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Don’t argue against government healthcare based on private insurance data

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By James Fieseher, M.D.
Seacoastonline.com (Portsmouth, N.H.), September 18, 2020

In a recent “Guest View” by Rockingham County Commissioner Kevin St. James, he concludes that “Government control won’t fix health care.” He cited data to support his conclusions.

There is a certain familiarity with the data that he cited. They coincide almost exactly with the information distributed by the private insurance industry.

This industry has a virtual “lock” on health insurance in this state and this country, which has helped to make them among the most profitable companies in the US.It is no wonder they would distribute skewed data to keep those profits high.

Let’s start with taxes. Mr. St. James correctly points out that “according to some estimates, payroll taxes might increase as much as $2,300 annually.” That would be true only if a single-payer system was based solely on payroll taxes.

However, since the average American pays between $10,000 – $36,000 annually for private health care, most people would save between $6,000 – $32,000 annually. If you think you pay less than that on healthcare, you should consider the amount your employer is paying for your health insurance as well.

Additionally, the US government is already paying $5,900 per capita on healthcare now, or roughly 11.2% of GDP. Those numbers are taken from 2016 data (American Journal of Public Health, June 2016) and I suspect the current figures are even higher. For comparison, in the same year Canada spent $4,351 (in American dollars) per capita or 10.2% of GDP. This doesn’t take into account that Canada’s system covers everyone, not the 85% covered in the US.

This indicates that after you add a payroll tax increase, the amount of healthcare paid by the U.S. government might increase, but that individual Americans would pay less overall taxes and insurance.

In a single-payer system, every doctor would be participating and therefore every doctor would be on the insurance plan. The real difference would be the decreased paperwork. This means that in theory, there could be more accessibility, but definitely not less.

The accessibility factor in the previous paragraph needs qualifications because there is currently a shortage in primary care doctors in the U.S. created under the present system of private healthcare. That shortage would still exist under a single-payer system, but the system would be able to adjust physician payment rates to encourage more primary care doctors, which the private system is incapable of doing.

Physician reimbursement can also be adjusted to encourage more physician participation in underserved and rural areas.In the essay by Mr. St. James, there is no mention of any means to address this existing problem that was also created under the present private insurance system.

That essay also cited problems with the COVID response. I strongly agree, but that problem was created because private insurance has too many “holes” or gaps where people don’t have any healthcare or inadequate healthcare. This is one of the reasons that the U.S. leads the world in number of COVID infections and COVID deaths. (I suspect that India may eventually pass us in both categories as they have many more people and fewer healthcare facilities.)

With a healthcare system that covers everyone, those gaps disappear.

In his last point, Mr. St. James (and the private healthcare insurance industry) claim that a system like “Medicare for All” would be “knocking down our present healthcare system and trying to rebuild it from scratch.” That can’t be true because we already have Medicare.

Medicare has been the most cost-effective, complete healthcare system for our oldest and most vulnerable citizens. Not even Donald Trump has tried to take away Medicare. There is no need to start from scratch, a “Medicare for All” system would expand an already existing system, not replace it.

Beside the poor response to the pandemic, we have the highest per capital rate of infant mortality compared with other industrialized nations as well as many third world countries. We also pay more than double the price of medications than any other country. It is not surprising that the U.S. has more bankruptcies due to healthcare costs than any other nation on the planet.

In his essay, Mr. St. James wisely offers no solutions to patch up our current system. We’ve gone beyond that point long ago. Like an old car that needs too many replacement parts, our private system of healthcare is woefully broken beyond the cost of repair. The insurance industry issues skewed data because they want to see us dump even more money into the system they’ve fattened up on for years.

I’m sure Mr. St. James does a fine job in other areas as a Rockingham County commissioner, but he needs to stop mining data from the private insurance industry when it comes to healthcare. Besides the American Journal of Public Health, he could check out some of the links at www.PNHP.org/NHI.

If it’s any consolation, I won’t be voting against him. I live in Strafford County.

Dr. James Fieseher, of Dover, practices family medicine on the Seacoast. PNHP is a 501c3 nonprofit organization, and does not endorse candidates for public office.

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