By Scott Berman, M.D.
The Morning Call (Allentown, Penn.), October 5, 2019
Let’s start with some facts about the Lehigh Valley: Between the two counties, about 53% of our citizens have employer-provided health insurance, about 30% are on either Medicare or Medicaid, about 10% are buying individual plans. That leaves about 7% uninsured.
Now there has been a lot of scary talk about the possibility that Medicare for All will forcibly “take away” employer-based health insurance from this 53% of people who have them. However, if your employer “gives” you health insurance, you should want to swap it for a universal Medicare plan. Why?
1. Employer-based health insurance is not free. Since it costs your employer money, the employer pays you less. In addition, there is often an employee contribution to the plan, not to mention deductibles and copays.
2. The employer picks the insurance products that you get to choose from. When times get tough, the employer saves money by offering less advantageous plans.
3. Job lock: You can’t just pick up and go to a different job until you know if they also offer insurance.
4. Underemployment: An employer can cut hours to make you part time to deny you health care coverage. Worse, big corporations can set their pay so low that their employees need to go on Medicaid, effectively making taxpayers pay costs the corporation should have.
5. Unemployment: If you are laid off or fired, your only immediate option to continue coverage is to pay much higher “COBRA” premiums to keep your family on insurance. And this only lasts for 18 months.
What are some advantages of Medicare for All?
1. Savings to the consumer. Yes, Medicare for All will likely raise taxes on the middle and upper class, but you still save money. Suppose you pay $10,000 into your employer-based plan — including your share of premiums, as well as deductibles and copays. Now suppose that the Medicare for All plan has no premiums, minimal deductible, and no or low copays. If your taxes go up by $5,000 you are still $5,000 the richer at the end of the year with a Medicare plan.
2. Security. Medicare is a national plan; so regardless of your employment status or where you live, you still get the same coverage.
3. Long-term cost savings. The three highest costs in the health care systems are hospitals, drug and medical device manufacturers, and for-profit health insurance companies. A single payer plan will be able to negotiate with and set price limits with all the players in the system, helping keep total costs down over time.
4. Fairness. Medicare for All would end people having no health insurance or access to care. It would end bankruptcies of families who have a wage earner who gets hit by the combination of being too sick to work and then having medical bills they can’t pay. It reduces cost burdens on small business owners.
So, don’t be scared off by the fearmongers. A recent ad on TV, “Thank You Senator Toomey,” talks about the senator blocking price controls on pharmaceutical companies so we don’t stifle future research. Translated, the ad wants you to believe that the poor drug companies are so tight for cash that if they can’t charge you an obscene price at the pharmacy counter, they might decide not to invest in a cure for cancer. The ad suggests this is a “patient-centric” approach, but I would argue it is an industry-centric approach.
Many Democratic countries successfully provide universal health care, including Canada, Denmark, Finland, France, Ireland, England, Israel, Spain, Sweden and Switzerland.
So don’t believe the scare tactics about government interference in your health care; it is far worse to have it controlled by the profit-making corporations that do not have your interests at heart.
So think carefully about how national insurance policy affects you personally.
Dr. Scott Berman is a psychiatrist practicing at Holcomb Behavioral Health Systems Allentown, and is active in the disability advocacy community.