Medicare is Great: Why Can’t We All Get It?

Guest Writer

Medicare is better than any insurance we ever had. Most of us on Longboat Key know this.

No co-pays most of the time. Go to any doctor you want. Small monthly payments. Couldn’t be easier.

But the problem is: Most people can’t get Medicare.

In the midst of the pandemic of the century and the greatest medical crisis this country has ever faced, tens of millions are living without health insurance, or losing it at an astronomical pace.

For most people, jobs mean health insurance. And then the jobs suddenly disappeared.

In the last few months, 50 million people have officially filed for unemployment insurance. This doesn’t count the millions more who lost their jobs and didn’t have health insurance to start with. Or the approximately 53 million independent gig workers who never got employer health insurance in the first place. It is projected that by 2023 more than half the US workforce will be gig workers at some point in their career.

41 percent of those who lost jobs in the current crisis relied on that job for health insurance, 20 percent of those were not able to come up with any replacement coverage, and the rest have had to pay double or triple on the individual market. This is not easy when you have no regular paycheck coming in. It is hard to imagine how the average laid-off worker will be able to afford two weeks of Covid19 treatment for a sick child in the ICU, with medical bills running over one hundred thousand dollars. It’s a disgrace that catastrophic medical bills account for more than 50 percent of the bankruptcies in this country.

The Covid19 crisis has provided us with an opportunity to fix the dysfunctional – and expensive – patchwork that is our employer-based healthcare system.

The consequences of continuing our present practices are not good for any of us.

Uninsured people are less likely to seek medical care making them more vulnerable and more contagious – not to mention a greater threat to all, especially to us older folks on Medicare.

Our legacy employer-based health insurance dates back to President Franklin D. Roosevelt’s effort to curb wage increases during World War II. Employers sought to attract workers with these untaxed benefits, which would not be counted in their remuneration, and act as hidden subsidies.

This archaic healthcare industry cartel evolved into The Great American Rip-off, costing over 18 percent of our gross national product, when we could be paying half as much and getting much better outcomes.

Americans pay twice as much per capita for their health care coverage as Canadians,  Germans, and the British, yet the outcomes in this country are vastly inferior. We rank 37 in overall efficiency by the World Health Organization.

America’s $3.5 trillion dollars spend per year on health care is more than Germany, Britain, France, China, Italy, Canada, Australia, Brazil Spain, and Japan spend combined. Of this, $500 billion is spent on administrative costs — yet still 30 million Americans are uninsured, even after Obama-care, and before the recent tsunami of pandemic-related layoffs.

Medicare for All would liberate small and large businesses from being involved in their employees’ health. Without paying for health insurance, businesses would be free to give their employees a $10,000 annual raise. Not only would this be vastly cheaper and more effective, it would also make the American business and the labor environment more efficient and dynamic.

U.S. companies are hobbled when competing in world markets by humungous healthcare costs. General Motors spends more on worker health care ($1,500 per vehicle) than they spend on steel for each car they produce. GM spends an average of $1850 monthly per employee on health insurance. “The three big automakers are ‘H.M.O.s on wheels’,” said former Goldman Sachs analyst Gary Lapidus. If GM builds a car in Ontario, Canada, which borders on Michigan and produces almost as many cars, the company would not have to pay for the health care of their workers and could thus price that car on the world market for much less than a similar Detroit-made vehicle.

“It’s a crazy, anachronistic idea that worked in the 60’s, but lost its validity in the 70’s when the car market became global,” said Princeton economist Uwe Reinhardt, referring to employer-based health insurance. Reinhardt, who wrote It’s the Prices Stupid: Why the United States is So Different from Other Countries, was one of the first to prove that while America spends much more than any other country on health care, it doesn’t actually get more care — just pays higher prices.

Our present health care system is like an old car that is not serving us well. We keep tinkering with every breakdown, but ultimately it is not sustainable. Significant change is inevitable. It’s not just a matter of if, but of when.

Is there a better, cheaper way to do this? What is working elsewhere? You don’t have to go far. Most of the developed world — Canada, Britain, Japan, Taiwan, Australia, New Zealand, and all of the EU — have a version of a single payer system that is cheaper and delivers better healthcare to its citizens.

One of the main indices of the success of a nation or its government is the health of its citizens. Life expectancy is the most verifiable statistic. 20 countries in Europe and four countries in Asia have a better life expectancy than the U.S. If you are a male between the ages of 15 and 59 your chances of dying are higher in the U.S. (140 per thousand) than in Canada (95), Costa Rica (127), Chile (134), and Cuba (138).

The U.S. Health system looks especially dysfunctional when you consider how much money we spend per capita – about $11,000 per year for health care, 30-50% more than most countries – and how little we get for it.

In Greece,  the government and individuals spend about $1500 per capita on health care each year, and the average life expectancy is 79 years. In the United States, we spend seven times that amount, yet our life expectancy is below 78.

