By Ed Weisbart, M.D.
St. Louis Post-Dispatch, Feb. 16, 2016
Remember the heated discussions about health care in the Republican debates? No, you donāt, because they were arguing about things like fantasy football. In fact, all we heard about health care was, āRepeal Obamacare!ā
We get it, being a member of The Repeal Obamacare Club is a prerequisite for running for president on the GOP ticket, as is having no plan with which to replace it.
Jeb Bush promotes tax credits for individuals to purchase āaffordableā and āportableā plans. We hope Bush thinks āaffordableā means less than 10 percent of annual income, but given that he wants to retain the same insurance industry whose bureaucracy now consumes 30 percent of every health care dollar, itās unlikely.
Ben Carson supports health savings accounts, a great idea for healthy and wealthy individuals, but a terrible idea for everyone else who would be more deeply trapped in increasingly expensive plans. Itās a particularly bad idea for women, whose annual cost of care typically is $1,000 more than it is for men.
Ted Cruz crows, āRepeal every blasted word of Obamacare.ā With what? All the problems Obamacare addressed? Crisis treatment in ERs instead of prudent prevention? Denials for pre-existing conditions? Denials for people with the audacity to get sick and actually use their insurance? Annual and lifetime caps?
Marco Rubio, like Jeb, would give you a refundable tax credit to purchase insurance. How does that control costs? And how is that so different from the premium subsidies provided by Obamacare, which Rubio opposes?
Donald Trump promises: āI am going to take care of everybody. I donāt care if it costs me votes or not. Everybodyās going to be taken care of much better than theyāre taken care of now.ā So far, Trump offers no details. He either doesnāt have them or doesnāt want us to know them. But when he does, theyāll be āfabulous!ā
And what about the Democrats? Hillary Clinton would retain the Affordable Care Act and lower out-of-pocket and prescription costs, but she hasnāt said how. The Affordable Care Act has saved countless lives, but it is essentially an insurance-reform/subsidy program, not the comprehensive solution our nation needs to remedy our chronic bloating of health care costs.
Bernie Sanders supports HR 676, the Expanded and Improved Medicare for All Act, co-sponsored by Rep. William Lacy Clay and 63 other U.S. representatives. Itās a comprehensive plan with robust details. It provides full coverage without premiums, like people enjoy in all other advanced countries, at roughly half of what we spend per person in the United States today.
Any candidate who isnāt forthcoming with these details is ignoring our current dire reality. Our health care system has a literal death grip on this nation. It is the new āgiant sucking soundā of money being vacuumed from our entire economy and into health careās deep, private-profit pockets.
More than another cycle of modest reform, we need to base our solution upon our nationās most successful health care system, Medicare. We need to divorce our health insurance from our employers, releasing businesses from that burden and giving job mobility back to employees. We need to implement universal access to health care, paid for by progressive taxes, delivered by the worldās best doctors and hospitals. We need to replace our woefully wasteful private insurance system with the efficiency of Medicare.
By eliminating sales, marketing, underwriting and other non-productive administrative functions required of private insurers, Medicareās overhead is 2 percent; private insuranceās is 18 percent.
We have some of the best health care in the world, but far too many Americans canāt afford to use it, and everyone pays way too much for it. Medicare offers 50 years of proof that our government can administer health care as well or better than anywhere else in the world. Letās make it available to each and every American, and demand that anyone running for high office explain how they could do better. They wonāt because they canāt.
Dr. Ed Weisbart is chairman of Physicians for a National Health Program ā Missouri chapter.
PNHP note: Physicians for a National Health Program (PNHP) is a nonpartisan educational organization. It neither supports nor opposes any candidates for public office.