President Obama and the Democrats who currently run Congress have been hoist on their own collective petard by their craven and gutless refusal to consider adopting a Canadian-style single-payer system to finance health care in the US, or simply to expand Medicare, which is a successful single- payer program, to cover everyone, instead of just people over 65 and the disabled.
Instead, because they are the recipients of tens of millions of dollars in legal (and probably plenty of illegal) bribes from the health care industry, they have cobbled together a “reform” in name only, which preserves not just the central role of the vampire-like health insurance industry, but also ensures the continued rapacious profitability of the other segments of the medical-industrial complex–the hospitals, the pharmaceutical industry, and the specialist doctors.
Now, like Hillary and Bill Clinton before them, these weasels and slimeballs who pose as the people’s advocates are left with nothing but a Potemkin Health Plan that looks on the outside like a reform, but that changes little or nothing, leaves vast numbers of Americans uninsured, forces tens of millions to buy crappy plans from private companies, and that will end up doing nothing to halt the continuing rise in health care costs that is bankrupting the people, employers and the country.
Nice going guys!
Let’s for a moment consider what could have happened (and what could still happen if the American people would descend on Washington with pitchforks and firebrands in hand to demand it!).
Medicare, which is wildly popular among seniors and the disabled according to every poll I’ve seen, currently covers 45 million of the highest-cost segment of this country’s 300 million people–its elderly and its permanently disabled. It does this at a cost of $484 billion.
Now that’s a heck of a lot of money–about 13% of the federal budget–but it’s money well spent. We’re talking about our parents and grandparents here, after all, and because they’re all covered by a government single-payer plan that pays virtually all of their doctors’ and hospital bills, we don’t have to pay those bills for them out of our own pockets. Okay, there are problems–the drug industry managed during the Bush/Cheney dark ages to get a prescription drug law passed that bars Medicare from negotiating group discounts for drugs, and that has added enormous rip-off costs to the program, but that’s just another example of corporate scamming of the system that needs to be fixed. And I know that Medicare is not as good as it should be–leaving out important tests, and requiring people to buy supplemental insurance. But it’s still better than all but the most expensive private insurance plans.
The important point that needs to be made is that according to Medicare analysts, 10 percent of Medicare beneficiaries account for fully two thirds of the total annual cost of Medicare.
What that tells you is that the cost of treating that 10% of the elderly is $320 billion, while the healthier 90% of the elderly–roughly 40 billion people–only cost $160 billion a year to care for.
Now, given that the rest of the population under 65–about 255 million people–need on average far less care than the 90% of seniors who are in that lower-cost group, extending care to them all would clearly cost less than $1 trillion. Add in the cost of the 10% of high-cost elderly, and you’ve got a total bill of $1.34 trillion to care for everyone in America.
That’s a big number, but now you need to subtract out the total cost of Medicaid–the crappy program that, primarily funded by the states through income and sales taxes, pays for the crappy care of the poor. That would be about $400 billion in 2009. So now we’re down to $944 billion to care for all Americans. But from that we need to subtract the cost of Veterans health care–another successful single-payer program that already cares for veterans (or at least some of themit’s grossly underfunded). If we had a single-payer system for all, we could just fold the Veterans Hospital system into the national program. That would mean eliminating another $100 billion that would be saved (because remember, we calculated that original expanded Medicare budget for covering all 300 million of us). So now we’re down to an annual budget of $844 billion for a single-payer program to cover all Americans. Finally there is uncompensated care provided by hospitals to those 47 million Americans who have no health insurance but who don’t qualify for Medicaid. This care, such as it is, is funded in two ways–one by state and county revenues, which come out of state income and sales taxes and also out of local property taxes, and the other is in the form of higher hospital charges and insurance premiums and Medicare costs for the rest of us. Uncompensated care is estimated to cost about $200 billion, all of which would be eliminated if we had a single-payer plan for all.
Okay, so now we’re down to a total net cost for a national single-payer program of just $644 billion. Now remember, we’re talking about expanding a single-payer program that we already have in place, that doctors and hospitals are already familiar with, and that the people who use it already like. And expanding it to cover everybody, instead of just the old and disabled would only cost an added $160 billion, or just 33% more than it costs now to cover only the old and disabled. In these days of trillion-dollar Wall Street bailouts, $160 billion is almost chump changeheck. Heck, it’s less than the cost of a year of war in Afghanistan.
Sure it would still mean a modest tax increase for everyone (to figure out how much, just look at your check stub, find the Medicare tax deduction, and multiply it by 1.33. Then double that to account for the employer share of the added funds). But wait, all you anti-tax nuts! Before you start freaking out at a tax hike and waving those little teabags Fox TV got for you, there are more savings we haven’t considered.
If everyone is covered by Medicare, that means no more out-of-pocket payments by you for doctor bills. No more co-pays. No more deductibles that you have to pay yourself before your health insurance kicks in. No more employee contributions to health insurance premiums, which these days more and more employers are forcing us to pay. That’s a lot of money. For many families, it adds up to thousands of dollars a year. But there’s more. Your employer, if the company is one of the one-in-three that still provides and pays at least something towards health benefits for its workers, would be off the hook. That would free up a lot of money that could go to higher wages and salaries for workers (especially if you have or get yourself a union to make sure that the managers pass the savings on to you and don’t just pocket it or pass it along to shareholders). We’re talking about big savings here. (Incidentally, we’re also talking about ending the feudal relationship that has you afraid to talk union, or even to talk back, or speak up, to your employer, for fear of losing not just your job, but your and your family’s health insurance. We’re talking about liberating you from a major shackle.
So while yes, your taxes would go up a bit to expand Medicare to all, it wouldn’t be by much, and on the plus side, you would be saving an enormous amount of money, making the added tax bite easy to swallow (and remember, your state and local taxes could be reduced).
Why didn’t Obama and the Democrats tell you all this? Why does Obama continue to diss single-payer, as he did to the American Medical Association, and as he continues to do, claiming it is not in the American addition, as though he never heard about Medicare?
Well, as a matter of fact, some people in Congress, notably Reps. John Conyers (D-MI), Dennis Kucinich (D-Oh), Anthony Wiener (D-NY) and 83 other members of the House are pushing a bill, HR 676, which would do exactly what I’m suggestingexpanding Medicare to cover everyone.
It is being opposed by the Congressional leadership to the point that advocates at one committee hearing were ejected and arrested for even mentioning the term single-payer. With the blessing of the White House.
Clearly, Obama and the Democratic Party and Congressional leadership are in bed with the health care profiteers. Otherwise, why wouldn’t they at least have the Congressional Budget Office do a formal analysis like I just did here in simple form? Clearly too, they think we’re just too stupid to understand that higher taxes to pay for single-payer would be more than compensated for by the amount of out-of-pocket savings we’d realize if we didn’t have to pay for health care on our own.
There is no other excuse for failure to do the obvious, and have America adopt some version of the kind of health care system that has been proven to be more effective and far, far cheaper than our own in every other developed nation in the worldand in many less developed nations, too.
My question: How long are we going to stand for this crap?
DAVE LINDORFF is a Philadelphia-based journalist and columnist. His latest book is “The Case for Impeachment” (St. Martin’s Press, 2006 and now available in paperback). He can be reached at firstname.lastname@example.org