Medicare Isn't The Problem, It's The Solution

laprogressive

The real problem is the soaring costs of health care that lie beneath Medicare. They’re costs all of us are bearing in the form of soaring premiums, co-payments, and deductibles.

Americans spend more on health care per person than any other advanced nation and get less for our money. Yearly public and private healthcare spending is $7,538 per person. That’s almost two and a half times the average of other advanced nations.

Yet the typical American lives 77.9 years – less than the average 79.4 years in other advanced nations. And we have the highest rate of infant mortality of all advanced nations.

Medical costs are soaring because our health-care system is totally screwed up. Doctors and hospitals have every incentive to spend on unnecessary tests, drugs, and procedures.

You have lower back pain? Almost 95% of such cases are best relieved through physical therapy. But doctors and hospitals routinely do expensive MRI’s, and then refer patients to orthopedic surgeons who often do even more costly surgery. Why? There’s not much money in physical therapy.

Of course. If Ryan's plan is enacted, seniors would be given a voucher to help pay medical costs on the open market. The open market's one objective is to make money, caring for the sick is just secondary to that. Ryan's budget does nothing to control the skyrocketing costs of healthcare today, even as we are in a deep recession and are less able to pay such costs.

One of the beauties of the single-payer Medicare program is that administrative costs are low -- only about 3% of the budget. Compare that to the administrative costs of private, for-profit corporations, which are between 15-20%.

Meanwhile, administrative costs eat up 15 to 30 percent of all healthcare spending in the United States. That’s twice the rate of most other advanced nations. Where does this money go? Mainly into collecting money: Doctors collect from hospitals and insurers, hospitals collect from insurers, insurers collect from companies or from policy holders.

A major occupational category at most hospitals is “billing clerk.” A third of nursing hours are devoted to documenting what’s happened so insurers have proof.

Trying to slow the rise in Medicare costs doesn’t deal with any of this. It will just limit the amounts seniors can spend, which means less care. As a practical matter it means more political battles, as seniors – whose clout will grow as boomers are added to the ranks – demand the limits be increased. (If you thought the demagoguery over “death panels” was bad, you ain’t seen nothin’ yet.)

Paul Ryan’s plan – to give seniors vouchers they can cash in with private for-profit insurers — would be even worse. It would funnel money into the hands of for-profit insurers, whose administrative costs are far higher than Medicare.

We already know how merciless for-profit insurance companies are; that's why the Obama administration, with the support of a huge number of Americans, wanted to enact reforms in the first place. Unfortunately, right wing ideologues eliminated all the savings and efficiency a single-payer plan would offer, simply because it wouldn't benefit the rich at the expense of everyone else, and their ideology prevailed.

So what’s the answer? For starters, allow anyone at any age to join Medicare. Medicare’s administrative costs are in the range of 3 percent. That’s well below the 5 to 10 percent costs borne by large companies that self-insure. It’s even further below the administrative costs of companies in the small-group market (amounting to 25 to 27 percent of premiums). And it’s way, way lower than the administrative costs of individual insurance (40 percent). It’s even far below the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

Reich outlines still more benefits for all Americans under a single-payer plan:

In addition, allow Medicare – and its poor cousin Medicaid – to use their huge bargaining leverage to negotiate lower rates with hospitals, doctors, and pharmaceutical companies. This would help move health care from a fee-for-the-most-costly-service system into one designed to get the highest-quality outcomes most cheaply.

Estimates of how much would be saved by extending Medicare to cover the entire population range from $58 billion to $400 billion a year. More Americans would get quality health care, and the long-term budget crisis would be sharply reduced.

Let me say it again: Medicare isn’t the problem. It’s the solution.

A single-payer plan for health care costs in America has always been the preference of liberals and progressives. To begin with, Medicare already has all the infrastructure for administering the program in place. It would just take an expansion of the existing structure, rather than the extremely costly start-up costs under the present plan. Unfortunately, ideologues have been successful in thwarting this plan.

