By Eve Shapiro, M.D. and Richard Wiebe*
As paychecks disappear for millions of Americans, so does their health insurance — at the worst possible time.
The COVID-19 pandemic exposes the most fundamental flaw of the for-profit health insurance system: Lose your job, lose your healthcare. Over 44 million Americans have filed for unemployment benefits; the Kaiser Family Foundation estimates that 27 million will lose their health insurance.
Medicare for All means healthcare for all – with or without a job. It operates under the principle that healthcare is a right, not a privilege reserved for those who can afford it. When you get sick, you go to the doctor with no worries about deductibles and co-payments.
Dental, vision, prenatal and mental health care, women’s health and long-term care are included. Patients would have greater access to mental health and addiction treatment. Hospitals would be paid under a global budgeting system, which would prevent the closure of many rural hospitals — a critical challenge faced in communities across the nation.
Recent polling shows that most Americans now support Medicare for All, including a growing number of conservatives who recognize the gross inefficiencies of the for-profit system.
Twenty million more Americans have healthcare coverage because of Obamacare, but millions are still unable to afford basic preventive care and treatment for illnesses and injuries. Americans pay $1 trillion more for healthcare than the Swiss, who have the second most expensive healthcare system. This equates to $8,000 in costs for the average U.S. household, according to Princeton University economists Anne Case and Angus Deaton.
The $8,000 can be viewed as a tax, the economists say, which is imposed on everyone regardless of their ability to pay. We don’t get much for that $8,000; life expectancy is lower in the U.S. than in Europe.
Although more people have health insurance, a growing number of Americans are avoiding medical treatment because it’s still too expensive. Dr. Laura Hawks of the Cambridge Health Alliance and Harvard Medical School found that even those with chronic conditions skip doctor visits because of co-payments, deductibles and other out-of-pocket expenses.
Much of America’s medical cost burden is consumed by waste. A study published last year by the Journal of the American Medical Association estimates 20-25 percent of total healthcare costs – $760 billion — are wasted. This is comparable to what the federal government spends annually on Medicare.
Administrative costs – time and money spent billing and reporting to insurers and public agencies – are blamed for $266 billion in waste. Removing that cost would be enough to insure 20 million people, or three of every four people uninsured before the pandemic. Traditional Medicare operates with administrative costs of about 1.1 percent, which increases to seven percent when private Medicare plans are included. Both compare favorably to the 13 percent private insurers now spend on administrative costs.
It’s not that Trump has a better idea. Republicans have never offered a viable alternative to Obamacare. Let the free market determine what we pay, they argue. Insurance and pharmaceutical companies can charge anything they want. The less fortunate can fend for themselves.
Although we spend far more on health care than any other nation, the World Health Organization ranks the United States only 37th for affordable health-care availability and quality. Healthcare costs are the leading cause of personal bankruptcies in the United States. This reality is costly and morally unacceptable. We don’t need to spend more on medical care; we need to spend smarter. The COVID-19 crisis is an opportunity to do the right thing and implement Medicare for All.
*Dr. Shapiro and Richard Wiebe are PC’s in LD 9.