January 6, 2022
  • January 6, 2022

Jim Scofield | When will national health insurance be available? | Columns

By on August 20, 2021 0

How long are we going to resist national health insurance? Almost all countries have them, certainly all developed countries. Even Democrats are afraid to push him because they think he’s a loser in the election, although most Americans seem to be in favor of it, as the polls show. Republicans are against any health plan except private insurance.

Democrats appear to have abandoned their Medicare for All proposals in favor of a stronger affordable care law.

Representative Pramila Jayapal is still pushing her Medicare bill, which would cover everyone, but Democrats appear to be afraid to back it. Nonetheless, a high percentage of voters, around 45%, support single-payer healthcare, according to a Rasmussen report (April 3, 2020) and the majority of voters under 40 support it.

The new version of Obamacare (Affordable Care Act-ACA), included in the COVID relief bill that the Biden administration just passed, will allow many more people to sign up for Obamacare at a more reasonable cost. Tens of millions of Americans do not have health insurance, and many more millions have poor insurance.

More and more workers lost their jobs and their health insurance during the pandemic.

Medicare for All would not only cover everyone, but lower overall costs for Americans. In contrast, this new COVID relief bill will cover insurance for more Americans at a more reasonable cost, but increase overall medical costs in this country.

Of course, Republicans want to repeal Obamacare and replace it with something that claims to be better, but never proposed by the Trump administration or the party. Indeed, they have no other plan than to let the public depend on private insurance, which they or their employers, if they are lucky, pay.

Health care costs in the United States are already higher than those of comparable countries, 50 to 60% more than systems in the heaviest-spending industrialized countries, according to Consumer Reports.

The Commonwealth Fund reports that in 2016, the United States spent almost 18% of its gross domestic product on health care, while the average expenditure among all high-income countries was 11.5%. Per person shipment to the United States is about double that of parallel countries. For example, spending per person is about $ 9,000 in the United States, but only $ 5,000 in Germany, $ 3,400 in Canada, and $ 3,000 in Great Britain.

Many Americans face heavy medical expenses and even go bankrupt. Trying to get coverage on your own is a daunting task for most people. In other countries, most people do not face this struggle alone.

A recent Yale study published in The Lancet shows that Medicare for All will save Americans more than $ 450 billion a year. Claims that it will cost more, trillions, are false.

Yet unlike us, other countries cover everyone. The Commonwealth Fund ranks the United States last out of 11 high-income countries in terms of health. Infant mortality and material mortality in the United States are shockingly bad. Life expectancy is three years less than that of these comparative countries.

Getting rid of our multitude of single-payer medical insurance companies would save a lot of unnecessary expenses.

They create significant overhead costs for administrative costs in hospitals and physician offices that do not occur under single-payer plans like Canada’s. Other countries are negotiating with pharmaceutical companies to lower the price of prescription drugs.

Yet Congress has banned Medicare from taking such steps and has banned Americans from crossing the border to pay for cheaper drugs in Canada. Our hospitals, like Conemaugh Memorial Medical Center, are now owned by equity investors, such as private equity firms, which are not about medicine and are only about how much profit they can make from it, often by reducing the number of spare beds and rural hospitals.

Hospital conglomerates, medical insurance companies (multitudes of them) and pharmaceutical companies pay their many executives salaries of a million dollars a year (which increases insurance costs).

The top five CEOs of for-profit insurance companies earn between $ 10 million and $ 17 million a year. So-called non-profit organizations are hardly any better. UPMC pays more than 30 executives $ 1 million or more each year.

Health care should not be used to enrich the top ranks. Our monopoly hospital chains pay equally high salaries and, like all these chains, increase patient costs – monopoly ownership always increases costs, as all economists know.

“Health care prices are higher in the United States because Americans are covered by private insurers, and these companies pay much higher rates for the same health services as public programs such as Medicare” (moneycrashers .com).

Our current health insurance system, primarily for the elderly, has a low surcharge of around 2%, although Medicare is stuck with older and sicker patients. Compare that to for-profit insurance which costs on average around 20% overhead.

Health insurance companies, because of their financial interest, pharmaceutical companies and even physicians through the American Medical Association have controlled the debate in the United States. However, more and more physicians are beginning to favor health insurance for all, especially the youngest, favoring good health over financial interests.

Jim Scofield is Associate Professor Emeritus at Pitt-Johnstown.


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