The debate over the Patient Protection and Affordable Care Act (PPACA) is an extensive one. From the Supreme Court ruling the individual mandate as a tax, to the President not telling the truth that we could keep our existing health plan and doctor, to the completely botched websites with the concurrent lack of accountability.
I have suggested that we look to provide Medicare for all, and those who want to “opt-out” buy private health insurance. Therefore all Americans have health coverage and those who don’t like what the government offers can visit a hospital, doctor, or caregiver of their choice on a plan of their choice.
A key benefit of this plan is actually very good for business as it gets companies out of the business of supplying health care for employees, unless they see private plans as a competitive advantage. For example, a mine in the United States must provide health insurance in a difficult, worldwide, competitive market, whereas its competitors in other countries do not have that line item expense. Medicare for all spreads that cost, in a more efficient manner, across 310 million people.
For all the appropriate concern about government inefficiency and waste, Medicare has proven to be a highly efficient system with only a 2% administrative overhead compared to the 15-20% for private health insurers.
The big knock against Medicare is the level of fraud. Somehow a number of unscrupulous individuals think it is better to defraud the federal government instead of private insurance companies, to the tune of $48 billion per year or a 10-15% fraud rate instead of 1.0-1.5% fraud in private insurance.
To make matters much, much worse. A New York Times article called, “The President Wants You to Get Rich on Obamacare” exposes beyond what I have suspected and discussed on-air many times, ObamaCare is a giveaway to health insurers and pharmaceutical companies. The NYT piece points out how many people will get rich because of PPACA.
From the article (added bold emphasis mine):
“Scully then segued to his main point, one he has been making in similarly handsome dining rooms across the country: No matter what investors thought about Obamacare politically — and surely many there did not think much of it — the law was going to make some people very rich.”
“Billions could flow from Washington to Wall Street, indeed.”
This is not how basic health care should be approached, it isn’t healthy for the average person and it isn’t healthy for our country. It is time to revise PPACA to become Medicare for all and allow an opt-out which requires purchasing private health insurance.
One thought on “Why Universal Single Payer Is The Only Way To Go”
You father encouraged me to read your article. In our book, Governments’ Real Role, my co-author and I reluctantly agree that the US needs a two tier health care system – in some says, as you suggest it. Not because it is a superior idea, but because it is realistic in a society where George expects others to pay for George’s health care cost. So we suggest a public and a private marketplace as a pragmatic response. But your cite of 2% overhead for Medicare is quite mistaken. Medicare pays no claims. They contract to others to do so, and those others are private insurance companies and TPAs. The CBO (2008) indicates that at least eight federal government departments spend money on federal health systems, but those overheads are not charged against health care spending. The cost of administering state health systems exceeds 16% according to the NEH calculations of CMS, while private insurance averages about 12% (including taxes and assessments). Some estimate Medicare fraud at $75 billion or more per year. So whether we end up as you and I think we will, it will not save money. And good luck finding highly skilled MDs to work in that new public system.
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