• Frank Romans

A Plea For Health Care

Since 1965, when President Lyndon B. Johnson signed legislation establishing Medicare and Medicaid, it has shielded millions from financial ruin due to medical expenses. Is it efficient? You operates with an overhead of only two percent. That compares to 20% in private health insurance. Even so, it is not a perfect system. Medicare has not adequately responded to the rising costs of health care, and the coverage is nowhere near robust enough. People over 65 spend an average of 20% of their income on health related expenses. Coverage should be expanded to include vision, dental, and hearing. As Senator Bernie Sanders has said "Last I heard, dental, hearing, and vision are part of health care."

One of the biggest obstacles to a national plan is our will to have it. Until we stop fighting about how to pay, and stop screaming socialism and communism from the rooftops, it won't happen. Until the public demands it so strongly, with a loud enough voice that can't be ignored, the politicians won't grant it. The struggle to provide health care is political. Here's a truth, and I'll just say it. There is no way to provide universal health care without a lot of government spending and regulation, Until there is agreement across parties, and the public elects those who are willing to stand up to the insurance industry, it will not happen.

The difficulty for us here in the USA in implementing a national system lies with the insurance industry, their powerful lobbyists, and the politicians they own. For those with money, the USA is a pretty good system. To those with terrific health care from their employer, like our politicians, it is a good system. For those over 65, with Medicare, it is a quite capable system. However, everyone else deals with a conglomeration of insurance companies, some private and some public, depending on the state where you live.

Fun Fact: Just seven insurers cover over half of the population. They are investor-owned, publicly traded companies. They have soaring profits and happy investors. Do you know what else they have? Powerful influential lobbyists. While the profits continue to climb, and our costs continue to escalate, we continue our race to the bottom. Compared to other developed countries, the US ranks near the bottom on infant mortality, life expectancy, and preventable mortality. How can we spend more on health care than any other nation and fare so poorly?

Medicare for All would decrease the inefficiency of so-called "job-lock." Unlinking health insurance from employment gives many economic options for workers. It would boost self-employment and the creation of small businesses. Nobody goes without care because of job loss. It benefits employers from the rising cost of providing health insurance to employees. It is a win for both employer and worker.

Opponents of a universal plan claim it increases wait times, stifles innovation, and causes a rationing of care. These common arguments are political demagoguery. The data is there to see...the wait times in most cases are similar in peer nations. They're selling you a falsehood. If we woke up tomorrow with Medicare for All, increased wait times would likely occur as a large part of the population entered the system for the first time seeking care. This would be short-term. In the long-term, it would lead to a healthier population thus lowering the economic costs of an unhealthy nation. Providing affordable, accessible health care to everyone could help us focus on preventive measures. I have an acquaintance in Europe, who gets bonus pay for riding his bicycle to work each day. Preventive measures lower the costs of an unhealthy population. I would suggest a multi-layered approach, a coordinated effort of public and private sector, that would focus on obesity, physical activity, and mental health. This type of system has worked in those Nordic region countries, but it has to start with all citizens given comprehensive health care.

Another argument against is the logistics. It is true, we are a very large country and implementation will be a challenge. It will have significant upfront costs. These costs will be offset by a healthier citizenry and ultimately less burdensome. If we fail to provide comprehensive health care to our people, and keep moving away from prevention, the economy of the US will suffer. The question is; Do we want it? Do we have the political will to demand it from our elected officials?

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