Medicare For All (Who Want It)
by John Lawrence, April 29, 2017
Bernie Sanders and other progressives want to change the health care system to a single payer system - Medicare For All. The main blowback by the health insurance and pharmaceutical corporations who like things just the way they are is that half of all Americans have employer provided health care and they like it just like that. So to finesse the whole issue I'm suggesting that what Bernie and other progressives should be talking about is Medicare for All Who Want It. In other words if someone like the health care they currently have, let them keep it. The Medicare system is already set up. It would be so easy to just accept more people under that umbrella with minimal disruption.
What could be simpler? You let the current system exist, but you open up the possibility that anyone can opt in to the Medicare system if they should so desire. You are not creating a new health care system from scratch. You are not imposing it on anyone. Obama said, if we were creating a health care system from scratch, he would be in favor of single payer. But since we were not, he and other Democrats came up with the fatally flawed system of Obamacare whose main strong point was that no one could be refused health care because of preexisting conditions. All well and good, but Obamacare had no cost containment features. I wouldn't be surprised if a Medicare for All Who Want It system were set up - and it could be implemented by simply changing of the law in Congress - that a lot of people would abandon their employer based health care system and join it.
Sanders proposed plan is almost too generous which is out of line with other countries that have universal health care. Vox reported:
The biggest difference between this plan and the version Sanders introduced in 2017 is the addition of a long-term care benefit that would cover care for Americans with disability at home or in community settings. This benefit was also added into the House version of the Medicare-for-all bill earlier this year.
The plan is significantly more generous than the single-payer plans run by America’s peer countries. The Canadian health care system, for example, does not cover vision or dental care, prescription drugs, rehabilitative services, or home health services. Instead, two-thirds of Canadians take out private insurance policies to cover these benefits. The Netherlands has a similar set of benefits (it also excludes dental and vision care), as does Australia.
What’s more, the Sanders plan does not subject consumers to any out-of-pocket spending on health aside from prescriptions drugs. This means there would be no charge when you go to the doctor, no co-payments when you visit the emergency room. All those services would be covered fully by the universal Medicare plan.
Bernie's plan is not the last word. Most other universal health care systems have co-pays. There's no reason why a Medicare for All system shouldn't have them too. I and Frank Thomas have written extensively about the health care system in the Netherlands which is a universal system, but is not government provided health care. You can read about it here. I am not that concerned about paying for a Medicare for All system. We have no problem paying for a trillion dollar defense budget which is not even capable of defending our borders. Of course, the wealthy should be taxed more, but the point is that there are myriad ways of paying for it especially if it is adopted incrementally which a Medicare For All Who Want It system would be. It could be set up in such a way that only so many would be let in every year so as not to overwhelm the system. Maybe we should start with 55 to 65 year olds first.
