We Need a Health Care Overhaul

There are few issues that exemplify the deep, partisan divide in this country more than Health Care. The problems associated with our health care system have existed for decades and have been growing steadily worse. The number of preventable deaths were in the tens of thousands every year, and medical bankruptcies – a uniquely American problem – were on the rise. Obamacare made some progress, but it was far from perfect.  And the recent bills from the current administration and the House have been deplorable.  

The truth is that the Affordable Care Act did make insurance work better for a lot of people, especially those with pre-existing and chronic conditions.  And in spite of a now record-low percentage of uninsured Americans, is sues of cost and access remain while current efforts only serve to roll back the gains that were made. But reducing costs by eliminating coverage should NEVER be an acceptable solution! And market solutions will not work as neither health insurance nor medical care are purchased in anything resembling a typical “market.”  Approximately 90% of people who purchase health insurance, buy a plan which their employer has chosen for them, and subsidized heavily, usually covering 75-80% of the premium. Can you image buying food this way? Or a car? What’s more, if you just had a stroke, are you going to shop around to see what hospital will get you the best deal? Probably not. And one does not shop around for different drugs or procedures in order to cut costs. Medicine just doesn’t work that way.

So what IS the solution, if more of the same won’t work? It turns out that we already have a system in place that works extremely well, and would further improve if expanded into the national standard: Medicare.

Medicare has always been, and remains very popular with Americans, consistently polling over a 60% approval rating. It is long known to be more efficient than private insurers, with overhead costs consistently below 2%. And unlike Medicaid, which pays doctors a significantly lower rate, thus resulting in many providers not accepting it, Medicare has one of the highest rates of acceptance by doctors and health care providers throughout the country. If this were expanded to all, the issues associated with Medicaid would disappear, as would any concerns on the individual level about the affordability of private insurance or uninsured medical care.

In addition, consider the advantages that Universal Health Care brings. The cost of the care itself would go down as compensating for unpaid bills and lower Medicaid payments would no longer be needed. Proper care of chronic illnesses would lead to less work-time lost by employers, and fewer hospital stays by those who cannot currently afford the proper care of their conditions. This, in turn, would further lower costs by easing demand for (and increasing the supply of) critical resources like hospital rooms and ER beds. And finally, by relieving employers of the burden of providing health care to their employees – currently a huge, fixed expense, directly tied to their head count – this becomes a significant job-creator, by lowering the marginal cost of labor.

Now let’s acknowledge the elephant in the room: How do we pay for it?

Will “taxes” go up? Yes. Yes, they will. But consider what they would be replacing: insurance premiums, deductibles; co-pays, and out of pocket expenses, and anything that your insurance company decides isn’t medically necessary for you to have, regardless of your doctor’s opinion. And all of that assumes you even have insurance! The fact is that, as a country, we are already paying for all of this – we just aren’t getting a quality of care commensurate with the money being spent. Putting the entire country into a single pool just makes sense. Spreading risk over the widest possible pool of patients is exactly what makes insurance work. Guaranteeing that providers will be paid, and paid at a reasonable rate, means no more jacking up prices for some people to make up for the lower (or non-) payment being received from others. Paying for this with public, rather than private funding, means that a company’s health costs will be tied to its profits, rather than its headcount, and individuals will never face the kinds of bills that can single-handedly destroy the American Dream, one working family at a time.

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