By James Binder, M.D.
The Cincinnati Enquirer, July 1, 2019
The private insurance industry cannot reasonably defend CEO salaries of $100,000 a day, wasting $ 500 billion dollars a year on excessive bureaucracy, denying care to sick and dying patients, restricting care to small networks, charging $5,000 deductibles, so they go on the attack. They attack single-payer Medicare for all with lies.
These are felony lies because many lives would be saved with an improved single-payer Medicare for all. Allowing the private insurance to restrict and deny care results in tens of thousands of unnecessary deaths a year due to uninsurance (and underinsurance), according to a 2009 Harvard study. I say unnecessary deaths because a single-payer, improved Medicare for all program would cover everyone automatically, provide comprehensive care (dental, mental, eye, long-term care) for life, allow free choice of doctors and hospitals and cost no more than what we are currently paying into the system.
Myths about single-payer Medicare for all are perpetuated daily by politicians and uninformed media. It is crucial to expose these myths, because they are the biggest obstacle to establishing a just, equitable and humane health care system in the U.S.
Myth: It will be expensive and lead to a large increase in taxes.
Single-payer programs in other nations, such as Canada, Taiwan, and Australia show that it is possible to provide high quality for everyone at about one-half the cost, per capita, that the U. S. is spending now. This is accomplished by eliminating the costs of a wasteful, complex private insurance bureaucracy, negotiating fair prices from Big Pharma through the power of a monopsony, and operating hospitals with a global budget, just like fire departments and public schools operate now.
Medicare has an overhead of about 2%; private insurers have a 12-14 % overhead. The only way the enemies of single-payer can argue against this type of basic economic fact is to use scare tactics and cite false information.
There would be a 2% increase in income taxes for individuals if single-payer Medicare for all was adopted. Since there would be no premiums, deductibles, and co pays, the net result for 95% of people would be to pay less for health care, yet get full, comprehensive care. Only the wealthy would pay more than they pay now.
Myth: The government will run it poorly. There will be rationing and long waits to see a doctor.
There are many parts of our government that run well, such as the CDC, NIH, and Social Security system. Many private companies run poorly. I’d rather have a committee of health professional and informed citizens with oversight responsibilities making health care decisions than CEOs responding to investors.
Remember, we are talking about the financing of health care; the delivery of health care will remain private. The clinician-patient relationship would become sacred once again, since the intrusion of private insurers would be removed.
Finally, we already have rationing of health care. We ration on the basis of ability to pay, and that is unjust. No one will be excluded in a single-payer Medicare for all program. We have a large capacity in the U.S. The flow of patients will be readily managed, just as it was when 19 million senior citizens were suddenly covered by Medicare in 1966.
Myth: It will take away patient choices of doctors and hospitals.
The truth is, patients would have free access to any doctor or hospital they wanted with single-payer Medicare for all. The narrow networks are the creation of the private insurance industry. People with employment health insurance often find that their coverage is not so great when they actually need to use it. Deductibles and copays are very high and specialists are frequently out of network. In addition, they forego other employment benefits, like salary increases, in order to have these limited health care benefits.
Myth: It will lower innovation for new treatments and worsen our health care.
Most health research is financed through the National Institutes of Health (NIH). Private companies become involved only after the public has paid for the development and clinical trials for new treatments.
Myth: It would be better to simply add a public option and retain the hundreds of private insurance companies. Examples: Medicare -X and Medicare for America.
This is a con. The private health insurers are trying to avoid elimination. They provide no value to the system or to the patient. They just add costs and complexity. The huge cost savings gained from eliminating the wasteful health insurance bureaucracy would be lost if we simply added a public option. Public option plans have been tried and tried and failed every time. It is time to move to a solution that has been shown to work in countries throughout the world.
Support single-payer improved Medicare for all.
Dr. James Binder is co-founder of the Cincinnati Chapter-Physicians for a National Health Program.