Why Fiscal Conservatives Should Love Medicare-for-All


Call me old fashioned, but a true conservative is someone who conserves, dislikes wasting money and is offended by endless corporate bailouts by hard-working taxpayers. A fiscal conservative like me. As a public health professional, I want to see health dollars used to keep people healthy through public health and wellness programs, as well as provide medical care when it’s needed.

We have a health care crisis in the United States. Nearly 50 million people do not have health insurance, and they are our family and neighbors.

There are 500,000 medical bankruptcies every year. Most of these half million families had health insurance; at least they thought they did because every month they paid for insurance. Millions of people have learned the hard way that for-profit sickness insurance does not prevent financial ruin during a health crisis.

One of the worst lies thrown around every time Congress debates health care is that the U.S. will end up with socialized medicine. Socialized medicine is when the government owns and operates health facilities as well as pays the salaries of the doctors, nurses and the rest of the healthcare work force.

Let me say as clearly as possible — President Obama and the Congress are not discussing, introducing or enacting socialized medicine.

Good old-fashioned U.S. socialized medicine

Today, the U.S. already has socialized medical systems serving more than 20 million people. The current U.S. socialized medicine systems are very popular. The largest in terms of numbers of people is the Military Health System. The largest in terms of numbers of facilities owned and operated is the Veterans Administration health system. Two additional smaller U.S. socialized medical systems are the Indian Health Service and the federal Bureau of Prisons.

Despite being socialized medicine, the VA is ranked the highest in a national survey of patient satisfaction by the University of Michigan. U.S. taxpayers own the 155 VA hospitals and 881 clinics; we employ 289,000 people working in the VA including 16,000 doctors and 42,000 nurses.

Even the bastion of capitalism, Fortune magazine, is impressed by VA health care, stating, “The seamless integration of science, information, and compassion is the dream of modern health care. Scenes like these are not fantasies, however, but daily realities at the Veterans Health Administration.” (Fortune, May 2006.)

Let me repeat, President Obama and the Congress are not discussing, introducing, or enacting socialized medicine. Unlike the socialized system military and veterans enjoy, most health care services are provided through a private delivery system. All reforms will build on the existing private delivery system.

2009 health reform debate

So now that we all agree that the President and Congress are not expanding socialized medicine in the U.S., what are they proposing? There are two basic options and neither creates a nationalized or socialized health care system.

Medicare for all: The first choice expands Medicare eligibility beyond its current limitation to elderly (over 65) and disabled individuals of any age. This is the most conservative, least-disruptive and cost-effective way to cover more people; it only takes a simple change to an existing, very popular program. Every time the Congressional Budget Office scores the cost of Medicare-for-all type programs, they pay for themselves through two key business principles, the power of bulk purchasing and administrative savings though the elimination of waste in the system.

Mandated insurance: The second choice forces taxpayers to buy for-profit insurance despite a wasteful administrative cost of $1 billion a day. Yes, a trillion dollars every two and a half years just for paperwork, not a penny of that for health care. As a fiscal conservative, I do not want to pay a secret corporate bailout so that greedy CEOs make bonuses based on how good they are at rationing care to sick people.

In this expansion of the current failed system, the U.S. spends more than twice as much per person than any other country and the excess cost does not result in better outcomes. The U.S. is about 37th in the world for life expectancy, infant mortality, and other indicators of health status.

We have to walk away from corporate rationing to create a seamless system with the highest quality services for the best price. The easiest way to hold down costs is to have the largest purchasing group possible to get bulk prices — this is the single-risk pool.

Especially in this economic downturn it is essential to help people get access to health care. Being creative now gives us the chance to create a brand-new system, an All-American plan.

False conservatives will parrot the corporate line and continue to bail out the failed sickness insurance system. True fiscal conservatives who want to eliminate waste, hold down costs and improve outcomes will support Senate Bill 703 and House Bill 676. All the other bills transfer tax dollars first into needless paperwork and corporate profits and then dole out whatever is left for medical bills.

The choice is clear. We keep our doctors and hospitals in the current private delivery system but let one public insurance plan handle the paperwork and pay the bills.

