Embrace single-payer: Medicare-For-All

By Nancy Churchill

I pay a small premium for Medicare each month. Medicare-For-All, as Democratic presidential candidate Senator Bernie Sanders proposes, will replace current insurance premiums with such a premium for everyone, saving Americans millions of dollars.

A revolutionary new documentary called Fix It – Healthcare at the Tipping Point, agrees (fixithealthcare.com).

Consider one highlighted business, MCI: its president estimates that, along with massive paperwork and phone time, from every $1 of health insurance premium paid to MCI’s private insurer, 33¢ is skimmed off the top for administrative expenses (staff to preapprove or deny care, CEO salary, sales and marketing), and for doctors and hospitals to interface with it. Additionally, private insurers pass along another 20 percent to companies like MCI, while physicians each spend around $84,000 annually interacting with them.

None of which pays for actual care.

Medicare, which spends 3 percent of its total budget on administration, passes nothing along.

Complex billing systems from many different payers dictate that hospital nurses work full-time getting preauthorization from for-profit insurers before patients can even receive care, and, stunningly, insurers can override physician’s decisions to keep patients hospitalized.

That’s not a healthcare system, it’s a massively wasteful profit-delivery system to private industry. It doesn’t have to be, unless we allow it.

The solution — Medicare-For-All, or Single-Payer (SP) — is a simple, efficient system with no deductibles, no additional out of pocket expenses, and no contentious preapproval for anyone, regardless of their circumstances.

And it’s not a government takeover of healthcare: doctors and hospitals remain independent.

If you must call that premium a new tax, consider that in exchange, neither you nor your employer will continue paying one dime into private health insurance. Quite a trade, eh?

But don’t Canadians die waiting months for care under SP, you ask? Well, that’s a myth, sort of.

Sara Robinson explains that because “each territory and province administers its own program… you can have waits” in Canada. “As a general rule, the farther north you live, the harder it is to get to care,” she says, “because the doctors and hospitals are concentrated in the south. But that’s just as true in any rural county in the U.S.” (pnhp.org/news/2008/february/10_myths_about_canad.php)

Canadians spend half what we do on healthcare — $4,550 per person versus $8,745 — yet they get better outcomes overall, as do most of the industrialized countries of the world.

Currently, the ACA — which Republicans are trying to repeal as we speak — is attempting to reduce insurance company administrative costs from 30 percent down to 15 percent or 20 percent, versus Medicare’s 3 percent total administrative budget.

Shifting resources from wasteful spending to actual care could save $710 billion annually by eliminating insurance administrative cost and profit, by establishing a standardized fee schedule for hospitals and providers, and by negotiating bulk pricing on medical devices and drugs, as do all other advanced industrialized countries.

Gerald Friedman, Economics Professor, UMass, believes “Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year,” with “money left over to help pay down the national debt.” (singlepayeraction.org/2013/08/06/single-payer-saves-billions) Sounds like a winner.

As for jobs, there’s no doubt insurance industry jobs would be lost (along with million dollar CEO pay!), but an abundance of jobs will be gained by companies like MCI, who could then afford to expand in America, and put more money into circulation by raising wages — supporting expansion for other businesses.

Our current system is unaffordable.

So we have a choice. We can rally to elect SP champions like Bernie Sanders, knowing that even if he wins, unless there’s a heap of progressive Democrats swept into office with him, an obstructionist Congress like we have now can still prevent us from getting it.

Or, we can throw up our hands and say, “What’s the use?” guaranteeing that we’ll be stuck paying into a prohibitively expensive, second-rate profit-delivery system that only covers the very few who can afford it.

Single-Payer (Medicare-For-All), or status quo. It’s up to us.

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