What do we want our health care system to do? Care for our health! Yours, mine, our families’, our country’s. But don’t look for such straightforward logic or ethics in the labyrinthian industrial complex that now controls the “care” we get – or are denied. The structure itself must be changed if care and the Common Good are ever to be prized over profit.
The proof of that is made clear by the Affordable Care Act, the admirable attempt passed almost a decade ago to mitigate the effects of unrestrained corporate greed. Dubbed Obamacare, the ACA dramatically decreased the number of uninsured Americans. And yet – because its Democratic authors caved to corporate demands that the profiteering structure be kept intact – Obamacare cannot deliver the universal coverage and range that other (often less wealthy) countries provide.
Don’t despair, for a warm glow of hope beckons from the very midst of today’s cold, often nightmarish system. Millions of Americans are doing much, much better through an alternative structure that already delivers superior care for much less: Medicare.
This government program pays the health care bills of 44 million Americans – those over 65 and 9 million younger people with disabilities. For more than half a century, Medicare has comforted and benefited so many patients and families that it’s now treasured and integral to our people’s sense of the Common Good. Yes, the program needs more controls to prevent hospitals, drugmakers and others from overcharging taxpayers and doing unnecessary treatments, but such fixes are included in various bills to extend the successful program to all Americans: “Medicare for All.”
As shown by other countries, a universal single-payer system eliminates insurance middlemen, dramatically cuts administrative waste, reins in price gouging and focuses care on the less-costly approach of improving long-term health. Thus, while Medicare for All would cover every American – from birth to death – it would actually reduce what we pay for the inefficient, insufficient, incomplete coverage provided by today’s industrial health complex. Check the numbers:
U.S. health expenditures jumped 16.5% between 2009 and 2016 for corporate-insured patients, while the cost dropped 2% for Medicare patients -- despite their having more complicated, chronic and expensive problems. The for-profit system eats up 12% of its of budget just on billing and paper shuffling, compared to Medicare’s 2%. Even a 2019 Koch-funded analysis concluded that Medicare for All would cut U.S. health spending by $2 trillion over 10 years. Less ideologically biased studies estimate even higher savings from Medicare for All’s administrative efficiencies.
Taxpayers already foot the bill for nearly two-thirds of America’s health care spending – including Medicare, Medicaid and the subsidies that corporations get for their health plans, plus coverage for congressmembers, veterans and a few other groups. Medicare for All’s big savings (as shown above) mean overall expenditures would drop while the quality and quantity of coverage would rise. And any additional funding needed for full universal coverage could come from progressive tax mechanisms (e.g., a transaction tax on Wall Street speculation) that don’t cost middle-income families a penny.
America’s Medicare patients are regularly able to get more timely appointments than privately insured people. In fact, delays in the corporate system are growing worse, as so much of doctor and staff time is consumed by insurance company red tape (plus, private insurers are increasingly limiting policyholders’ choice of doctors). Also, among advanced countries, our corporate-run system produces by far the highest percentage of people who skip treatment because they can’t afford it – making some wait times ... eternal.
Every major Medicare for All bill in Congress includes several transitional years, with substantial funding for training, placement and other assistance for those whose jobs will not be part of the restructured system. Besides, some new administrative and fraud protection jobs will be created in the single-payer program, and universal provision of dental, mental health and other health services will create new jobs as well.
Health care giants already spend more than half a billion bucks a year on lobbying – the most of any industry – and that spending is mushrooming as they rush to maintain, by hook or crook, the status quo ethic of profits over care. But a growing majority of Americans see that we’re being robbed of our money, health and rights, and they’re demanding that politicians reject the entrenched interests and produce real change. (At least 48 of our newly elected congressmembers ran on pledges to support Medicare for All or similar health justice programs.) The power of the establishment’s money and lies wilts in the face of the moral imperative that is at the heart of Medicare for All: Everyone deserves, as a human right, affordable access to quality health care.
Jim Hightower is a columnist, political activist and author who served as commissioner of Texas Department of Agriculture.