Which “Medicare For All” System Can We Pass?

There seems to be many very loud people who think they can just force everyone in the country onto a government-paid health insurance system, and few, if any, will complain about it. These same people seem to think we can cover all 320 million Americans with full healthcare coverage, and most of us will pay less. In fact, many people seem to think most of us will be able to get healthcare for “free,” despite the fact that such a thing is not doable.

The version of “Medicare for All” in which everyone is covered for either a modest or no premium charge, the one in which everyone just shows up at the doctor’s office and everything is paid for at all times? That’s a pipe dream.

When you start talking about expanding to the Medicare system to everyone, you have to start with the difficult reality that, while Medicare is a better system for payees than most other insurance plans, the fact is, it only covers 80% of healthcare expenses. These people imagine banning private health insurance, but the fact of the matter is, without private insurance picking up much of the slack, Medicare would be unaffordable for many, if not most, seniors.

I know a lot of white “progressives” are hell-bent on transforming our system into a “single-payer” system, but that’s just one way to pay. What this country needs is universal health insurance, in which everyone has access to the healthcare they need when they need it, without the cost taking them broke. Universal healthcare is the goal, and “single-payer” is but one way to pay for it.

Another “fun fact:” While almost every other developed country has universal healthcare, it’s instructive to note that almost none of them are “single-payer.” In fact, when The WHO rated us as #37 in the world for healthcare outcomes, only TWO of the 36 countries ahead of us were/are “single-payer” systems; Canada, at #18 and the UK, at #30.

The ACA, as the bill was conceived, was not modeled after an old Republican plan, as was rumored by many who think they know everything. It was actually modeled after several European universal healthcare systems, which are hybrids; a combination of private insurance, supplemented by a public system as a way to spread risk over more payers, which is a great way to lower overall costs.

Now, call me a traditionalist, but I have always believed that, if our country is going to copy progressive policy, we should aim for whatever we know that works, not just whichever policy meets our rhetorical wants. Far lefties have just, for some reason, glommed onto the phrase, “single-payer,” and decided it is the only possible solution to our health care financing dilemma. Unfortunately, their position contains very little common sense.

In any case, the newest version of “Medicare for All” is much more reasonable and less likely to be demonized by the right-wing. More importantly, it puts the concept of “revolution” on the back burner and makes the change more incremental and more reasonable.

Oh, God, I can almost hear the professional lefties and the unicorn progressives screaming at me, that “‘single-payer’ is the best system because it will lower costs! And costs have to go down!” Well, yes and no.

There is nothing wrong with a single-payer system, in and of itself. And it is a hell of a lot better than the system we’ve been dealing with for the past 80 years or thereabouts. The problem is, we have to move the system we have to a universal system, and single-payer is, of course, the most difficult and bracing move we could possibly take. Think about this a minute:

According to the original “Medicare for All,” we were supposed to force everyone onto the “single-payer” “government healthcare plan.” Why would anyone think the vast majority of the country would go along with that without kicking and screaming? The fantasy that we could just take everyone’s private insurance and replace it with a government healthcare system in one shot is the ultimate in hubris.

Most people like their health insurance. Sure, it’s mostly because they don’t use it, but it’s still a fact, regardless of the reason. There is also a tendency among many Americans to think of any government program as inferior, and not entirely without reason. That is why the ACA kept the private insurance companies (not all are for-profit) in the system and set up a “public option” for those who needed help in affording even the lower premiums that would have resulted in its implementation. Yes, the “public option” was gone after the GOP had their way with it, but that points up another major problem with a “single-payer” system. If the government controls all of the purse strings, what’s to prevent Republicans from messing with the financing, or anything else?

It’s really funny, but unicorn progressives seem to have tunnel vision when it comes to public financing. Even after the GOP has repeatedly cut funding on so many programs, like SNAP, which they keep cutting, and AFDC welfare, which they essentially eliminated back in 1996, we still have unicorn progressives pushing single-payer health insurance and the public financing of elections, both of which we know Republicans will screw with every time they get a chance. We can’t get the same white liberals to support Democrats wholeheartedly and also work to keep voter turnout trending upward, which means they are not poised to keep Republicans the hell out of office, and yet they want to turn healthcare and campaign finance over to Congress, to let them do as they will.

It makes no sense. Yes, we can add a ton of regulations to supposedly limit what can be done with the health and campaign finance systems, but we now have a Republican Party that doesn’t care about rules. This is the United States of America; we already did our revolution, almost 250 years ago now. To get a major change in this country, it has to be done in stages and everyone has to be patient. It took 40 years for Medicare to become a reliable health insurance system, and it took more than 50 years for Social Security to become the “third rail of American politics” that it is right now.

Be patient, but more importantly, be smart.


Which “Medicare For All” System Can We Pass? — 2 Comments

    • I told you. They have a hybrid system, much like ours. Mostly private insurance, with a public system for those who can’t afford premiums. They’re not single-payer at all.