August 16, 2012 by David K. Sutton
We Can’t Have Medicare-for-All Because Conservatives Need a Bogeyman
Health care costs keep rising rapidly, and even when the Affordable Care Act fully kicks in (2014), the expectation is that cost increases, while tempered, will still be unsustainable. There are many ideas, solutions and hybrid solutions to tackle rising health care costs, but at its most fundamental level there are two approaches, and only one makes sense in the long run.
Choice 1 – The Private Insurance Market
If you put aside any sense of critical thinking the idea of a private insurance market where many private insurers compete for your business sounds like the best way to control costs. And to be sure, this is the defacto Republican position on everything, not just health care insurance. See, conservatives inherently distrust people. They distrust people so much that they say the only fair and equitable way to solve big problems that affect everyone is to let the market sort it out. They say the market has an invisible hand that guides it to the best outcome, and anytime you add human beings into the equation you will always introduce special interests and biases. Well, I have news for conservatives, the market is run by human beings. There is no way to remove special interests and biases from any human-invented entity. So what really matters is the motivation behind the entity. If we are talking about the market and private insurance companies, the motivation is money. The motivation is profits. I’m not saying that people working for these companies are uncaring, but their primary goal in their jobs is to make the company successful. The most optimum outcome from that primary objective does not necessarily equate to a fair and equitable universal health care system for all citizens.
Choice 2 – A Central Government-Run Insurance Program (Medicare-for-All)
Republicans and conservatives have spent so much effort over the past 30 years demonizing government they are unwilling (or even unable) to accept when a public-run solution to a problem is the best solution. All we have to do is look at Medicare which is a government-run single payer health care system. Republicans and conservatives have labeled President Obama and Democrats as evil socialists because of “Obamacare” yet the Affordable Care Act is less socialist than Medicare. The Affordable Care Act is not an insurance payer, it’s simply a set of regulations that makes health care insurance more accessible to the millions of Americans who lack health care insurance. The Affordable Care Act also mandates a number of insurance requirements to improve coverage for all Americans. But under the Affordable Care Act, you still have private (for-profit) insurance companies. There is no public insurance option.
Medicare on the other hand is a single payer insurance system, but it’s only available to seniors (65 and older) and people with disabilities. Medicare does have solvency issues, and the Affordable Care Act begins to address these issues. The $716 billion that you hear Mitt Romney, Paul Ryan and other Republicans talking about (they say Obama steals from Medicare to pay for Obamacare) is part of the reforms that the Affordable Care Act begins to make to address the solvency issues with Medicare. This $716 billion cut from Medicare is not a reduction in benefits to seniors (as Republicans would have you believe), it is instead cost savings in the form of reduced payments to hospitals (they agreed to this) and cutting over-payments to private insurance companies. So, the $716 billion that is cut from Medicare is waste, something Republicans talk about all the time, but it took a bill passed by Democrats to actually make it happen — and now Republicans lie about it.
Even taking into account the above mentioned waste, Medicare is still a tremendously efficient insurance program compared to private insurance. Medicare’s administrative costs (costs not directly related to health services) runs around 2 percent. Compare that to private insurance which has administrative costs running from 10 to 20 percent or sometimes much higher. Explain to me: How is it more efficient to provide health care insurance by a for-profit company compared to a non-profit, low overhead public-run program? The answer should be obvious. Who said we need to have for-profit health care insurance? Just because this is the way it’s always been in America doesn’t mean it has to continue. We can make a more efficient health care system if we adapt Medicare into a system for all citizens.
But Conservatives Need A Bogeyman
Unfortunately we can’t have Medicare-for-all because Republicans and conservatives need a bogeyman. Whether it’s government, Democrats, liberals or President Obama, conservatives need someone to blame and someone to pin “destroying America” on. Instead of a genuine attempt to tackle the problems we face, conservatives know what the problem is: liberals. It seems many conservatives truly believe if they could only get rid of all the Democrats and liberals destroying America, they would be able to build their free market system to run everything and all of our problems would magically be gone.
Back in the real world, complex problems usually need complex solutions. It’s going to take people willing to make an honest and genuine effort, willing to use the brain power necessary to fix the many problems we face. Conservatives cannot be bothered with this. They simply want to privatize everything. Throw everything at private companies and let the market sort it out. If people get left behind, well, they probably deserved it anyway. / photo by janinsanfran