Yes, there is an economic and efficient way of covering health care costs for all citizens. Unfortunately, many Americans just want to continue with the status quo, in which the interests of the big corporations rule.

We have seen what has happened to America since libertarians and ultra-conservatives have pushed through their agenda in the last 30 years. "Trickle down" economics has only succeeded in making the rich vastly richer while the wages of the middle and working classes have remained flat since Reagan. In fact, the middle class is rapidly shrinking, as more and more people are sinking into poverty.

The fight over health care is also a fight over the class war that is being waged against the middle class and the poor. It has done nothing to help us to cover health care costs for the vast majority and has only succeeded in moving the wealth of the nation upward to the top 10.%

There really is a way to do it better. Most advanced nations have much better health care than we have here and much more universal coverage. We just have to shake off the ideological blinders that insist that going back to the nineteenth century is the way to fix all of America's healthcare problems.

ya it won't ever happpen,,,.. the elite won't allow it.

But OMG!

SOCIALISMZ!!! HITLER!!!



This is interesting, I will check back to see all the misinformation that will inevitably be spread as an argument against providing health care to people in this country. I'm not sure I understand how we got to the position where some people think it's somehow beneficial to society to deny health care to millions of people based on the fact that they are not rich (or have preexisting conditions) and thus allow them to rot in the streets and die...when every other industrialized country cares for the health of their citizens as a basic moral tenet. I actually looked up countries that have some form of universal health care, and it was surprising to me how many 3rd world countries also provide this for their citizens (the fact that Cuba is rated above the U.S. in health care services speaks to this point). Yet some people will still insist that these programs are the devil spawn, they will tell you that these programs are "costing too much" when in fact the costs are, as you pointed out, a product of the current for-profit system that encourages inefficiency and unnecessary procedures that don't actually help the patient (but only serve to line the pockets of everyone else). I'll wait until the myths and lies start up before referring to anymore specific data. All I have to say, is at this point, it's not about which system is most efficient, we already know that based to data from other countries, (a single payer system, or combination of a public option to compete with private plans, would mean the greatest savings while still providing high quality care, a CBO analysis by our own government also showed this)...at this point it's a battle of ideology and whether or not you believe that every American has a right to see a doctor when sick, and whether or not we as a society value the health of our citizens, or do we believe health care should be rationed based on one's economic class and ability to pay? Is it "okay" that inability to pay means a death sentence for some, or do we value the lives of these people regardless of how much is in their bank accounts.

S & F

I agree with the OP.

Medicare is not the problem. It is the solution.

The problem lays with Big Pharm and the Insurance Corps. They are ones whom are milking taxpayers dry. Capitalism in the world had been long dead, with mergers and globalisation. Check every director in those corporations and you see all of them are interlinked with one another, with powers to control and act as monopolies behind the scenes and fool the masses with clever marketing.

Please wake up.

Totally agree, OP. Single payer is what we need. But the people are too stupid to vote in their own best interests, so I doubt we will ever see it.

I'm very happy to have all this support.

But doesn't anybody else want to discuss the benefits of Medicare vs. the merits of dismantling it or giving vouchers to be used on the private market?

Or is the second option indefensible?

They say Social Security (and by extension Medicare) is the "third rail" in American politics. Touch it and you're dead.

Is even the Tea Party scared of touching it? That says a lot for Social Security, doesn't it?

I too agree with the OP. Medicare for "all" is the only reasonable answer. I only fear that we have waited too long to demand adoption of such policies. TPTB have been reaping the profit from the health care insurance industry for so long that they have amassed huge wealth and they're using that wealth to lobby against any legislation that would support a "single payer system."

If they have their way, they will privatize every aspect of government and instead of one that's Of, By & For it's people, we'll have one that's Of, By & For ever increasing profit margins.

Well thought out post. I'd like to know your (and anyone else's that agrees with this) opinion on something. What if someone doesn't want it? What if they would rather go with a private insurance company? Would you agree to an "opt-out" system? You don't pay in, you don't get the benefits of it? Thanks!

/TOA