By Johnathon Ross, M.D.
The Blade (Toledo, Ohio), Jan. 31, 2016
Calculations on the affordability of an improved and expanded Medicare as proposed by Sen. Bernie Sanders (I., Vt.) are not “fuzzy” (“Mr. Sanders’ fuzzy math,” Jan. 22). They are based on health economic research.
The General Accountability Office, the Congressional Budget Office, several highly respected health econometric firms, and research published in peer-reviewed journals all agree: Using single-payer financing, and traditional Medicare, we could provide comprehensive benefits, minimal out-of-pocket payments, and allow patients total choice of doctor and hospital for substantially less than we spend now. Public spending (taxes) would be increased, but private spending such as insurance premiums and out-of-pocket payments would be eliminated.
Currently, we have a bewilderingly complex system of hundreds of insurance entities with an army of paper-pushers, billing clerks, and bureaucrats to process the premiums and bills. Under a single-payer, hospitals would not bill individual patients, but would receive an operating and capital budget from the Medicare trust fund with both local and national public oversight.
Hospitals would continue to be managed by local boards accountable for these budgets. Management of doctors’ offices would be simplified with only one entity to bill, which would use a negotiated fee schedule covering the care for all patients. There would be no bad debt or co-payments so fees could be lower and still provide the same income to caregivers. Alternatively, caregivers could work under institutional budgets for a salary as many do now. Experts agree savings from eliminating bureaucracy would adequately cover all the uninsured and improve benefits for all.
All of our wealthy allies have similar systems in place. Their health outcomes are better and they all spend much less than we spend now.
Dr. Johnathon Ross resides on Brookside Road. He is a past president of the Physicians for a National Health Program.
PNHP note: Physicians for a National Health Program (PNHP) is a nonprofit, nonpartisan, educational and policy research organization that neither supports nor opposes any candidate for public office nor any political party.