Is it time for another look at Medicare for All?

Here we go again, people. In the wake of the GOP’s failure to pass a healthcare bill, universal healthcare advocates are back on the campaign trail with the goal of enacting a single-payer (“Medicare-for-All”) system. One such push is coming from Sen. Bernie Sanders’ (I-Vt.) with his announcement over the weekend that he will introduce a Medicare-for-All bill in the U.S. Senate.

Is this a good idea or a bad one? I think I have changed my mind.

After working in the Medicare industry for six years, I have a different point of view today than I did in years past. While I once believed free market health insurance was best, I now believe that a single payer system could be the right move for America. Here’s why:

Healthcare is NOT a basic human right, as Liberals would argue.

Nothing about our constitution offers citizens healthcare as a basic human right. In my opinion, this is the wrong argument.

However, as goes the health of our citizens, so goes the health of our nation. For this reason alone, making sure that all citizens have access to basic and catastrophic healthcare should be as much a Federal responsibility as border security.

Medicare is one of the most successful programs in U.S. history.

While the program remains fraught with fraud and abuse, the overhead is very low. The Congressional Budget Office (CBO) has found that administrative costs under Medicare are less than 2 percent of expenditures, compared with approximately 11 percent of spending by private health insurance.

Medicare is not free… And it never should be!

We all pay into the Medicare system through payroll taxes. This is a system that works and will continue to work.

Raising the payroll tax to include those under age 65 would help, not hurt, the current Medicare funding situation. Medicare can’t be a handout. People must pay for it.  If you’re healthy and can work, you need to work to help support our society and way of life.

Medicare does not cover 100% of all healthcare costs… Nor should it!

The Medicare system was designed to be a safety net, not all-inclusive healthcare. Medicare pays about 80% of all cover services. That sounds pretty good until you realize what’s NOT COVERED by Medicare, including prescriptions, dental, vision, hearing and much more. It needs to remain this way. People must have a stake in their healthcare, including the cost of being stupid (over eating, bad diet, no exercise, heavy drinking, drug abuse, etc).

In recent years, Medicare (CMS) has done a good job controlling costs… And it can do more!

It’s ridiculous that healthcare is a sixth of the U.S. economy, but it is what it is. Under the Obama Administration, healthcare costs to the government were reined in while private health insurance costs skyrocketed. Under the Trump Administration, HHS has the opportunity to continue the cost-cutting trend by addressing big Pharma’s fleecing of America. The power of Medicare, as a single payer, gives HHS the power and right to demand lower costs.

Private health insurance will remain alive and well!

This should make Conservatives quite happy, but no one talks about it. As is currently the case with 65+ Medicare beneficiaries, private insurance companies offer supplemental insurance (Medigap) to pay the 20% of health costs not covered by Medicare. This is a good system and shouldn’t be changed. There’s a lot of room for insurance creativity here.

We should each buy the level of coverage we need and can afford, while allowing the government to do the heavy lifting. Obamacare, forcing people to pay for coverage they don’t need or want, was a ridiculous notion from the beginning. However, Medicare got it right with the coverage it offers.

Medicare’s prescription drug program (Part D) works, too. Let the insurers and pharmacies compete for better rates, and let each of us buy the level of coverage we need at a modest cost. The ability to mix and match works!

Portable electronic health records.

Although the government mandated that all healthcare providers move to electronic health records, the government itself is the only central repository for a large base of EHRs. The Department of Health and Human Services (HHS) maintains electronic health records on everyone in the Medicare, Medicaid, VA and TRICARE systems. Their innovations in this space are spectacular. Having the health records of all Americans on this system would spur new cost-saving capabilities in areas such as telehealth, which is desperately needed as our hospital networks are shrinking.

I could go on for days listing benefits of a properly designed and managed Medicare-for-All program. My fear is that it would be anything but “properly designed”.

Will California and New York be the beginning of the end?

A California lawmaker recently unveiled details about Senate Bill 562, also known as the “Healthy California Act”. It’s a single-payer proposal to create universal health coverage (including inpatient, outpatient, emergency care, dental, vision, mental health, and nursing home care) for every California resident. I have not read the proposal deeply enough to understand how the Act, if passed, will be funded. However, I have to imagine a personal and corporate income tax hike in the range of an additional 5%.

The Huffington Post reports that “the push to implement a ‘Medicare-for-All’-type system in New York state just took a significant step forward Wednesday.” The push came from state Sen. Jeffrey Klein, who heads the Independent Democratic Conference (IDC) in the New York state Senate.

If the two most powerful states in the Union pass universal health coverage, with such massive entitlements, what will it mean for the rest of us?

One final point…

If Liberal forces get their way with a free-for-all, everyone gets everything system, like Obamacare, it will sink the country. As a nation… as tax payers… it’s simply not sustainable. Medicare works because it’s not inclusive of everything and all costs.

If Conservative forces get their way, with a pure free-market system, the insurance companies will grow richer, big Pharma will become more powerful, and millions of Americans will continue to be uninsured. Obamacare gave insurance companies a big present, and the current thinking on the right would not fix the problem.

When it comes to healthcare, what Americans need is for the best of right and left ideologies to come together. Only when this happens will the people get what they need; a basic coverage guarantee from the government, and open market insurance that covers what they actually want and can afford.

Recommended: H.R.676 – Expanded & Improved Medicare For All Act