Why Medicare for all makes sense
By Kirk Caraway
Every once in a while in the process of writing a column, I come across a tangent that begs to be explored further.
This is what happened last week when I was researching the State Children’s Health Insurance Program, known as S-CHIP, which President Bush had just vetoed.
Looking into the legislative history of this bill, I found out that Republicans had managed to strip out a provision that would have ended a multibillion-dollar subsidy for private insurance companies as part of the Medicare Advantage program.
What it boils down to is that the program was set up to compete with traditional Medicare, but companies found that they couldn’t match Medicare’s efficiency. Customers voted with their feet and began leaving the private policies. To keep the program going, a subsidy was tucked into the Medicare prescription drug bill in 2003, allowing for these private companies to be paid an average of 12 percent more per patient than standard Medicare. This overpayment is expected to drain $54 billion out of the already-strapped Medicare coffers over the next five years.
So, the same Republicans who complained about the $35 billion cost of providing kids with health insurance had no problem handing out $54 billion in subsidies to their insurance industry friends.
We could justifiably rail about the depths of hypocrisy that today’s GOP has sunk to concerning health care policy. But that would miss the bigger issue and the bigger opportunity.
All the top Democrats running for president have their own health care plans, which are mixes of public and private insurance and a few tricks to make it sound like they will actually work. But they all ignore that there already is a system that works.
Medicare has proven it can provide health care better and cheaper than private insurance companies – so much better that it takes government subsidies for private companies to compete. And they do this for seniors, a population that has much higher health care needs than the rest of the country.
So why not provide Medicare for everyone? Why not let anyone who wants coverage buy into the system? And why are there no Democrats pushing this option?
For the same reason the Republicans ditched their free-market principles to keep the subsidy gravy train flowing.
None of today’s politicians are truly going to bite the hand that feeds them. The health care industry has successfully bought off everyone in any position of power that could make any real change. If anyone thinks that whatever Democrat finds him or herself in the White House is going to make the kinds of fundamental changes needed to reform health care in this country, I have a bridge to nowhere I’d like to sell you. Sure, they will make some changes around the edges, maybe slow the rising costs a little.
But I’ll bet that it will take something far more shocking than the next election to make any real reform.
That is a shame, because expanding Medicare would be the most simple and effective reform for this ailing system. And let the private companies compete. If they can find ways to do it better, then we all win. But don’t keep giving them handouts to make up for their inefficiencies like we do now.
Naysayers will point out that Medicare is facing a looming financial crisis in about 15 years. But this is a problem with the funding, not the system.
If everyone pays for their own coverage under Medicare, plus a couple of percentage points over, it would cover its cost and help cover care for the people in the system now.
And as Medicare expands, its power to help control costs will expand as well. Throw in an added bonus by letting Medicare negotiate for better prices on prescription drugs, and then you have some real reform.
But don’t hold your breath. It will take a lot of pressure from Americans to get the politicians of all parties to ditch their sugar daddies and sign on to any such effort.
At least we need to get them to discuss the issue. Maybe Medicare isn’t the answer. But it doesn’t look like private insurance is the answer, either. We need to keep reminding our elected officials that they need to answer to us, not the lobbyists, if they want to keep their jobs.
— Kirk Caraway is editor of NevadaPolitics.com and also writes a blog on national issues at KirkCaraway.com.