By Jack Kotecki
Green Bay (Wis.) Press-Gazette, Feb. 28, 2017
Health care reform is a high priority on the newly elected Congress’ to-do list.
As a University of Wisconsin medical student who grew up in northeastern Wisconsin, I am concerned that the proposals being put forward by Republicans in Congress will harm Wisconsinites’ ability to access and receive the care they need.
It has been well-documented that the Affordable Care Act has failed to significantly control health care costs; I’ve heard firsthand from patients, family members, and friends about the unbelievable increases in insurance premiums they now face. This, then, presents the new Congress with an opportunity to vastly improve the health insurance infrastructure in America.
So far, their plans have been a conglomeration of conservative ideas like health savings accounts and interstate insurance markets. Such plans will fall well short of the true affordability and health care access that Americans deserve. It may seem like we are mired in a hopeless situation, but there is a way to create better more affordable health insurance: Medicare-for-all.
Medicare-for-all (sometimes referred to as “single-payer”) is a simple program. It requires the elimination of for-profit health insurance companies in favor of a nonprofit government entity that covers all medical expenses. Health care payments would be financed through progressive taxation and fully offset by the elimination of premiums and out-of-pocket expenses. Single-payer systems would cover every American, and they would pay less, to boot.
The strength behind Medicare-for-all lies in its ability to control administrative costs. For example, private health insurance companies take between 12 percent and 25 percent of patient premiums to pay for overhead (advertising, underwriting costs, etc.). This is money that doesn’t pay for care and would be all but eliminated in a Medicare-for-all program (traditional Medicare’s overhead was 1.6 percent in 2013). Instead, that money would stay in patients’ pockets, to be used as they see fit.
Medicare-for-all leads to more freedom and control for patients. It eliminates the concept of “provider networks”; patients can choose to see any doctor and hospital they prefer. Departing from the current private insurance provider networks, profit will not fuel decisions surrounding your care, so there is little incentive to deny insurance claims.
Businesses and workers would both benefit tremendously from this program. Businesses would no longer be legally obligated to provide health insurance to their employees and could put more money toward growing their business. Conversely, since health insurance wouldn’t be tied to your job, workers could change careers without worrying about losing their coverage. This would lead to a much more dynamic labor market and help businesses fill job openings.
Critics who argue Medicare-for-all is “socialized medicine” don’t realize, or mention, that the U.S. already has the largest government-run health insurance program in the world, our Medicare program. This program does an excellent job controlling costs, especially considering they insure one of the most expensive subsets of patients, the elderly. Medicare patients also are happier with their insurance, consistently having higher levels of satisfaction with their insurance coverage than those with private insurance plans.
Admittedly, the United States health care system is a complex, economic juggernaut with myriad vested interests. But we do have a cure for the expensive, inadequate health insurance Americans now experience. Medicare-for-all is the insurance program that Americans deserve. It will guarantee affordable coverage for everyone. It will lend more freedom to patients over which doctors and hospitals they use. In the coming weeks, I will be contacting my Congressional representatives’ office and voicing my support for a Medicare-for-all insurance program. I hope that you will consider doing the same.
Jack Kotecki is a first-year medical student at the University of Wisconsin School of Medicine and Public Health and a graduate of Coleman High School.