There is growing public awareness that our current health care system costs more and often delivers less than that of any other country, and there is growing support for single-payer, universal health care. The most famous plan is Sen. Bernie Sanders’ Medicare for All Act.
I recently participated in a campaign to collect signatures to put the issue of universal health care before the Maine voters. While the campaign fell short, I learned a few things. A healthy majority of those I met were supportive but had questions and concerns. I’ve collected a few of them here, along with my answers.
1. This is Bernie’s idea, and I don’t like Bernie.
We may not embrace the entire agenda of the senator, but we must be willing to adopt the best ideas, whether from the left or the right, in making public policy. Slavic adherence to ideological imperatives closes minds and stifles creativity.
2. It is socialized medicine.
No, it isn’t. The entire delivery system – hospitals, doctors’ practices, pharmacies, testing laboratories, etc. – remains under private ownership. It is only the social insurance function that the government performs and, as demonstrated with current Medicare, performs well.
3. It takes away our freedom to choose.
The only freedom we lose is struggling to choose from the confusing packages of benefits, prices, deductibles, co-payments and exclusions offered by private insurers. Those with employer-sponsored plans must accept what the employer offers. The freedom we care most about is choosing our providers, but private insurers have restrictive networks. Medicare does not.
4. We must allow the invisible hand of the market to work its magic to control costs, not the government.
I am a firm believer in free markets. For ordinary trading, there is no better way to discover the price at which supply will meet demand. But when there is monopoly power and lack of transparency on the supply side, as is the case with health care, markets fail and the government must intervene. And private insurers have a conflict of interest. They have interests in both profits and the health of their subscribers. When profits are down, we know what must be compromised. With ordinary goods and services, businesses can increase profits by cutting costs. Private insurers are tempted to do this by refusing pre-approval of tests and procedures or by denying claims after the fact.
5. We can’t afford it.
Many studies have shown that we can. One study, published in 2020 in The Lancet, a peer-reviewed medical journal, showed that the Sanders plan could guarantee coverage with generous benefits to all and still reduce national health care spending by 13.1 percent, or $458 billion a year. can reduce It also showed that 68,500 American lives could be saved each year.
6. It will take away jobs from workers in the insurance industry.
Some proposals include plans to mitigate this, including funding for early retirement, retraining programs and relocation expenses. Any change in the economy that benefits society as a whole will inevitably displace some people. We must accept this, but make provisions to assist them.
7. My taxes will go up.
It helps to think of deductions for health insurance premiums as taxes we already pay. This will be replaced by a tax/premium adjusted for ability to pay. This would be instead of, not in addition to, what one pays now.
A final thought: If I decide to oppose universal health care, I will need to identify the group of people to exclude. I couldn’t do it and I don’t believe anyone could. So we are all supporters of universal health care. Health care should be considered a public good, like fire protection, infrastructure, national defense, etc. We leave no one out, not even those who, for whatever reason, are not thriving in our highly competitive economy.
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