Commentary: Single-payer heath care just makes sense
News Virginian (Waynesboro)
Sen. Bernie Sanders has recently reintroduced his universal coverage "single-payer" Medicare for All bill. Its intent: realign our health insurance system to focus not on the bottom line of the nation's health insurance and pharmaceutical industries but on the health of every American.
It would make sure everyone had affordable health care. In an America where a 2019 survey showed that 3 out of every 4 Virginians worried about paying their medical bills, single-payer has attracted widespread support.
However, there is vehement opposition from health insurance and pharmaceutical industries, which are adept at using our health care dollars against us when lobbying in Washington to do their bidding, not ours. Consequently, misinformation from certain talking heads, politicians, and "think tanks" abounds.
So let's look at what Medicare for All is, then at some of the arguments for and against it.
Medicare for All is a single-payer system of health insurance. It replaces our current multiple-payer insurance system, composed of hundreds of insurance companies as well as government-sponsored programs (Medicare and Medicaid), with a single, government-funded, but still privately delivered health care system.
It is an improved version of Medicare. Single-payer would cover 100% of all medically necessary care: doctors, hospitals, labs, X-rays, medications, dental, vision, hearing, mental health and even nursing home care, without any additional out-of-pocket costs. So there is no need for an expensive supplemental policy. Contributions to the system are based not on an arbitrary premium but on income, so it is truly affordable for everyone.
Why do we need a different health insurance system? Because our current system isn't working—it has failed to do the two things any decent system should do: cover everyone, and do it affordably.
We spend about twice as much per person ($12,000/year) on health care compared with other advanced nations, but get worse outcomes. We leave 30 million without any insurance, and another 40 million, because of increasingly onerous out-of-pocket costs, with insurance they cannot afford to use.
Each year, 500,000 Americans undergo a medical bankruptcy, largely attributed to exorbitant medical costs. Each year, 68,000 Americans die because they can't afford timely medical care.
The current system is also incredibly expensive to run. Excess administrative costs alone are estimated to be $600 billion annually. That's money better spent on health care, not medical bureaucracy. Excess pharmaceutical costs run some $100 billion yearly. Adding a "public option" here is a nonstarter: it merely adds another payer, perpetuating the waste.
The good news? A single-payer system would cover everyone and still save hundreds of billions of healthcare dollars each year.
Some argue that it would be a hardship for those on a commercial plan to give it up, but how great can such plans be when 75% of us worry about paying medical bills? And those who already have a plan they like and are reluctant to leave it might not be aware of single-payer's exceptional benefits: no additional out-of-pocket costs; unrestricted choice of provider; no denials of care designed to enhance insurance company profits; and the coverage of all medically necessary care are all benefits that most of us would find exceedingly hard to match.
Some opponents of a single-payer system argue that the free market, despite its reliance on middlemen who are as expensive as they are wasteful and add no value to your health care dollar, is the answer. Yet the free market has so far utterly failed to make health care either affordable or universal. After all, in the free market you can only buy what you can afford.
Under a single-payer system, pharmaceutical and other innovative industries can still flourish—just as they do in other advanced nations with universal coverage for their citizens.
We're at a crossroads: indifferently continue with a failed system that wastes trillions of healthcare dollars and hundreds of thousands of lives; or switch to an affordable system that puts us first.
It won't happen on its own. Only continued pressure on Washington to support single-payer Medicare for All will make affordable universal healthcare a reality.