Oct 3, 2018 Florida Times-Union (Jacksonville, FL)
Oct. 03--Medicare
for all is the newest Democratic Party talking point.
Gubernatorial
candidate Andrew Gillum has adopted the favorite line of democratic
socialist Sen. Bernie Sanders.
But it's wildly
unrealistic and would do little to deal with the high costs of health care
without rationing.
The first reason
that Medicare for All is unrealistic is that it would have to scrap the entire
health insurance system in the country.
The fact is that
most Americans are satisfied with the health insurance they receive from their
employers. They don't want to be transferred to some Canadian-style system.
The Patient
Protection and Affordable Care Act, Obamacare, was designed to deal with those
uninsured Americans who are not covered by employer health insurance, Medicare
or Medicaid. It's a relatively small number of Americans but under the previous
system, some uninsured Americans were threatened by bankruptcy with high health
care bills. This is the segment that needs affordable health insurance.
There are
reasonable proposals in Congress to deal with the uninsured and make
Obamacare work better. But they haven't been able to gain wide support.
At issue is the
incredible complexity of U.S. health care. It forces physicians to
spend too much time on billing. Yet Switzerland and Germany use
third party providers like the U.S. employer-based system but with
far less complexity.
The United
States actually has several different health insurance systems:
--Employer-provided
insurance, funded in part with federal tax incentives.
--Medicare for
those 65 and older.
--Medicaid, which
covers certain low-income people, in Florida but not single adults.
--Military systems,
including the Veterans Administration and TriCare for active
military.
--Individual
policies in which people often don't receive the advantages of mass discounts
and negotiation.
A Medicare for All
proposal was considered in Sanders' home state of Vermontbut dropped
because it was too expensive.
The flaws with
Medicare for All were listed in an opinion column by Richard Kocur,
assistant professor of business at Grove City College (Pennsylvania).
The cost of
Medicare for All has been estimated at $30 trillion over 10 years,
which would require a doubling of federal taxes.
Beyond the gigantic
tax increase, proposals resume a drop in expenses. For instance, reducing
provider fees would cause a drop in access as providers drop out.
The real problem
with the U.S. health care is that high prices are baked into the
system. Cutting prices means a cut in someone's profits.
Here are some facts
from The Wall Street Journal:
--Health care
overtook retail as America's largest industry. That equates to a powerful
lobbying force for the status quo. Health care companies have doubled lobbying
spending since 1998. The only segment big enough to challenge the health care
industry is business itself.
--Prices for health
care started rising faster than inflation in 1960s. Drug prices have risen the
fastest. In response, some large companies have started their own insurance
networks and drug providers.
--Lack of
transparency frustrates the effort to control prices. A consumer, faced with a
diagnosis of appendicitis, does not have time to solicit bids and analyze
treatment alternatives.
However, as much as
40 percent of care could allow for shopping, such as joint replacements or
nonemergency MRIs. So how are consumers supposed to compare price and quality?
The average cost of
a hospital MRI is more than double the cost at an imaging center, reports The
New York Times.
Yet patients are
not shopping for medical care. What seems more practical is to give physicians
the price and quality information and give them bonuses for recommending tests
and procedures that save money.
High drug prices
The Trump
administration has protested high prescription drug prices and taken some
action.
One example is
exploring the importation of prescription drugs, reports Kaiser Health
News. This would be limited to cases in which one company makes a high-priced
drug that is off its patent.
There are many bad
examples, such as a pill that once cost $13.50 and now
costs $750.
It's just a start
toward reining in many outrageous examples of unaffordable drug prices.
The real issue with
health care in America is simple: high prices. Until they are reined in, no
system will work, especially not Medicare for all.
___
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