Medicare-for-all or single-payer are hopefuls, but both are still subject to over-billing and fraud. And politicians.
By Jack E. Lohman
Mainly political corruption. Because with this system the insurance industry is not needed, or at best, it plays a minimal role by providing “Gap” insurance to cover co-pays and deductibles. Thus they are willing to pay big money to the politicians who block it.
Guys like Sen. Max Baucus (D-MT) and Sen. Mitch McConnell (R-KY) are high on their list, but should be at the bottom of yours. They have their own gold-plated taxpayer-funded health care plan, even after their retirement. They are fixed for life.
Single-payer is a term we use, because the taxpayer is that payer. Medicare, Medicaid, and BadgerCare are all in that category, but importantly they only provide the administrative services. It all cases the medical services are provided by the same private hospitals and doctors we are currently using.
It makes a lot of sense, but that’s exactly why it is having problems attracting politician support.
Getting rid of the high profits to shareholders, high CEO salaries and benefits, sales commissions, excessive legal fees for defending denials and cherry-picking, and the cost of political bribes is key. Still remaining as problems is the fee-for-service system of compensating physicians, which encourages over-ordering, and the lack of a Certificate of Need which discourages overbuilding and the purchase of expensive MRI and other high-tech instrumentation.
Deductibles and co-pays are generally counter-productive
They keep patients away from the doctor and allow minor problems to escalate to more costly problems. People sometimes just can’t afford them, and even so, their cost of administration is often equal to the payment. Yes, unnecessary doctor visits may result without them, but few people relish sitting in a doctor’s waiting room unless they feel they need it.
Getting single-payer on the table
Not an easy thing when politicians are paid to keep it off the table. About eight healthcare activists attempted to get it discussed and were arrested for disturbing the peace at a Senate Finance meeting. Just allow a vote on it, was all they asked. Sen. Max Baucus, with his $5 million from the healthcare industry, wouldn’t have any such thing.
From the public’s standpoint …
… single-payer makes sense, because it gets employers out of the business of providing healthcare and it allows portability — giving people the opportunity to quit their job and start a new business on their own — without the fear of killing healthcare for their family.
But it doesn’t make sense for the politicians because it will kill campaign contributions.
From a cost standpoint, a Medicare-for-all makes sense for the taxpayers AND the business community… the non-insurance businesses, that is.