By Jack Bernard
The Florida Times-Union (jacksonville.com), Aug. 2, 2016
Single payer really does a much better job than an inefficient multi-payer system like ours.
And, before his candidacy, the Donald knew that fact. Per Trump’s own words (his 2000 book, “The America We Deserve”): “The Canadian Plan also helps Canadians live longer and healthier than Americans. We need, as a nation, to reexamine the single-payer plan.”
Even with Obamacare fully implemented, 9 percent of Americans are still uninsured (16 percent in my home state of Georgia, one of the highest uninsured states, along with Florida).
The uninsured depend on expensive, inefficient private medical insurance. The key exceptions are the very poor (covered by Medicaid), plus seniors and the disabled, who are getting Medicare.
The leaders of my party, the GOP, want to “privatize” traditional government-offered Medicare to “save” it, thus virtually destroying it.
Many continue to view Medicare as socialism, despite the fact that almost all providers do not currently work for our federal government and would remain private under “Medicare for All.”
As a former Republican elected official, I believe that many aspects of government are inefficient. For example, due to Congress, we have a staffed Post Office in every small town, rather than having an automated facility. And many times an unneeded local military base was going to close, only to be kept open via raw politics.
But that does not mean that all government programs are no good or that government employees are to blame for shortcomings. Most waste is caused by politicians skirting their responsibilities due to interest groups and political pressures, a Trump talking point.
I believe in eliminating governmental waste and in utilizing the private sector when it is shown to be more effective, But Medicare, with only 3 percent administrative costs, has been shown to be more efficient than private insurers, with up to 20 percent administrative and marketing overhead.
It is time to depoliticize this fight and look at the experience of other nations with single payer. Their health outcomes are better and they spend much less per capita on health care, per every reputable study. What we lack is political will in the leadership of both parties.
During this campaign, Donald Trump has stated multiple times that our current health care system is broken. Unfortunately, during the primary, he caved in to the GOP right wing and earlier this year released a bland rehash of the same old Republican ideas — pushing private Health Savings Accounts, having insurance sold across state lines and creating block grants for Medicaid.
These are simply Band-Aids on a gaping wound, not resolving the basic cost escalation problem in our current system. Furthermore, access to care will clearly be impeded under the current Trump plan which would wipe out the incontrovertible access gains of Obamacare. Only a single-payer system can eliminate the expensive bureaucratic maze of billing created by multiple payers and have the clout with drug companies and providers in order to accomplish the goal of universal access and cost containment.
It is my hope that, for the general election, Trump will decide that it is better politics to return to his earlier idea of a Canadian-style “Medicare For All” system. I truly believe that he knows this is the correct course for the nation and will get him votes in that a 2016 Gallup survey shows that the majority of the nation now “wants a federally funded health care system that provides insurance for all Americans.”
Even if he does not take this position before November, I also suspect that if he is elected, flip-flopping Donald will eventually go back to single payer.
But only time will tell.
Jack Bernard of Peachtree City, Ga., was the first director of Health Planning for the state of Georgia. He also served as a senior level executive with several national health care firms.
PNHP note: Physicians for a National Health Program (PNHP) is a nonpartisan educational and research organization. It neither supports nor opposes any candidate for public office or any political party.