By Johnathon Ross, M.D., M.P.H.
Cleveland Plain Dealer, May 12, 2019
Americans are justifiably concerned about healthcare costs. Even though the U.S. spends twice as much on healthcare as other rich countries that provide universal coverage, our outcomes are mediocre in comparison.
Two-thirds of bankruptcies are caused by illness and medical bills. Nearly 30 million Americans are uninsured, another 40 million are underinsured and all of us are unsure whether our coverage will protect us when we are seriously ill and most vulnerable.
Uninsured and underinsured Americans suffer tens of thousands of unnecessary deaths every year due to care forgone.
Recent polls suggest that a solid majority of American people (including doctors like me) support Medicare for All. However, many also say they are happy with their current coverage and are afraid of the modest tax increases needed to expand Medicare to everyone.
I suspect that most who are “happy” with their coverage have not been sick enough to discover how flimsy private insurance can be, with high co-pays, multi-thousand-dollar deductibles, surprise bills, narrow provider networks and scandalous drug prices that can shock us and block us from needed care.
Those seriously ill must buy or die.
Most people don’t know what their private insurance costs them now. A Kaiser Family Foundation calculator sheds light on this. For example, a family of four earning $50,000 yearly with employer coverage pays 15 percent of its income ($7,450) on healthcare. That amount includes costs such as monthly insurance premiums and co-pays, as well as hidden costs like the taxes that support public employee coverage, veterans’ care, state Medicaid plans, ACA subsidies and tax breaks for employer health plans.
Families earning $150,000 per year pay 12 percent of their income ($21,250) toward healthcare costs.
Workers with employer-provided plans face another hidden cost. Economists agree that companies providing workplace coverage spend proportionately less on wages.
The disease of our healthcare system is its financial hyper-complexity. We need simplicity. The massive administrative savings, bargaining power and increased efficiency of a single-payer system such as an improved Medicare for All can save enough money to provide everyone in the U.S. with comprehensive benefits, protect us from medical bankruptcy and allow us to visit the doctor or hospital of our choice. We can seek care when needed, not just when we can afford the copays and deductibles.
Medicare for All will not be “free,” but will finally be financed equitably through progressive taxes. Except for the very wealthy, most Americans will pay less overall. And everyone will feel the freedom of increased financial security — of being able to change jobs, go back to school or start a new business without the fear of financial ruin from medical bills.
An improved Medicare for All would save lives and save money. It is the right thing to do.
We have comprehensive Medicare for All bills now in front of Congress. The powerful private insurance and pharmaceutical industries have a lot to lose under Medicare for All. They are ready to spend billions on lobbying, TV ads and campaign contributions.
But the rest of us have power, too. Call your member of Congress today and demand real change — improved Medicare for All.
Dr. Johnathon Ross is a past president of Physicians for a National Health Program. He has practiced and taught primary care in poor rural and urban communities, but it was his experience inside the health insurance industry that convinced him of the logic and need for a national health insurance program.