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OpEdNews Op Eds    H2'ed 1/18/17

The Murky Future for US Health Care

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President Barack Obama signing the Affordable Care Act
President Barack Obama signing the Affordable Care Act
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All eyes are on the Republicans and Obamacare, as the dominant GOP now proceeds toward dismantling President Barack Obama's signature healthcare policy plan, formally known as the Affordable Care Act. What they plan to replace it with is still anybody's guess.

I spoke recently to public healthcare expert and single-payer advocate Dr. Don McCain about the debate, the negatives and positives of Obamacare, and what kind of healthcare system we need in the U.S. to really attend to the medical needs of all people.

McCain, a senior health policy fellow with the group Physicians for a National Health Program, said recently about the current debate, "President Obama meeting with the Congressional Democrats, and Vice President-elect Pence meeting with the Republicans are being touted as a strategy efforts on the two opposite sides of the healthcare reform debate. But are they really opposites?"

Dennis Bernstein: What do you mean by that? Aren't they opposites? It does seem like the Democrats are on one side, and the Republicans are on the other.

Dr. Don McCain: That's certainly the way they framed it. Of course, they passed Obamacare. The Democrats passed that even though it was a Republican plan. And now the Republicans claim it's a Democrat plan that has to be repealed. Yet, what are they talking about, as far as reform is concerned? They are talking about tweaking our current system. Well, that's all that Obamacare did.

We have a highly dysfunctional system, fragmented, with extreme administrative excesses. And a system that doesn't function very well because it leaves people with insurance in debt. It leaves too many people uninsured and takes away choices for our healthcare providers, through these narrow networks that are increasing in prevalence.

The Democrats did improve that, but the improvements were very small compared to what needs to be done. The Republicans would turn around, and maybe repeal some of those things, and then introduce their own tweaks. But these are all only tweaks to our current, highly dysfunctional, wasteful, fragmented system.

So the opposite would be an integrated, universal system that provides healthcare to everyone, and eliminates this profound administrative waste. And gives people their choice again. Of course, that's a single payer, national health program commonly known as an improved Medicare For All -- fixing Medicare, and providing it to everyone.

DB: Well... the Republicans would say that's a budget buster, that's a big government program, that's socialism, and ultimately it will be a disaster.

DM: Of course, it is paid through taxes but we already... two-thirds of our healthcare is already paid for through the tax system. In fact, we pay more in taxes for healthcare in the United States than other nations pay for their entire healthcare system.

So tax isn't the problem. Getting the tax right is the problem, and we've got to make it much more equitable through progressive taxes where everyone can afford to pay the taxes that we would need to run the system. But it doesn't bust budgets.

In fact, the efficiencies of a single payer system actually slow down the increases in healthcare costs. So we would not be having these high increases every year. Yeah, there's been slowing for a couple of years, but they haven't really fixed the fundamental defects, whereas through a Medicare-like system, they do control healthcare costs, much more effectively. So we would all be ahead and we would all have health care.

DB: ... Let's do a compare and contrast: Under Obamacare, how does the U.S. system compare to, say, Europe?

DM: It is much less efficient [with] extreme administrative waste. We pay about a trillion dollars a year in just administration of our system. It's because it's this fragmented system of multiple programs, and other reasons, for the excesses. We could recover about one-half of that trillion dollars, and redirect it into health care. They don't have that in the European systems. They have much more efficient financing systems. None of them pay near what we do, in administration.

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Dennis J Bernstein is the host and executive producer of Flashpoints, a daily news magazine broadcast on Pacifica Radio. He is an award-winning investigative reporter, essayist and poet. His articles and essays have appeared in The New York Times, The Boston Globe, The Nation, and (more...)

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