Delaware should move to single-payer health care

By Earl Jaques and John Kowalko
The News Journal, delawareonline.com, Dec. 11, 2012

The recent Supreme Court decision followed by the re-election of President Obama guarantees that the Affordable Health Care Act will be with us long into the future. As each day passes we have learned more about the law, what is contained in the bill and how states will play a major role in the implementation and funding of many portions of program. The Affordable Health Care Act requires everyone to have coverage but at a cost to be determined.

The ACA will not change your situation if you are currently in an employer-provided program (not exceeding 9.5 percent of a person’s income) or if you are enrolled in Medicare, Medicaid or Tricare.

The ACA will require you to purchase insurance through the Health Insurance Exchange program if you’re an individual or family with income between 139 percent-400 percent of the federal poverty level ($15,029-$43,500 for a single person and $30,844-$88,200 for a family of four) and your employer does not provide health care coverage.

Delaware has chosen the Blue Cross-Blue Shield Small Group plan as the benchmark for certification of Qualified Health Plans offered by insurers who wish to compete in the exchange that is being set up by the state. Coverage under this plan will be very basic, as determined by the insurance company as long as it meets the chosen standard. At this time, cost has not been determined. Delaware will receive 100 percent funding from the federal government through 2016. After that, Delaware’s share for newly eligible enrollees will be 5 percent in 2017, increasing to 10 percent in 2020 and beyond. Individuals who fail to have or purchase insurance will then be subject to a tax, as determined by the U.S. Supreme Court. Many experts have reported that it will be cheaper to pay the tax then to purchase insurance.

As the Affordable Care Act ultimately plays out, we know two things for certain: Millions and millions of Americans will remain uncovered; and it will leave the for-profit insurance industry in charge of prices and life-and-death treatment decisions.

So what is the answer? Many industrialized countries around the world have some type of “Healthcare-for-All” (single-payer) system. In our country, we have several of these systems: Medicare, Medicaid and Tricare, which have repeatedly received high marks for outstanding patient care at relatively low cost.

As Dr. Marcia Angell, former editor in chief of the New England Journal of Medicine put it, “Healthcare-for-All is not only the best health care reform, it’s the only health care reform that will cover everyone and control costs.”

As elected representatives, we are convinced that we need to move to a single-payer system as soon as possible. Although the Affordable Care Act has taken a step forward in health care access, it will still leave millions of Americans without coverage. Personal bankruptcies triggered by medical bills will continue to pile up. Medical bills are the No. 1 cause of personal bankruptcies in the United States.

We can’t afford to wait as health insurance costs continue to spin out of control. More and more companies are dropping health care plans for their employees because of the costs.

How long will the federal government or state governments be able to cover their share of medical costs?

It’s time to dispel the myths about a single-payer system.

It is not socialized medicine. It is guaranteed access to health care. You get a health care card and you can go to any doctor or hospital in the U.S. Doctors are not employees of the government and hospitals remain in private hands. You get free choice of doctor and hospital.

A single-payer system will not lead to rationing. In fact, currently, private health insurance companies ration care is based on cost and if you don’t have health insurance, you don’t get care. Costs will not skyrocket under single payer; in fact single payer is the only health care reform mechanism that will save enough money to insure everyone. Eliminating the health insurance industry will save millions of dollars each year in administrative costs and profits.

Drugs will be cheaper under single payer because of the advantage of bulk purchasing. The system will provide a buying power advantage similar to the health care provided veterans which includes a 40 percent discount on pharmaceuticals.

Single payer will mean a vast improvement in access to health care for a majority of Delawareans. All medically necessary care would be funded including all doctor visits, hospital care, prescriptions, mental health services, nursing home care, rehab, home care, eye care and dental with no more bills, deductibles or co-pays.

Under our proposed single-payer funding mechanism, we believe a majority of individuals and companies will save money. We have checked the numbers that are contained in our previous HB 392 and had those figures verified by the Secretary of Finance office.

Recently, pundits have said our country will eventually have a single-payer system in place, but the people cannot afford to wait. Not one more person should die from lack of access to proper health care and as representatives of the “First State,” we must move forward now.

Earl Jaques represents the 27th District and John Kowalko represents the 25th District in the Delaware House of Representatives.

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