By Rob Stone, M.D.
Bloomington (Ind.) Herald-Times, October 16, 2017
Donald Trump has done for health care what no Democrat was ever able to do: He has made the Affordable Care Act popular. The Senate has tried and failed three times to repeal and replace the ACA. What next?
One thing is certain — it is difficult to predict the future. The most unlikely things have come to pass the last two years: Almost no one predicted that Donald Trump would win the Republican nomination, Bernie Sanders would win the Indiana Democratic primary, and then Trump would win the presidency. Absolutely no one in either party predicted the ACA would still be standing at the end of September 2017.
Is there a way for Republicans to repeal their hated Obamacare and replace it with something that both keeps Trump’s campaign promise to “cover everybody” and that Democrats would get behind? A bipartisan solution?
The answer is hiding in plain sight — repeal Obamacare and replace it with universal Medicare. It will never happen, you say? Stranger things keep happening. Bernie Sanders has introduced such a bill in the Senate, with 16 Senate co-sponsors. The companion bill in the House has 120 co-sponsors.
The great humanitarian-physician Dr. Paul Farmer said, “I can’t show you exactly how health care is a basic human right. But what I can argue is that no one should have to die of a disease that is treatable.”
Especially in the richest nation on earth. I believe everyone deserves health care. You may not believe health care is a “right,” but please tell me whom you believe does not deserve health care.
Medicare already takes care of the sickest and most expensive Americans. Simply expand it to cover everyone. In the process, improve it, remove the co-pays and deductibles and add better hearing and dental coverage. We don’t have to re-invent the wheel.
There is wide agreement that a universal Medicare program is the ideal way to take care of everyone and control costs. The greatest barrier is those who say it can never happen, that it is pie-in-the-sky, that the corporate power against it is too great.
Why have large corporations not championed universal health care? Because it would cause the disintermediation of the private health insurance industry. Disintermediation (a seven syllable mouthful of a word) is what happens when the free market economy figures out how to remove a middleman and let people deal directly with the services they want. Like buying airplane tickets online, or Uber for a taxi, or Airbnb for a hotel room.
We don’t have a true free market for health care. Some say that is because there is too much government regulation, but that turns out not to be the case. Purchasing health care is not like buying a new car. It starts with a doctor and a patient. Patients want choices, but not the choice of which insurance policy to buy. We don’t want insurance companies coming between us and our doctor. We want the freedom to choose our doctor and our hospital. That’s what traditional Medicare does. You can seek care anywhere and not worry about being “in-network.”
The health insurance industry is an expensive middleman that adds no value, but adds huge complexity, cost and inefficiency. Can this unpopular industry be dis-intermediated? Actually, it is inevitable. We can’t afford not to. Private for-profit health insurance is superfluous and obsolete.
Universal health care is where we draw the line; where we make our stand. This is our wedge issue — the people against the powerful and corrupt corporations. I’m betting on the people. Now is the time.
Dr. Rob Stone is director of Hoosiers for a Commonsense Health Plan and Indiana coordinator for Physicians for a National Health Program.