With lowered costs and universal coverage, single-payer American health care would cure many ills
By David L. Adams, M.D.
Portland (Maine) Press Herald, Dec. 26, 2015
EDITOR’S NOTE: David L. Adams, M.D., lived with his wife and family on Cousins Island in Yarmouth for almost 40 years. He retired in 1998 after 30 years in active practice with Maine Cardiology in Portland. He was a dedicated volunteer after retirement, winning several awards for his activities. A passionate advocate for single-payer health care, Adams was one of the organizers of a celebration of Medicare’s 50th birthday in Monument Square in Portland on July 30. As he became cognizant of his approaching death from cancer this fall, he wrote the following column as an act of devotion to his patients and his belief in the importance of affordable health care for all. Adams died Dec. 6, the day before the end of open enrollment for Medicare in 2015.
COUSINS ISLAND, Maine — It is open enrollment time for Medicare. Many people are finding themselves totally perplexed by the need to evaluate the competing offerings of the different Medicare supplement plans and Part D drug plans they have to choose from before the Dec. 7 deadline for enrollment.
The problem is the choices are so complicated that comparisons of apples to oranges don’t begin to describe the difficulties.
So why not simplify things by going to a single-payer, Medicare-for-all system, as many industrialized countries around the world have done with striking success? That success can be measured by their administrative costs, which are less than half the costs of our system of private health insurance.
Another measure of success is that there are better outcomes of care in countries with universal coverage, such as those with single-payer health care. There were 15 countries around the world with single-payer systems as of 2009, and all but four had higher-rated health care systems (by the World Health Organization) than the United States.
We pay considerably more for our health care, per person, than do people in any other country. Thanks to Congress, our current system prohibits negotiating about drug pricing, which is another source of cost savings in many countries. But our system does allow inflated salaries to the CEOs and administrators whose main function seems to be to refuse care whenever it will enhance their profit margin.
So, what are the drawbacks to single-payer Medicare for all, which have been cited by conservative Congresses since the 1960s?
• It’s socialized medicine: “Socialized medicine” refers to government-controlled medicine. Medicare for all is certainly not socialized medicine. The people providing your health care would not all work for the government. The decisions you and your health care provider make would continue to be private, without “death panels” or other suggested forms of government interference;
• It would lead to higher taxes: Because of potential savings on administrative costs and on negotiated drug prices, a recent study by economist Gerald Friedman showed that Medicare for all could save $592 billion per year in health care costs. These savings come from $476 billion saved if administrative costs were limited to the percentage spent on administration by Medicare, along with the $116 billion saved by negotiating pharmaceutical prices down to the levels charged in Europe.
This would be enough to offset cost increases for universal coverage. Gerald Friedman’s research shows that 95 percent of U.S. households would save money overall with Medicare for all.
Most importantly, by providing access to care for everyone, our health outcomes such as infant and maternal mortality, life expectancy and care for chronic illnesses, which now lag behind many developed countries, would improve.
Universal coverage and better outcomes at lower cost! So why not Medicare for all?