The news that Sen. Bernie Sanders has introduced a new Medicare for All bill with 16 co-sponsors has generated a lot of attention from both supporters and detractors of the plan. It’s important that those who are trying to make up their mind on the subject understand how to evaluate competing claims.
Here’s a simple test: Any argument that says such a plan cannot work is verifiably false, since nearly every industrially advanced country has universal health care. Most use a similar single payer system, such as Medicare for All. Those that don’t have such systems use more costly ones involving tightly regulated insurance coupled with the same types of rules we see in single payer systems, including defined benefits, mandatory purchase of insurance and other mandates.
The idea of such regulation is as unacceptable as single payer to those who cling to the discredited idea that the free market will cure all the ills of the current non-system of health care delivery in the US. The truth is that health care is not a commodity. It does not meet the assumptions of a free market model, because people are not free to choose not to buy it. When they need it, they often have no choice as to where to get it. That is why it needs to be regulated. An unregulated health care system designed to maximize profit will tend toward monopoly and can only result in millions being left out.
Not only is a single payer system like Medicare for All feasible, but it the most cost-effective alternative to allowing the insurance-based health care system to collapse. This failure would be the inevitable result of a well-known phenomenon known as the “death spiral” of insurance costs: As premiums rise, fewer can afford insurance. To maintain profits, premiums rise again and more cannot afford insurance. It’s easy to see why this cannot be sustained. Consequently, if we don’t come up with a system that covers everyone, in a few years no one will have access to medical care. Obviously, this cannot be allowed to happen. The question is how long we will tolerate having to pay outrageous costs for health care before we demand that the government step in.
Obamacare is an attempt to shore up the current system by injecting tax money in to keep average direct costs to the consumer down, but it does little to control the spiraling cost of premiums that make subsidies necessary. As a result, it is only delaying the inevitable day when taxpayers refuse to foot the bill for a system that costs nearly twice per capita as the average of other countries, and consumes a corresponding fraction of the GDP. The money used for these subsidies would be better spent helping to finance a system of universal care that does not leave out 28 million Americans, the vast majority of whom come from families with at least one full time worker.
It’s critical that people understand that the relatively small increase in taxes that would be necessary to ensure universal coverage is more than outweighed by the savings of eliminating premiums, copays and deductibles under an improved system of Medicare for All. It has been estimated that over 90% of taxpayers would save money under such a plan. Importantly, employers would save several thousand dollars per worker even if payroll taxes were raised, since they would no longer have to pay premiums that are predictable only in the sense that they reliably increase faster than inflation. The predictability of health care costs is a key factor in encouraging investment in new jobs.
The fact is that the only reason we have not adopted a single payer system like Medicare for All is that there are powerful special interests that have too much power in Washington. We need to realize that the only beneficiaries of the current system are Wall Street investors in the medical insurance market, pharmaceutical industry and corporate health care. Their right to make a profit should not trump the rights of all Americans to health care. We are already paying enough to provide universal health care. Do we really want to deny ourselves its benefits just to maintain Wall Street profits? The only way to counter the power of these lobbyists and corporate campaign contributors is for the American public to stand up and demand what other countries have.
If you want Medicare for All, please join Health Care for All Oregon of Douglas County’s demonstration of support on Saturday, October 10 at noon. We will be standing on the sidewalk on Garden Valley Boulevard from noon until 2 PM. Be sure to bring a friend. The more support we show, the more people will have to pay attention to the issue.