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As imagined by Dave Lindorff
My Fellow Americans.
I stand before you a chastened president. I made a mistake. Two mistakes really. (wild applause from Republican side)I thought that Congress could do its job and through the deliberative process, produce a health care reform plan that would win broad support across the aisle and among all of you. But I'm afraid that I was wrong. Health care is an enormous industry--maybe the biggest and most powerful industry in the country--and it has far too much power in the nation's capital. Literally thousands of lobbyists, carrying tens of billions of dollars in campaign contributions--have invaded these halls (and my house!) (relieved laughter) and distorted the process, and in the end have stymied reform. (some hissing)
Meanwhile, I have realized that the answer has been staring us in the face all along.
And that was my second mistake. I told the American Medical Association that while single-payer medical plans, where the government is the insurer, might work well in other countries, the idea of government running health care was not part of our American tradition.
In fact, it is, and has been since 1965, when President Lyndon Johnson signed into law the Medicare program. Medicare is a classic single-payer program, and polls and surveys show it is enormously popular with older and disabled Americans. Medicare has relieved our parents and grandparents from the fear that they will not get medical care when they stop working, and it has lifted the enormous burden and worry off of younger Americans over how to pay for the care of their elders, and it has done this with enormous efficiency, all while allowing recipients to choose their own doctors and hospitals. (applause)
So we really don't need to re-invent the wheel here. There is no point in members of Congress having to hold endless hearings, and to sit and listen to the pitches of lobbyists from the medical establishment. We can just expand Medicare to cover everyone. (applause)
How much would that cost? Well, we know that 10% of the elderly--the oldest and sickest among us--account for 50% of total Medicare costs, so that means the other 90% only cost some $200 billion a year. Even if we assumed that the rest of the population's medical bills were as high as those 90% or older Americans, it would mean that expanding Medicare to cover them would cost less than $1 trillion a year, and probably closer to $750 billion. So roughly speaking, we're talking about adding $750 billion a year to the cost of Medicare.
Now that's a big number, and I know that some of you--a lot of you--worry about higher taxes. But let me assure you, expanding Medicare to cover everyone is going to save you money--virtually everyone. Let's look at why that is, and why you cannot just look at the federal tax when you consider those savings.
Today, the United States spends nearly 20 percent of GDP on health care. That is more than double what any other country in the world spends on health care. And you know what? We don't get our moneys'worth for all that dough. Canadians, who spend half that percentage of their GDP on health care, and who have what amounts to Medicare for all with their single-payer system (they call it Medicare too), have longer lifespans and better infant mortality statistics than we do. In fact, Cuba and Mexico have better child health statistics than we do!
By the way, I want to introduce, in the gallery, Shirley Jean Douglass, whose father, Tommy Douglass, was the founder of Canada's Medicare program. We will be consulting closely with experts and administrators of Canada's Medicare program as we move forward with our own reform. (applause)
Now I've been accused of lecturing (laughs and applause),
and I don't want to sound like a college professor here, but let me just highlight a few reasons why simply expanding Medicare to cover all of us makes not just moral, but also economic sense. If we were to make that change, we could immediately eliminate the Medicaid program, which as you know is funded by the states, and costs them (and you) about $400 billion a year, mostly to cover low-income families and individuals. Now that money would not be totally eliminated, because Medicare currently doesn't cover all health care costs--just 80%. And Medicais covers the remaining 20% for those elderly and disabled people who cannot afford to pay for Medi-Gap private plans. The government would still have to do that, for current recipients and for new low-income Medicaid recipients inan expanded program. Even so, eliminating Medicaid for the poor, who would be switched to Medicare, would save at least $300 billion. We could also eliminate the Veterans Administration--which incidentally is an excellent example of true government healthcare, with publicly owned hospitals and doctors on salary, and it runs very well and very efficiently. (smattering of nervous applause)
Something those folks at last month's town meetings who were saying government can't do anything right should think about. (wild applause from Democratic side)
Sorry. I just had to say that. (more applause and laughter)
