By Susanne King, M.D.
The Berkshire Eagle (Pittsfield, Mass.), Jan. 15, 2019
The majority of Americans and their doctors have long supported a national health program, an expanded and improved Medicare for All, that covers everyone, and is cost-effective, efficient and practical. This single payer program would cover every American for all medically necessary services, including mental health, rehabilitation and dental care, without co-payments or deductibles. Under such a program, patients would be able to keep their doctors and other health care providers: the delivery of health care would remain the same. Only the administration of the health care funds would change: from multiple insurance companies to the federal government, which becomes the “single payer” for all health care. This administrative change would free up billions of dollars currently spent for the bloated bureaucracy and profits of these private insurance companies.
The Affordable Care Act was forged under the promise “If you like your health plan, you get to keep it,” but that promise no longer looks so great. More than half the people under 65 get their health insurance through an employer. In these employee-based plans, premiums rose sharply in 2017, with family premiums of $20,000 or more in some states. The amount workers have to contribute to those premiums has continued to rise, along with increasing annual deductibles. These payments by workers are eating into their take-home pay, with an average worker paying over 11 percent of their income for this out-of-pocket spending in 2017.
How would a Medicare for All program be cost-efficient, effective, and practical?
Cost-efficient: cutting administrative costs would generate $400 billion in administrative savings annually. Effective: even after full implementation of the Affordable Care Act, tens of millions of Americans remain uninsured, or only partially insured, so a national health program that covers everyone would be effective. Practical: everyone would have a card to present at the doctor’s office or hospital, allowing for treatment without a co-payment or deductible.
Some think a single payer program may too costly for our country. However, a recent economic analysis of a Medicare for All program by the Political Economy Research Institute at UMass addresses this concern. It found that such reform would provide universal and comprehensive coverage without increasing overall health expenditures. This is in line with Congressional Budget Office estimates, and also with a study by the Mercatus Institute (funded by the Koch brothers), which concluded that a single payer program would realize significant savings..
The idea of a national health program is gaining more traction in the legislature. Last week Nancy Pelosi said through her spokesman that she supports holding hearings in the House on Medicare for All. Our state representative, Richard Neal, chairman of the Ways and Means committee, said last month that Medicare for All deserves “a conversation.” And there is a class of new members of Congress who are vocal in their support. All this enthusiasm marks a major step forward for supporters of single payer.
There is a bill in the House, H.R.676, “The Expanded and Improved Medicare for All Act,” which has a growing number of sponsors, because it is cost-efficient, effective and practical. You can support single payer health care by contacting Rep. Neal, who wants to protect Medicare. Ask him to go further, and sponsor this legislation for Medicare for All.