By Jack Bernard
The Atlanta Journal-Constitution, June 24, 2016
I have been amazed at the number of negative Medicare-for-all attack pieces printed in various respected papers over the last few months, making me wonder why primarily liberal economists would be attacking a program that progressives have been trying to enact since Truman.
The underlying implication is that the current private system is more effective than a federal government run single-payer model. As a Republican former elected official with a very conservative spending record, I too believe in eliminating governmental waste and in utilizing the private sector when it is more effective.
Therefore, my record makes some citizens surprised when I advocate for Medicare for all. Objectively, the U.S. healthcare system is and has been severely broken. Despite our spending far more per capita, our country is far behind all developed democracies, which scoff when our politicians make the false claim that we have the best healthcare in the world.
For example, the National Research Council and Institute of Medicine recently commissioned a panel of experts to compare our health with that of 16 other developed nations. We ranked poorly, on the bottom in several key areas! The NRC/IM report stated that our health care is “inaccessible or unaffordable” with “lapses in the quality and safety of care”.
The nations with the lowest cost and best outcomes have comprehensive universal health insurance, either: A.) the government provides direct care (like England or the “socialist” VA here); B.) there is a public utility model (like Denmark and France); or C.) there is single-payer (like Canada, with Medicare covering everyone).
Despite the demagoguery, options “B” and “C” do not represent a government takeover of health care delivery. These options eliminate private-sector insurance company marketing and administrative costs, and big pharma price gouging, directing that money into patient care rather than paying for bureaucracy and multimillion-dollar CEO salaries.
Medicare, the U.S.’s national health care insurance for the disabled and those over 65, has under 3 percent overhead costs (Canada is under 2 percent). Private insurance companies complained because the Affordable Care Act (ACA) required them to get down to 20 percent, or pay a fine.
You will notice that the list of options used by other nations does not include an “Obamacare” model, with dozens of private insurance companies offering a multitude of confusing, expensive plans. In fact, the ACA is a direct descendant of the private insurance plan model derived by the conservative Heritage Foundation as an alternative to “Clinton Care” in the 1990s. That overly complex model became “Dolecare,” which then became “Romneycare.” Oddly, the ACA was then passed by Democrats.
For the ACA to function at all, everyone has to buy insurance, which is the main complaint of the public. Older, sicker folks can afford their premiums only because younger, healthier folks must also pay their premiums. No insurer is going to accept long-term losses, which currently appear to be rising. Insurers will simply raise premiums or get out of the business, as several are currently doing.
The best alternative to the ACA is expansion of Medicare. Americans know and like the program. Few object to paying for Medicare each month versus private insurance premiums.
Taxpayers are beginning to see the benefits of single-payer versus the ACA. In May, Gallup reported that “58 percent of U.S. adults favor the idea of replacing the law with a federally funded healthcare system that provides insurance for all Americans.”
For the most part, it can be funded in much the same way as Social Security, through a payroll tax, with additional funding coming from a variety of other sources. More detail on this subject can be found on the Physicians for a National Health Program website (www.pnhp.org).
A recent study by Dr. Gerald Friedman of the University of Massachusetts found that substantial annual savings can be achieved via single-payer. When combined with the spending reality of other developed countries, this fact should be enough to get our elected officials to objectively examine expanding Medicare, rather than simply attacking the idea due to raw politics.
But Republicans just continue to repeat their worn-out talking points about our current system being perfect — so long as we repeal the ACA. The Democrat front-runner is little better, supporting the ACA but having no clear plan to cover the 27 million Americans still without coverage or the millions more with inadequate insurance.
Given that special interest groups are making billions from our broken system, and contributing heavily to both parties to keep health insurance private, the real question is “will politicians in both parties ever have the courage to act?” If not, this nation is headed towards medical bankruptcy while still failing to insure its taxpayers
Jack Bernard, the first director of health planning for Georgia, has been an executive with several national health care firms. A Republican, he’s a former chairman of the Jasper County Commission.