CAROL MILLER is a New Mexico public and rural health expert. She has public service in Washington, D.C., in both Republican and Democratic administrations, including the Clinton White House. In 1994 she was the health reform policy adviser for the National Rural Health Association and the New Mexico Secretary of Health. Miller, a former Commissioned Officer in the US Public Health Service, has used both the uniformed services and veterans health care systems.








Carol Miller is a community organizer from Ojo Sarco, New Mexico (population 300) and an advocate for “geographic democracy,” the belief that the United States must guarantee equal rights and opportunities to participate in the national life, no matter where someone lives. She is an officer of the Peaceful Skies Coalition.

December 01, 2015
John Wight
From Iraq to Syria: Repeating a Debacle
Conn Hallinan
Portugal: the Left Takes Charge
Mike Whitney
Putin’s Revenge? The Fight for the Border
Sami Al-Arian
My Ordeal: One of America’s Many Political Trials Since 9/11
Steffen Böhm
Why the Paris Climate Talks Will Fail, Just Like All the Others
Gilbert Mercier
Will Turkey Be Kicked Out of NATO?
Bilal El-Amine
The Hard Truth About Daesh and How to Fight It
Pete Dolack
Solidarity Instead of Hierarchy as “Common Sense”
Dan Glazebrook
Rhodes Must Fall: Decolonizing Education
Colin Todhunter
Big Oil, TTIP and the Scramble for Europe
Eric Draitser
Terror in Mali: An Attack on China and Russia?
Linn Washington Jr.
Torture and Other Abuses Make Turkey as American as Apple Pie
Randy Shaw
Krugman is Wrong on Gentrification
Raouf Halaby
Time to Speak Out Against Censorship
Jesse Jackson
It’s Time for Answers in Laquan McDonald Case
Patrick Walker
Wake Up Zombie, Kick Up a Big Stink!
November 30, 2015
Henry Giroux
Trump’s Embrace of Totalitarianism is America’s Dirty Little Secret
Omur Sahin Keyif
An Assassination in Turkey: the Killing of Tahir Elci
Uri Avnery
There is No Such Thing as International Terrorism
Robert Fisk
70,000 Kalashnikovs: Cameron’s “Moderate” Rebels
Jamie Davidson
Distortion, Revisionism & the Liberal Media
Patrick Cockburn
Nasty Surprises: the Problem With Bombing ISIS
Robert Hunziker
The Looming Transnational Battlefield
Ahmed Gaya
Breaking the Climate Mold: Fighting for the Planet and Justice
Matt Peppe
Alan Gross’s Improbable Tales on 60 Minutes
Norman Pollack
Israel and ISIS: Needed, a Thorough Accounting
Colin Todhunter
India – Procession of the Dead: Shopping Malls and Shit
Roger Annis
Canada’s New Climate-Denying National Government
Binoy Kampmark
Straining the Republic: France’s State of Emergency
Bill Blunden
Glenn Greenwald Stands by the Official Narrative
Jack Rasmus
Japan’s 5th Recession in 7 Years
Karen Lee Wald
Inside the Colombia Peace Deal
Geoff Dutton
War in Our Time
Charles R. Larson
Twofers for Carly Fiorina
John Dear
An Eye for an Eye Makes the Whole World Blind
Weekend Edition
November 27-29, 2015
Andrew Levine
The Real Trouble With Bernie
Gary Leupp
Ben Carson, Joseph in Egypt, and the Attack on Rational Thought
John Whitbeck
Who’s Afraid of ISIS?
Michael Brenner
Europe’s Crisis: Terror, Refugees and Impotence
Ramzy Baroud
Forget ISIS: Humanity is at Stake
Pepe Escobar
Will Chess, Not Battleship, Be the Game of the Future in Eurasia?
Vijay Prashad
Showdown on the Syrian Border
Dave Lindorff
Gen. John Campbell, Commander in Afghanistan and Serial Liar
Colin Todhunter
Class, War and David Cameron
Jean Bricmont
The Ideology of Humanitarian Imperialism