MEDICARE FOR ALL IS JUST THE FIRST STEP

 JAZZMAN CHRONICLES

 

  

FALSE FRONT:  FRAMING THE MEDICARE DEBATE

MEDICARE FOR ALL IS THE FIRST STEP

A heated debate has broken out among the Democratic presidential contenders pitting Medicare for All advocates against the moderates who generally want to supplant the Affordable Care Act with a public option.  If we have learned anything from the Obamacare experience it is that compromise measures rarely fulfill their promise.  Obamacare did not achieve anywhere near full coverage and the cost of care continues to rise. 

Why would anyone choose to pay for medical insurance when medical services are free?  It turns out there are people who opt for private insurance even when public insurance is provided free of cost.  We see throughout Europe where governments provide universal healthcare but a certain percentage of the population nevertheless purchases private insurance.  There is nothing inherently wrong with skipping to the front of the line with Cadillac coverage.  But if someone is willing to pay thousands of dollars a year so that they don’t have to sit in a waiting room with ordinary people, let them pay a price.  If millionaires and billionaires want to pay for privileged care let them help improve the system for everyone else.  Let them pay a privileged care fee equal to ten, fifteen or twenty percent of the cost of coverage to supplement the medical system. 

There is a shortage of doctors in this country.  We need competent and well-trained doctors not only in the cities where doctors command top salaries but especially in the rural communities across the nation.  The privileged care fee should be substantial enough to provide educational opportunities for medical students who are willing to relocate to high need areas.  The fees could also be used to assist hospitals that are struggling to survive under the dictates of a profit-motivated system. 

Eventually we need to take the profit completely out of health and medical care.  Until then we will continue to see the spectacle of medical personnel demanding credit cards in the emergency centers of private hospitals.  This would not happen to anyone anywhere else in the civilized world where health and medical are considered fundamental rights. 

To those who say we can’t pay for it, I reply:  We are already paying for it and much, much more.  According to Questex – a media company serving the corporate elite – the top eight insurance companies generated profits in excess of seven billion dollars on income in excess of $132 billion during the third quarter of 2018.  Extrapolating that amount to one year that’s an annual profit topping twenty-eight billion on revenues of more than $500 billion for only eight companies. 

How many lives did they save for that extraordinary amount of money?  Absolutely none.  In fact, it is more appropriate to inquire:  How many lives were lost because the insurance companies did their job well?  Their job is to bolster profits by cutting costs and increasing revenues.  They accomplish that by cutting medical services to people and jacking up the premiums and co-pays of their policies.  We don’t know how many lives were lost due to insurance companies denying coverage but we do know that many of our fellow citizens have been forced to give up or cut back on their medicines because they could not afford them.  We all know someone who was forced to delay or forego a needed operation or medical procedure because the cost was prohibitive. 

Insurance companies are rewarded for denying services and those who are responsible for carrying out the decree are given bonuses and promotions. 

It is easy to see that if we eliminated the insurance industry we would gain billions and billions of dollars to fortify and rebuild the healthcare system.  The employees in the insurance industry are extremely competent and highly educated people.  We could put many of them to work exposing waste and finding savings in the healthcare system.  We could hire them to uncover money-laundering operations in the real estate business.  We could find any number of useful endeavors for those who are unable to find employment in the private sector. 

To continue arguing that we cannot afford healthcare is an affront to common sense.  We cannot afford to continue a system that serves money interests to the detriment of health and medical care. 

Medicare for All is only a first step but it is a vital step.  We should then take aim at the private for-profit hospitals.  The American Hospital Association estimates that 18% of hospitals in the United States are for-profit institutions.  They concentrate on the most profitable areas of specialty – like rehabilitation – and cater to the privileged.  They often take the best medical personnel and deprive communities of needed resources. 

Anyone who has visited a hospital in recent years knows they are counting costs when you walk in the door.  The patient in an emergency room is facing a personal crisis but that does not prevent hospital personnel from hounding the patient for proof of insurance or a credit card. 

There has to be a better way. 

Reforming the medical service delivery system will be every bit as complicated as health insurance reform but it must be addressed.  Government must play a role in establishing and supporting services in underserved communities and no one should be hounded for payment in a hospital emergency room. 

“Big Eight health insurers rake in more than $7 billion in Q3, setting up strong finish to 2018,” by Rose Meltzer.  Fierce Healthcare.  November 19, 2018.