Get More; Pay Less

Who wouldn’t want to get more while paying less? The answer is: Apparently enough of our elected officials in Washington. Let’s explore.

I don’t keep count but a plethora of items enter my inbox daily. Most of them are deleted almost immediately. Many more get the most cursory of glances before deletion. The other day a brilliant friend of mine forwarded a piece entitled New Report: It’s Actually Easy to Pay for Medicare for All that Dylan Dusseault had written for the Business Initiative for Health Policy on February 6, 2019 based largely on the work of U-Mass at Amherst Economics Professor Dr. Gerald Friedman. Essentially it proved what “lay people” like me and experts like Dr. Zeke Emanuel have been saying for years: Americans are already spending more than enough money on health care; we just aren’t getting the outcomes we deserve. It is poetic justice that this piece is being published on Lincoln’s birthday. Lincoln saved the union and freed a group of Americans from enslavement. A better health care delivery system, which we are already paying for, would make us a better country and free a lot of Americans from illness and premature death.

Friedman advocates a Medicare for All system as the next improvement in the American health care delivery system. I am among the progressives who feel we have to eventually come to a single payer cradle-to-grave system. As Obamacare evolves, (like Social Security has), that is the next logical and achievable step. It won’t be easy or quick but the fact that every 2020 Democratic hopeful seems to be putting it in their platform is a great sign of progress. Don’t expect it during the 116th Congress with Mitch McConnell controlling the Senate and Donald Trump in the Oval Office but it is coming.

We already spend more than enough money to pay for better coverage and coverage for all. That is not a pipe dream; it is simple arithmetic. Dr. Friedman proves that a Medicare for All system would save America 12-25% of what it now spends on health care. The key is to eliminate for-profit health insurance (there are other significant areas of saving like drug cost negotiation.) Most insurance plans operate on a cost margin in the 17 to 20% range. Medicare operates on a 2% cost margin.

For the skeptics, yes there would have to be a tax increase. However that increase would be less than what we are already paying henceforth the savings. You say you get your health care from your employer. Think again! It is actually part of your compensation and the gross profit you generate pays for the premium just as it does your paycheck. Nothing is a gift from a benevolent employer; that is capitalism and I have no problem with it.

The example used in the piece is that of Richard Master CEO of MCS Industries. In 2018 health care insurance accounted for 22% of MCS’s total payroll cost. Family coverage cost MCS $27,000 a year or $13.50 per hour.

Under the proposed Medicare for All system we could insure the uninsured and still reduce the cost for MCS and every other American business that offers health care to its workers. Not to mention the millions of Americans who privately contract with health insurers for health insurance and in the process upgrade many people’s coverage. We would literally get more for less!

A dirty little secret is that even with Obamacare there are still about 600,000 bankruptcies a year primarily attributable to health care costs. Under Medicare for All this societal cost is eliminated.

In America we currently spend $10,348 per year on health care. In Canada that number is $4,753, in France $4.600 and in the UK it is $4,192. Canada, France and the UK are similar countries and they have a better outcome when measured by life expectancy (Canada and the UK +3 years, France +4years) at less than half the cost.

Dusseault concludes his article with the same question I will pose to my readers today. “The question isn’t can we afford to pay for Medicare for All” the question is, “How can we afford not to?” Sometimes, somebody simply says things better than I can. In this case several similar countries are handling health care better and at less than half the price that we are.

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One thought on “Get More; Pay Less”

  1. Read “Sick around the World” by T. R. Reid for further examination of this issue.
    Unfortunately, the stumbling block here is not logic. It is the insurance industry. When Democrats/Progressives can convince the people to reject the insurance industry with the same zeal as the conservatives convinced them to reject communism, etc., then we may have a chance to make this happen.

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