OPINION: Going beyond Obamacare

What Medicare for All really means

  • Friday, February 22, 2019 1:30am
  • Opinion

By Roger Ledbetter

Special to the Record

Some weeks ago, the Snoqualmie Valley Record published Don Brunell’s column “Health Care Top of Mind.” Brunell reported that 33 percent of voters say health care is the most important issue, explaining Americans fear cancer leading to financial ruin. But the fear goes beyond money. We fear loved ones dying or being crippled due to being unable to afford health care.

Brunell discussed an easy fix of procedural checklists. Checklists reduce medical errors, lowering costs. But checklists became standard practice many years ago, and costs continued to rise. Brunell implies there are other common sense, easy-solutions that can fix our current health care system. However, many Americans believe health care needs a major redesign, saying tweaking isn’t enough.

Obamacare (formally the Affordable Care Act) was primarily an access bill, and only secondarily a cost control bill. Remember Obamacare was originally a Republican plan. The billionaire-funded conservative Heritage Foundation proposed the idea. Former president Richard Nixon embraced it because it preserved insurance companies. Once presidential contender Mitt Romney implemented it in Massachusetts. President Barack Obama adopted it hoping in vain for bipartisan support.

Liberals were disappointed. Many wanted Medicare-for-all, or a public option for single-payer. Single-payer systems eliminate insurance companies, lowering costs. Doctors and hospitals would remain private businesses, but the government administers payment, like Medicare. A public-option is a half-way measure where those who want private insurance can keep it, but others would be able to choose a system like Medicare.

All other industrialized countries have some form of single-payer. Guess what? They pay less for more. They have healthier citizens, at about half the cost.

Private insurance is inefficient.

According to a study reported in “The New England Journal of Medicine” insurance overhead added about 31 percent to health care costs. Obamacare limited administration costs to 15-20 percent. Democratic presidential candidate Bernie Sanders says Medicare administration is only 2 percent, implying Medicare-for-all overhead would be similar. Politifact says Sanders is only half correct, pointing out that Medicare shares costs with Social Security, and Medicare-for-all overhead would likely be more. Still, it sounds like significant savings.

Prior to Obamacare, the “American Journal of Public Health” estimated that 45,000 Americans died annually because of not having health care. In 2017, 28.5 million Americans still did not have health insurance, and preventable suffering continues.

Even with insurance, people die because millions forgo their medications due to cost. Going without high blood pressure medicine is common, and can be deadly. My wife was a critical care nurse and tells a tragic story of a self-employed woman who, during an economic down-turn, stopped her blood pressure medicine to save money. She suffered a massive stoke, and lost the use of much of her body. How do we, as Americans, benefit from a productive woman being crippled?

High deductibles cause many to forgo the treatment they need. The cost of not taking prescribed medications, alone, is estimated to be in the billions.

If the goal is a healthy America, it isn’t efficient for insurance companies to pay employees to find ways to deny coverage.

Insurance horror stories are common. Mine is having my insurance company tell me I couldn’t go to my surgeon, of 18 years, for a knee replacement. My surgeon’s group reduced prices by 3 percent at my insurance company’s request. Then my insurance demanded a 6-percent reduction, while raising their prices 14 percent. My surgeon’s association refused. Suddenly, my surgeon was “out-of-network.” After appealing, I was allowed to go to my trusted surgeon. But then my insurance company denied $8,000 of my bill on a technicality.

Obamacare was never completely implemented, and then was weakened by Republican attacks. While better than what we had before, it clearly isn’t sufficient to prevent needless suffering.

Are Americans awakening? A recent poll shows about 70 percent of Americans want Medicare-for-all. All the Democratic candidates have health care plans which go beyond Obamacare. Currently a single-payer bill, SB-5222 is in the Washington Legislature. California has similar plans. Why couldn’t California, Oregon and Washington form a single-payer health care coalition?

Billionaire Howard Schultz says it’s unamerican to do away with insurance companies. Is it patriotic to let Americans suffer needlessly?

Roger Ledbetter is a politically-active resident of the Valley. He and his family have lived in Snoqualmie since 1979. Contact Roger Ledbetter through the editor by email: editor@valleyrecord.com.

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