to urge a national celebration of Medicare’s 46th anniversary this Saturday, July 30.
After all, if we’re to believe top lawmakers, Medicare is part of the problem, right? Aren’t we supposed to be talking about raising the eligibility age from 65 to 67, reducing benefits, increasing seniors’ co-pays and deductibles or, even more dire, abolishing the program altogether and handing seniors vouchers to buy private insurance?
Wrong. Despite its market-obsessed detractors and those who would weaken the program in the name of deficit reduction, Medicare is the solution, not the problem. More precisely, an improved Medicare for all – a single-payer health system – is the right prescription for treating not only our health care woes, but our ailing economy as well.
The biggest albatross around the neck of our health care system is the private insurance industry, which remains firmly entrenched under the new federal health law.
Thanks to companies like UnitedHealthcare, WellPoint, Aetna, Humana and Cigna, our nation’s patients, businesses, and health providers are chronically tormented by skyrocketing premiums, denials of care, endless paperwork and bureaucracy, and the spectacle of obscene CEO salaries and insurance company profits.
And what does this so-called system get us? Fifty-one million people who have no coverage at all; 45,000 annual deaths linked to lack of coverage; a million personal bankruptcies annually (62 percent of the total) linked to illness or medical debt; and World Health Organization indicators that put us in 37th place globally, even though we spend twice as much per capita as any other nation.
Waste in our system is staggering. Research shows about 31 cents of each U.S. health care dollar is currently spent on administration, over half of which is unnecessary. That translates into $400 billion wasted annually. If we recaptured that money and applied it to clinical care – as we could under a single-payer system – we’d be able to assure everyone comprehensive, first-dollar, high-quality coverage.
So how does this relate to Medicare? As it happens, Medicare is an excellent model for a more rational, single-payer alternative to our present dysfunctional arrangements.
Medicare works. Patients go to the doctor or hospital of their choice. It’s efficient: its overhead is less than 3 percent, less than a quarter of private insurers’. Costs rise more slowly in Medicare than in the private insurance sector.
Medicare isn’t perfect, of course. The program can be empowered to negotiate with drug companies for lower prices. The deductibles and co-pays can be eliminated. Its funding can be augmented from general revenues or a miniscule tweaking of the general payroll tax rate.
But thanks to Medicare, the health and economic security of millions of seniors, the severely disabled, and our nation’s families have dramatically improved. It should not be weakened or destroyed. Those who advocate doing so will reap a whirlwind of popular rage, as GOP Rep. Paul Ryan, an exponent of ending Medicare, has found out.
In such an environment, the obvious approach of President Obama and Congress should be to join the American people in embracing Medicare, not to cut it. But right-wing ideologues, with personal assists from the president himself, have forced a debate on the wrong issue: the debt ceiling, as opposed to enhancing the health status of the American people.
The paradox in this flawed debate is that the solution to our nation’s fiscal problems would be greatly simplified by the creation of a streamlined, efficient and high-quality single-payer Medicare-for-all program. Data suggests that if we had a single-payer system like other industrialized nations, we’d currently have a federal budget surplus.
The 46th anniversary of Medicare should be a time to celebrate its achievements and to strengthen it by expanding it to all.
Quentin D. Young, M.D., is national coordinator of Physicians for a National Health Program (www.pnhp.org) and former chief of internal medicine at Cook County Hospital in Chicago.