Single-payer system could remove burden from employers

By Jack Lohman

Source: Milwaukee Small Business Times

Think about it. They now have a filibuster-proof Congress, and if health care fails in 2009, it’s the Democrats’ fault. They can’t even blame the Republicans for their normal obstruction, as they no longer need a bipartisan bill.

President Barack Obama didn’t count on that when he was making all those campaign promises, but now it’s 100-percent his baby. He supported a single-payer plan, though he left some wiggle room in case Congress split. But it didn’t. The Dems now have total control and they don’t want it!

Single-payer is the most cost efficient system for our nation and is the most humane. You get sick, you get care and the caregiver gets paid. Nothing could be simpler. And though Medicare is not perfect it is indeed the least costly system of all with full physician choice, no wait times and no rationing.

But our politicians have a problem. Both Democrats and Republicans have shared in the $46 million in campaign contributions from the insurance industry. Needless to say, what is in the best interest of the nation is exactly opposite to the best interest of the for-profit insurers. The 22-percent saved comes right out of their pocket.

The question is how do we pay for it as a universal program? But first let’s understand who’s paying for it now.

Everybody is. We pay in cost-shifting, bankruptcy costs, and lastly, when businesses add their employee health costs to their product price and we reimburse them at the cash register.

In the process we make our businesses highly uncompetitive with foreign products, which often forces employers to build their products in countries that do not burden them with health care. We make more cars in Canada than in Michigan because their health care costs are $800 per employee per year and ours is $6,500. That adds $1,500 per car.

Flat out, businesses should not be involved in providing employee health care at all, but that leaves either individual insurance or a public pool. Our politicians should create a single-payer Medicare-for-all system that is funded by our national infrastructure instead of the mish-mash of payments and non-payments. That’s what most advanced nations have done, and it works.

Over 31 percent of health care costs are consumed by the make-work insurance bureaucracy; as compared with the 9 percent needed for a single-payer. A huge savings to the public could be had.

With a single-payer system you see your same doctor and go to the same hospital as before. The only thing that changes is where they send the bill, and most people could care less about whose logo is on the invoice.

The beauty of Medicare is its simplicity. Everybody gets care, everybody pays into it through progressive taxation, companies are freed of the expense, jobs are increased, 100 percent of the public is covered, and consumers save $400 billion per year in reduced overhead.

The current for-profit system includes extra premiums to offset high CEO salaries and bonuses, broker sales commissions, shareholder profits, actuarial and gatekeeper costs, and even their lobbying and campaign contributions which are passed on to the patient.

Isn’t it nice to know that your politician is getting a piece of your private health care dollar? That’s why politicians always prefer private companies over government entities; one can give campaign cash and the other can’t. That’s why they choose to leave insurers in the loop.

Bottom line; most people would rather spend $500 per month in taxes to pay for an all-inclusive system than $700 per month for an exclusive system that doesn’t give better care and drives jobs out of the U.S.|

And all doctors and hospitals will be privately run and you’ll have 100-percent choice. What’s not to like about that?

But get this: our problem today is not health care, it’s political. Your politicians need to hear from you, and your voice must be loud if it is to drown out the moneyed interests. Your politicians work for you, not them.

6 Responses to Single-payer system could remove burden from employers

  1. We have a very serious problem with health care, and a lot of other things as well.

    We have absolutely the best doctors and nurses and hospitals in the world, if you are lucky enough to have access to them.

    But you must (a) have a job, with (b) an employer still willing to provide health care, or (c) otherwise can afford insurance coverage on your own. Or be a politician with a gold-plated policy funded by the taxpayers, or have Medicare that is also funded by the taxpayers.

    We must expand Medicare to 100% of the population, but the insurance industry doesn’t want that because they’d lose their 31% take on 16.5% of our GDP. And they are willing to pay big dollars to protect their position. The $400 billion per year we’d save would be their profits, and that’s a no-no.

    Unfortunately, we have a corrupt political system with politicians willing to take campaign cash and protect the insurance industry at the expense of the public. Money, incidentally, that originates from health care premiums. So our politicians are getting a piece of every “private” health care dollar.

    And now we expect them to fix the system?

  2. ezag says:

    This is a recent comment about an “optout” of a physicians practice from Medicare.

    “We opted out of Medicare because the service won’t pay for phone consultations, won’t pay for email consultations, barely pays for an office visit, and does not pay nearly enough to cover a house call.

    All of these services are critical to our medical practice. Medicare would require us to hire too many staff, as well as require us to do too much paper work and administration. I cannot afford to invest in either and still manage to operate in the black. Medicare has too many regulations and rules; we can’t understand a lot of them, and frankly, Medicare doesn’t seem to understand them most of the time either.”

    Underpayment by Medicare is estimated to be 20-30% of the necessary reimbursement for sustainable health care availability.

    As I understand your position, these reimbursements will improve (despite current financial stress)in time to prevent a loss of physicians.

  3. The last 25 years of my business life I owned a mobile echocardiograph service that we provided to doctors. We charged $300 per test and the doctors charged Medicare $400, a 33% markup that also included their overhead and interpretation. However, they would bill the privates up to $1800 for the same test; a 600% markup. You can well imagine why your friend prefers the privates over Medicare.

    But your doctor’s story doesn’t hold water. In Wisconsin there are 1500 insurers he’d have to contract with, and most doctors claim more problems with “private” gatekeepers and spending hours on the phone with a nurse at the insurer’s office trying to justify his treatment. Over 59% of doctors support a Medicare-for-all system, and almost all would see a decrease in staff because of only one insurer to deal with.

    The 20-30% loss is not possible, else (a) we wouldn’t have 59% physician support and (b) my doctor would not be reminding me monthly that my yearly checkup is overdue. He’d be happier than hell if I were to stay away. See http://www.pnhp.org Your doctor friend is not the usual.

    And besides, IF we had a Medicare-ONLY system the Feds would have to pay fairly or they wouldn’t have any doctors left. That isn’t going to happen. But the doctors making $1M per year are likely going to have to make do on $300-500K.

  4. ezag says:

    Those cardio economics were only possible because the hospitals were charging the same or more. The reason: they care for people that don’t pay and pass much of the cost on to private insurance.

    Under the proposed system, the number of people that don’t pay may go up…not down. Most of the people that don’t buy insurance now are (usually single) young men. I think they will continue to refuse. It is a very large de facto tax increase on people that use very little medical care. Even advocates are admitting that about 2/3 of the uninsured will remain uninsured.

    You are right about doctors leaving the system, what you have wrong is that reimbursements will increase. Medicare (already under paying) is proposing an 11% cut in reimbursments for next year). Already many doctors have opted out of Medicare either by quitting the system entirely, or limiting new Medicare patients.

    By the time that it is apparent that the supply of doctors has been ridden into the ground, there will be a gap in availabilty right at the peak of baby boomer retirement. I hope your doctor is young…if he retires, you will be out of luck.

  5. Under the current system some overcharging is necessary to cost shift for the uninsured and charity care and bankruptcies. But under a Medicare-for-all system those would not exist. You are confusing Medicare-for-all with something else. The number of nonpayments will go to zero because everybody will have Medicare. The young will not have to “buy” insurance because Medicare will cover them. And I doubt that doctors will opt out, unless they also received training in plumbing.

  6. ezag says:

    Under the proposed system, plumbing might pay more.

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