By Dave Lindorff
I'm with Marcia Angell, editor of the New England Journal of Medicine. The Obama plan for health care "reform", as well as the two versions passed by the House and the Senate, are all devious disasters that do nothing to solve the nation's burgeoning health care crisis, and in fact, will make it worse.
The only thing to do at this point is to take the whole stinking pile of paper and put it in the compost heap. Kill it.
This whole effort was never about reform from the day last March when the new president called on Congress to begin deliberations on health care reform. It was about catering to the wishes of the big players in the Medical Industrial Complex--the big pharmaceutical multinationals, the hospital companies, the physicians and, most of all, the insurance industry. People and their health care needs had little or nothing to do with this.
That's why we've ended up with proposals that would do nothing to control costs, that would force health young people to buy unregulated, high-cost and high-profit plans that would be money in the bank for the insurance industry, and that would finance any subsidies for the poor by cutting back on benefits for the only group of Americans who currently have a form of single-payer insurance--the elderly with their Medicare.
President Obama began this whole obscene nightmare with a lie, when he said that even though single-payer systems clearly work to open access to all and keep costs down while providing better overall health results in places like Canada and some European countries, they cannot be applied in America "because that would mean starting over from scratch." He knew when he said it that this was a lie. America already has a well-run and successful single-payer healthcare program in place that is bigger than the entire Canadian health care system, and that's Medicare, which was established in 1965, and which currently finances the care of 45 million Americans. You just have to be 65 or disabled to be eligible for it.
As Dr. Angell pointed out on a recent Bill Moyers Journal segment, the simplest way to solve America's health care crisis would be to just start a gradual expansion of Medicare, say by lowering the age of coverage to 55, and then 45, and then 35, until everyone was covered and the insurance industry was pushed out of the health sector. The right-wing couldn't use their scare tactics about a "government takeover of your medical care," because the elderly love Medicare, and besides, far from "inserting a government bureaucrat between you and your doctor," Medicare gives the elderly a freer choice of physician and treatment than any but the most gold-plated private insurance executive health care plan.
Obama continued this lie when he claimed, in his last mention of the issue during his State of the Union address to Congress, that he and Congress had considered every idea. In fact, he and Congress have for the last year, carefully prevented any consideration of the idea of single-payer, or of expanding Medicare to cover every American. Bills that would do that, authored by Rep. John Conyers (D-MI) in the House and Sen. Bernie Sanders (I-VT) in the Senate, were in fact blocked from hearings or votes in both Houses by Democratic leaders, at the White House's urging, while the White House itself barred single-payer advocates from any of its discussions.
Instead the president met behind closed doors with the lobbyists of the various health care industries, to cut deals with each sector in order to gain their support for his "reform" plan. It was as if the Department of Justice had called meetings with the various crime families of the Cosa Nostra in order to cut deals before developing a plan to "tackle" the Mafia.
The plan being proposed to "reform" health care--actually they long ago stopped calling it health care reform, acknowledging that this was never even contemplated, and started instead referring to what it being contemplated as health insurance reform--is, we are told, going to cost about $100 billion a year. That wouldn't be bad if what we got in return was universal health care, but we don't even get that. Instead we have a measure that will reduce access to health care for the middle class by taxing benefits and encouraging higher deductibles, that will force the poor, the young and the self-employed to buy terrible, over-priced plans offering minimal coverage, that will chip away at the coverage provided to the elderly, and that will ultimately lead to higher costs for everyone, and that will still leave nearly 20 million people with no coverage. The US currently devotes 17.5 percent of Gross Domestic Product to health care, and if this "reform" in any of its guises is passed, that share of the economy devoted to health care will quickly rise past 20 percent, with no end in sight.
This is madness. Expanding Medicare to cover everyone, as I have written earlier, would actually save everyone money immediately, and the country as a whole. Consider that the most expensive consumers of health care--the elderly--are already in the system. Adding younger, healthier people to Medicare would cost incrementally much less. That's why the Canadians spend about 9 percent of their GDP on healthcare, while covering every Canadian, while we spend nearly twice as much and leave 47 million of our citizens uninsured and unable to visit a doctor. How could it be cheaper to add everyone to Medicare? Expanding Medicare to cover everyone would probably cost somewhere between $800 billion and $1 trillion a year. That sounds like a lot of money, until you consider that we already spend $100 billion a year to care for veterans through the Veterans Administration, and $400 billion a year to care for the poor through Medicaid. We also spend $300 billion a year subsidizing hospitals that have to provide "free" charity care to the poor who don't qualify for Medicaid, too. Since all those people would be covered by Medicare under Medicare-for-All, that's $800 billion a year in current expenditures saved right there.
So even if my higher figure of $1 trillion for adding everyone to Medicare were correct, we'd only be talking about an extra $200 billion annual expense. And that could be covered by increasing the Medicare tax paid as a payroll deduction. You don't want to pay more taxes? Well wait. If you were covered by Medicare, you and your employer would no longer have to pay for private insurance, which would mean a savings to workers of thousands of dollars a year, and even more to employers who currently pay the majority of health insurance premiums for employees. The net savings would be enormous.
Nobody has talked about this.
Universal Medicare would make American companies more competitive in the global marketplace, where other companies are not responsible for health care costs of their workers. It would make Americans wealthier, because they would no longer be paying for health care out of their own pockets. It would make everyone more secure, because they would no longer have to fear losing access to health care if they lost their job, and would eliminate most bankrupties, which are reportedly caused by medical bills.
So we know what needs to be done.
And we know that the current "reforms" on offer don't do it.