Get rid of the insurance companies

(MGN Online)

Last week, the big drama was about “Trumpcare.” It was defeated by the president’s own party. He said move on and let the ACA ex- (or maybe im-) plode.  Some talk about a bi-partisan approach to a “fix.” I strongly disagree. I see this as a golden moment to structure a real, effective healthcare system based on the idea that healthcare is a right of every citizen.

It seems to me that the AHCA and the Affordable Care Act (ACA) were literally written by and for the insurance industry. Both laws are based on the idea that healthcare is a commodity and therefore is a vehicle for increasing profit. We all have suffered the consequences and know this is not working. The current system is in crisis and the proposed AHCA would only have made things worse.

Tens of millions of people are without insurance, tens of millions of people are also under-insured. They have health insurance, but they still can’t afford the care they need. The quality of employer-based insurance plans is being eroded as they become less comprehensive and more like the high-deductible plans sold on the health insurance exchanges. Republicans heard all this at recent town hall meetings.

In addition to the health care crisis, the whole insurance system is out of control. One of the biggest wastes of health care dollars in the U.S. is on administration. One-third of our health care dollars — hundreds of billions each year, is spent on paperwork to determine what policy a patient has, what that policy covers, where a patient can go for care, how much the patient pays, whether they have a deductible or co-payment, etc. This is because there are hundreds of insurance companies with different plans with different coverage, provider networks and out-of-pocket costs.

The cost of this bureaucracy is a burden to people who have health insurance, because it is included in the cost of the premium, and to health professionals and facilities that must hire staff to interface with insurance administrators.

Instead of getting rid of private health insurance companies, under the ACA, the government became a broker for them as people are forced to buy insurance policies. And the insurance companies are given hundreds of billions of dollars each year in subsidies while they continue to pay millions in salaries and bonuses to their executives.

The healthcare crisis continues because of the corruption of Congress by those who profit from the healthcare system. Tens of millions of people are without insurance and the number increases. Each year, the death toll rises when people cannot get adequate healthcare.

Both the ACA and the AHCA have failed their approach to correct the system. They do not cover everyone, do not control prices for individuals, fail to provide adequate insurance coverage and control costs for government.

Think about that. Every year, there are tens of thousands of annual deaths and hundreds of thousands of bankruptcies when the U.S. knows how to solve the problem. The solution has been in place since 1965 for the elderly and chronically ill. Medicare is an effective, proven solution that offers excellent health outcomes.

I believe that creating a national single payer health plan can be the smallest incremental step to take to solve the healthcare crisis. The private National Improved Medicare for All would create a national health care system that covers every person living in the United States. It would be financed through a progressive tax to ensure predictable costs to be paid up front. Barriers to adequate health care would be eliminated. Medical debt, the leading cause of personal bankruptcies and foreclosures, would be eliminated. There would be a single standard of high quality comprehensive coverage for everyone. A similar system, the Veterans Health Administration, has demonstrated that single payer ends disparities in health outcomes.

When people hear about NIMA, often the first thing they say is that we can’t afford it. The reality is that we can’t afford not to do it and we are already spending enough to cover everyone. The U.S. spends the most per capita on health care each year compared to all of the other industrialized countries. The U.S. spends even more in public dollars per capita alone than many other countries. Studies show that a National Improved Medicare for all would be less expensive than the current health system and that it would control health care spending.

A NIMA system would simplify the bureaucracy with one system using one set of rules. The administrative savings are estimated to be 400 to 700 billion each year. Each year, NIMA would allocate a lump sum to hospitals to cover costs. NIMA would control costs by giving hospitals global operating budgets, rather than charging patients for each individual item. The program would control costs by negotiating with pharmaceutical and medical device companies for fair prices.

The United States could provide high quality, comprehensive benefits to everyone for the amount of money currently being spent on health care, if we eliminate the waste. A national improved Medicare for All system would greatly simplify paperwork, control drug prices by negotiating fair prices and end commodity-based health care. Other industrialized nations recognize that welfare systems are inherently inferior to universal systems.

There is already an excellent bill developed by advocates for a national health plan introduced by Rep. John Conyers, (D-MI) HF 676, that has 73 co-sponsors.

Senator Bernie Sanders plans to introduce a similar bill in the Senate. There is, indeed, hope that we can create a healthcare system that really does care for people.


Art Serotoff welcomes reader comments to