By F. Douglas Stephenson, L.C.S.W., B.C.D.
The Gainesville (Fla.) Sun, July 28, 2018
This month marks Medicare’s 53rd birthday. In July 1965, Congress enacted Medicare to provide health insurance to people ages 65 and older, regardless of income or medical history.
In the years since, Medicare has become proof that public, universal health coverage is superior to private insurance in every way. Medicare is more efficient than private health insurance and is administered at a cost of 3 percent to 4 percent, as opposed to private, for-profit health insurance, which has administrative costs above 15 percent.
Medicare’s costs have risen more slowly than those of private health insurance. Medicare provides better access to care, better financial protection and higher patient satisfaction.
Although many have negative feelings toward government, and examples of government inefficiency and incompetence abound, the record of private health insurers is far worse. Dozens of financial profiteering scandals have wracked private insurers and HMOs in recent years.
To continue our progress, it’s time to upgrade Medicare by establishing a 21st century “Medicare for All” health insurance system that covers all age groups, cradle to grave. Newborns will leave the hospital with their new Medicare card, and drop it off years later at life’s end.
A bill now filed in Congress, H.R. 676, covers all medically necessary services, including primary care, medically approved diet and nutrition services, inpatient care, outpatient care, emergency care, prescription drugs, long-term care, palliative care, mental health services, dentistry, eye care and substance abuse treatment. Patients have their choice of physicians and other providers, hospitals and clinics.
Co-pays and deductibles paid at health professionals’ offices are ended because payment for health insurance is fully prepaid directly into Medicare, much like Social Security, and covered at first dollar amounts. This means the obsolete 80 percent/20 percent payment split between private health insurance companies and Medicare is eliminated, with Medicare for All covering 100 percent.
All citizens are guaranteed access to decent health care while achieving significant overall savings compared to our existing system by lowering administrative costs, controlling the prices of prescription drugs and fees for physicians and other health-care professionals and hospitals, reducing unnecessary treatments and expanding preventive care.
Good health care would be established as a basic human right, as in almost all other advanced countries. Nobody would have to forego needed treatments because they didn’t have insurance or they couldn’t afford high insurance premiums and co-pays.
Nobody would have to fear a financial disaster because they faced a health care crisis in their family. Virtually all families would end up financially better off and most businesses would also experience cost savings compared to what they pay now to cover their employees.
We finance our new Medicare for All by eliminating profiteering by the private health insurance industry and slashing the system-wide administrative waste they generate, with a single streamlined, nonprofit public payer health insurance system. Such savings, estimated in 2017 to be about $500 billion annually, would be redirected to patient care.
Existing tax revenue would fund much of the system. According to a 2016 study in the American Journal of Public Health, tax-funded expenditures already account for about two-thirds of U.S. health spending. That revenue would be retained and supplemented by modest progressive taxes based on ability to pay, taxes that would typically be fully offset by ending today’s very high premiums paid to the for-profit private insurance industry and out-of-pocket expenses for care.
The vast majority of U.S. households — one study says 95 percent —would come out financially ahead. The system would reap savings by dealing with drug and medical supply companies for lower prices.
More than two dozen independent analyses of federal and state single-payer legislation by agencies such as the Congressional Budget Office, the General Accountability Office, the Lewin Group and Mathematica Policy Research Group have found that the administrative savings and other efficiencies of a single-payer program would provide more than enough resources to provide first-dollar coverage to everyone in the country with no increase in overall U.S. health spending.
A majority of Americans support Medicare and expansion of this program to provide health insurance for all. Write to your senators and representatives and let them know how you feel about expanding Medicare. Ask them to improve and strengthen Medicare with Medicare for All, H.R. 676.
By making health insurance available to all age groups, we can enjoy and celebrate Medicare’s 53rd birthday with the assurance that this life-saving health insurance program will continue.
F. Douglas Stephenson is a retired clinical social work psychotherapist.