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.
