Take it from an economist, Medicare for All is the most sensible way to fix health care

My Comments: I’ve been covered by Medicare for 15 years, my wife for more than 10. It allows us the freedom to seek medical help whenever the need arises, without a corresponding fear of what it might cost.

I’ve been a licensed insurance professional for over 45 years, during which I’ve sold dozens of group health insurance policies to small business owners and individual policies where appropriate. The premiums charged over these years have grown dramatically.

There is a fundamental imbalance today in terms of who has access to appropriate medical care, leading to higher costs, wasted dollars, and everyone pissed off to some degree. Don’t let the COVID issue cloud your judgement about the economic impact of impaired health, minimum wages, inability to perform basic tasks, and the like. The current system is broken, and must be corrected if I’m interested in a better life for my grandchildren.

There are more than a few highly industrialized countries across the world with government sponsored health care for all that work. Pure and simple. In my judgement, it’s beyond stupid for us to not work toward a similar outcome.

If you worry about health insurance companies going out of business, let them do what they’re doing now, with fewer employees. Hire them to keep track of who is in the system, using the system, and directing money to health care providers. Yes, it’s going to be more complicated than that, but for me, the increase in overall productivity of members of society will more than make up for short term upheaval.   

by Gerald Friedman \ 8 APR 2019 \ https://tinyurl.com/3w6vra9x

There is an instinct among political pundits to confuse caution for practicality — an assumption that those who advocate for incremental change are being reasonable, while those pushing for bold reforms aren’t. This is seen most starkly in the debate around health care reform, despite the fact that the “practical” pushers of limited reform fail to address the real problems in our health care system.

We all recognize that the status quo isn’t working. We spend more per person than any other country on health care, but we aren’t getting any bang for our buck. We have lower life expectancy, higher infant mortality rates and more preventable deaths, and too many personal bankruptcies are due at least in part to medical bills.

Where we disagree is the solution. The favorite new “reasonable” plan is “Medicare for America,” a bill from Reps. Jan Schakowsky and Rosa DeLauro that has won the support of big names like Texas presidential hopeful Beto O’Rourke and the Center for American Progress, the left-of-center think tank where the plan originated as “Medicare Extra for All.” It has been extolled in opinion pieces for some of America’s largest newspapers as a “realistic” plan to fix what’s broken in our health care system.

On the other side, if punditry is to be believed, there are the Medicare for All “hard-liners” who believe in expanding a significantly improved Medicare system to every American, with coverage that includes dental, vision and long-term care. This is portrayed as radical or even unreasonable.

Time to get real. As an economist who has spent decades studying our health care system, I can tell you that Medicare for All advocates are the only ones who are being reasonable, because theirs is the only plan that will control health care costs while finally achieving universal coverage.

Insurance companies are middlemen

The problem with incremental plans, whether they are public options, buy-ins to Medicare or Medicaid, or pumping more money into subsidies in the Affordable Care Act’s individual marketplace, is that they preserve the private health insurance system weighing down our health care.

This may be why pundits and centrist politicians view those plans as “reasonable,” but it means that they are leaving the main reason for our system’s dysfunction in place: the multipayer, for-profit financing model.

Commercial insurance companies are nothing more than middlemen. They add no value to our system, but they do drive up costs with their bloated claims departments, marketing and advertising budgets and executive salaries. We pay for all of these things before a single dollar is spent on the delivery of care.  

They also create extra costs for providers who need large administrative staffs to deal with billing systems, accounting for as much as $100,000 per physician.

Any plans short of Medicare for All leaves these costs in place. In other words, they leave hundreds of billions of dollars a year in savings on the table.

Medicare for All attacks costs

The waste goes beyond administrative savings. While pharmaceutical companies and hospital groups are consolidating and forming regional monopolies, our fragmented, multipayer system leaves no one insurance plan with a large enough share of the market to negotiate effectively. That allows these companies to essentially set their own inflated prices and bilk the public for hundreds of billions of dollars.

Is it any wonder that they oppose Medicare for All?

If we’re talking about which health care reform plans are serious about attacking cost, providing universal coverage and making sure everyone has access to health care, Medicare for All is the only reasonable answer. No other plan does this effectively, which is why I suspect that the Center for American Progress has not come out with spending estimates. Basic economic tenets tell us that their plan will not reduce health care spending as effectively.

Is Medicare for All bold? Absolutely. Is it reasonable? You bet. It is time to accept that Medicare for All is the practical alternative.

Gerald Friedman, a health care and labor economist, is an economics professor at University of Massachusetts Amherst and the director of The Hopbrook Institute. Follow him on Twitter: @gfriedman

2 thoughts on “Take it from an economist, Medicare for All is the most sensible way to fix health care

  1. Tony B

    He leaves out a few important factors. I’ll give him the benefit of the doubt and assume he has tunnel vision focused on this one industry. Does anyone, living in the real world, really believe government can competently do ANYTHING? He ignores the fraud, waste and abuse in our current Medicare system that is going bankrupt already…some say faster than social security.

    The problem with our multi-payor system is too much government involvement. Obamacare did NOTHING to reduce the cost of care. Just the opposite. It was a payoff to big insurance.
    Companies have too many government forced mandates to compete effectively, and they can’t compete across state lines.

    WE do pay a lot in this country, but to say we don’t get bang for the buck is a lie. In the mortality rates he references, we include murder and highway deaths. Unfortunate, yes, but shouldn’t be utilized to criticize our health care system.

    Our Doctors, hospitals, universities and research top the world….but the government just gets in the way. They pee on you and tell you it’s raining.

    I’m not saying it’s perfect…..we need to separate employment from healthcare. Being provided by employers in the US leads to over-consumption (as it’s pre-tax and the marginal cost of service is lower to the consumer), and worse, does indeed help lead to the fractious less efficient organization of insurance (and the famous, and real, “portability” problem). I certainly agree that this structure raises costs, but if you have a simple problem like this, you fix it, you do not say “hey, let’s try hand it all over to government.”

    A dictatorial socialist system is unnecessary for this purpose. It’s only necessary to enslave the population.


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