By Pamella S. Gronemeyer
Illinois Business Journal (Edwardsville), Jan. 2019
I am a physician and an employer, as well as a purchaser and a recipient of my own health care. I strongly support improved Medicare for All, a/k/a/ a single payer health care, because it is the most economically affordable, equitable and patriotic health care for this country. Most other industrialized nations have long ago realized that the health of their nation is no better than the health of their sickest individuals.
As a recent Medicare enrollee, I know that Medicare works. I have conventional Medicare with a supplemental plan and a prescription drug plan. I chose my supplemental plan with a company that treats providers with respect and pays fairly. As a Medicare enrollee, I have my choice of physicians and health-care facilities. I know that the bills will be paid. The downside, however, is that the Medicare supplemental plans and drug plans are not cheap. Many seniors cannot afford these outlays. That is why we need to improve Medicare when we expand it to the entire population. Medicare for All would incorporate dental and vision services as well. The issue of long-term care coverage is still being discussed.
For many years, I have known, as a provider, that Medicare pays a clean claim in 30 days. The Medicare rates are published every year online and are observed. Patients and providers are not pitted against each other in the payment process. Insurance companies often confuse both the health-care provider and patient by telling them conflicting information. Many insurance claims are unpaid beyond 60 days, and it is difficult to run a small business without consistent cash flow. Most insurance companies base their provider rates on a multiple of at least one times Medicare. However, unfairly, some change the rates without notification.
As a small-business owner, I provide health insurance to my employees and their dependents with as low a deductible as possible. I pay the premiums and they pay their deductibles and copays. I do this because I know that my employees are vital to the success of my business and I care about their health and the health of their families. For many years, my premiums rose more than 10 percent a year. While this increase stabilized under the ACA, the premiums rose again 8.2 percent this year. As my employees age (I have good employee retention) their rates go up based on their age. The fact that more and more money is needed to pay health-care premiums limits my ability to give raises. My employees use their health care wisely. The thought that health care for all would create abuse of the system is ridiculous. If we had Medicare for All, I could use the time and energy that it now takes me each October to review available plans, select a plan that is affordable and re-enroll to do my real job of providing pathology and cytology services.
Medicare for All could be paid for by an employer payroll tax that would replace the premiums that my business currently pays to the health insurance company. The employee may pay a small tax that would replace their co pays and deductibles. Would Medicare for All be more expensive than what people are currently paying? Credible economists and healthcare experts say uniformly “NO.” The additional taxes that a person would pay annually are far less than the average person is now paying in premiums to insurance companies. Also, the savings created by a system that spends money for health care and not administrative costs is indisputable. Medicare operates on an overhead of 2 percent to 3 percent; the overhead of private insurance companies is around 20 percent. In addition, the costs of workman’s compensation and retirees’ health benefits would disappear. Malpractice premiums would go down since settlements would no longer include payments for future medical care, because an improved Medicare for All would cover virtually everything.
The entrepreneurial character of Americans is well known. Starting a business would be easier with the knowledge that health-care costs would not discourage people from the process. People would no longer be restricted from creating a business or changing jobs because they are worried about their health care. Medicare for All is a win-win proposition for businesses and for the nation.
Dr. Pamella Gronemeyer is an anatomic and clinical pathologist. She is the director and owner of SEMC Pathology in Highland.