April 8 is National Day of Action for Medicare-for-All. Roseburg will be among the cities where advocates of a universal, single-payer health care system will march for healthcare justice. Because they regard health care a human right, they are working to make universal health care a reality in the U.S., as it is in every other economically developed nation. However, there is no way to convince people that health care is a right. It is a matter of values.
The good news is that regardless of ideology, just about everyone will benefit financially from a single-payer system. Given that the Affordable Care Act (Obamacare or ACA) can only be sustained by giving ever-increasing amounts of tax money to private insurers, shouldn’t an alternative that will save over 90 percent of Americans’ money by eliminating premiums, copays and deductibles be carefully considered? Medicare-for-All would cut total costs by as much as half, control the rate of cost increases and provide healthcare to all Americans that is more comprehensive than all but the most expensive plans available in the insurance market. A single-payer system like Medicare-for-All is the only rational option for “repeal and replace.” The current debacle around this effort makes clear there is no other viable alternative to Obamacare.
Some may imagine that the promises made by single-payer advocates are too good to be true. The short answer to these skeptics is that experience in other countries has proved otherwise. The cost per capita of health care in France and Canada, for instance, is about half that of the U.S. The quality is also much better, in terms of measures used by the World Health Organization. This is in part because they are comprehensive, including vision, dental and medications among benefits. As with Obamacare, there is an emphasis on preventative medicine that keeps patients healthier and hospital costs lower. Other savings come from the ability to negotiate drug prices and most of all, from eliminating the tremendous inefficiencies built into a system with a multiplicity of payers, all of whom have their own requirements and who routinely waste resources battling providers over payments.
Americans need to quit ignoring the experience of nations around the world, which proves the superiority of single payer-systems in terms of cost, quality and universality. We cannot ignore the fact that even after the passage of the ACA, costs have been rising far faster than inflation even as wages are dropping. That means that without continually increasing the amount of public money being directed into Wall Street pockets through the insurance industry, the system is bound to collapse.
The reason is simple: As premiums rise, fewer can afford insurance. The fewer customers, the more insurance corporations have to raise prices to maintain their bottom lines. Absent tax subsidies to those who cannot buy insurance on their own, this “death spiral” would eventually cause a catastrophic failure of the system.
The basis of insurance is shared risk. That’s why the Republican proposals to replace Obamacare would only hasten the long-overdue demise of the medical insurance industry. Remove the requirement for healthy people to have insurance, and everyone else pays more. Allow people to opt out of paying for reproductive benefits, and only the wealthiest will be able to have children without being bankrupted.
And so it would be for all the other care that some may need and others may not. Every time the risk pool is divided up, more people will find themselves unable to afford insurance and average costs will rise even more, to maintain profits. The sickest will be left without insurance. It doesn’t take much foresight to see that this would increase costs exponentially, since they would only have access to care through emergency rooms or after they became so sick that they needed hospitalization. Oregon’s experience with CCOs has proven that preventative care and early intervention saves money and keeps people healthier.
The choice is easy. We can pay more and more for less and less, or slash costs with a system of universal, comprehensive and high quality health care. It’s time we demand our representatives in Congress deliver on their promises.