Canada spends $7,068 and boasts a life expectancy two and a half years longer than the U.S. Switzerland, which ranks second in health spend, devotes about 11 percent of its Gross Domestic Product on universal health care, while the U.S., with 30 million uninsured, spends 17 percent of GDP with embarrassing results.

Why has our vaunted, free enterprise system – which has produced such great benefits in delivery of most goods and services – failed so completely with regard to this most fundamental need?

One answer is that health care is not amenable to some of the basic rules of supply and demand that govern other consumer transactions and our capitalist system. Sick people don’t negotiate with doctors or hospitals or drug companies. If you are having a stroke, you can’t be shopping around looking for the most affordable drug.

This vulnerability has been exploited and hijacked by greedy drug companies, doctors,  insurers, personal injury lawyers, H.M.O.s, and hospitals, who have preyed on our most vulnerable for too long.  About 50% of health care funds never even get to doctors or hospitals, both of which run bloated operations.

Who is going to pay for Medicare for All?

The answer is, if done right, it will only cost half as much as our inflated employer-based system. If 20 other developed countries have figured out a way to pay for their single payer systems, surely with American ingenuity and willpower, we can solve it too. The majority of the American people support a single payer system, but have been thwarted by propaganda from entrenched special interests who reap enormous profits by scamming the American people, denying us of the affordable health care we need and deserve.

The crisis has become especially acute in recent years. Ordinary people cannot afford these grossly inflated prices, which, for some families, totals more than $24,000 per year.  Even after Obamacare, 30 million Americans are not covered by health insurance and this number grows by a million and a half each year.

What is true is that the U.S. has the best medicine in the world with the best doctors, the newest techniques, the latest high-tech machines, and the best drugs. Wealthy people from all over the world come to the U.S. for the most advanced treatment and pay cash.The best U.S. health care has been reserved for rich foreigners and wealthy Americans and sadly unavailable to millions of ordinary citizens.

The overriding moral question is should a child of a poor family have the same chance of receiving adequate prevention and treatment as a child of a rich family?

The only answer, of course, is yes. But today’s overwhelming evidence shows otherwise. If you live in an affluent part of town, you can expect to live 15 years longer than people who live in poorer sections.

We can do better.

Tags: , ,

Longboat Key News

3 Responses for “Medicare is Great: Why Can’t We All Get It?”

  1. Lack of Health Insurance as a public health risk during a Pandemic given that America is the highest infected country in the world…

    Thank you for the conversation Mr. Fleetwood. I believe we can do better, as well.

    As a public health professional, I must seriously contemplate what the solution for 30 million people, who are suddenly without employment and employer sponsored health insurance now do?

    The current administration’s plan is to let the states deal with the uninsured. However,
    the qualification for the State run Medicaid programs and low income subsidy qualifications, along with unemployment compensation and, aided by the Federal Lost Wages Assistance Program, places many individuals and families above the low income guidelines for subsidized health insurance.

    This is the dilemma many of the uninsured individuals thrown into a national health crisis, they had no time to plan for, are now facing. An unemployed worker and family above the guidelines for subsidized health insurance is risky, and brings up the principles of public health ethics from multiple vantage points.

    The ACA officially known as the Patient Protection and Affordable Care Act provides patient protections for pre-existing conditions and essential health benefits including hospitalization for the American public. This in comparison to the Consolidated Omnibus Budget Reconciliation Act (COBRA) with it’s high premiums and deductibles, along with, exclusions, that a former employer may or may not elect to contribute to, on behalf of their former employees, requires careful review for protection against medical financial liability. To pay the full premium rate for many COBRA plans as an unemployed worker is unaffordable for most.

    The newly uninsured worker joins and ranks among nearly 27 million Americans who are uninsured.
    Moreover, in the US, many people have two or more chronic conditions as they age, therefore severing the ACA, at this time, and for those not yet Medicare eligible, could result in
    non coverage of these conditions, which does not help the uninsured and sick.
    Yes, Medicare is a wonderful benefit, Mr. Fleetwood, and one that is earned and a financially shared benefit contribution throughout a lifetime as an American worker.
    Without the PPACA and it’s protections we will have a second catastrophe to the Pandemic in this country, the uninsured.


  2. bibi giordano says:

    We all can’t get it because it appears that the politicians in power don’t want to use our tax dollars to give back to us what we need and deserve. When we cast our vote, we should remember The Declaration of Independence and the “unalienable right to life, liberty and the pursuit of happiness” given to all humans by their creator, and which governments are created to protect.
    Is health care for all an inalienable right–a protection by government to ensure quality of life for its people? And then, there’s liberty and the pursuit of happiness–Something to think about on election day.

  3. Ewa Hammer says:

    Excellent article!

Leave a Reply