Medicare For All is the Right Choice: Part 1

by Jason Frerichs

Right now there is a major debate about health care going on.  Republicans want to “repeal and replace” the Affordable Care Act (Obamacare) with the American Health Care Act (Trumpcare), which is a much worse system.  The Congressional Budget Office warns that 23 million people would lose their coverage by 2016 under the proposed bill. Republicans argue that replacing “Obamacare” with the “Trumpcare” would reduce the deficit by $119 billion dollars by 2026.  This begs the question, how much is a human life worth?  Have we really become so callous that we’re putting a price tag on a human life just so a few wealthy people can have a couple more bucks?

The biggest thing on the chopping block is Medicaid expansion.  According to the CBO, if we end the expanded Medicaid provisions it would result in 14 million people losing their insurance.  This would save $800 billion over the next decade.  As a result, the wealthiest people would be able to get hundreds of billions of dollars in tax cuts on the backs of our most vulnerable citizens.  The sickest people would pay much higher premiums for worse coverage than the currently have.  Uninsured emergency room visits would skyrocket because easily treatable problems will progress to be being full-blown emergencies due to lack of coverage.  The middle class would pick up that tab via paying higher premiums themselves.  All so people who don’t need a tax break can buy another gold plated faucet.

The AHCA is the exact opposite of fixing Obamacare.  People would have higher out of pocket costs.  Those who work in health care can tell you that high out of pocket costs delays people from seeking care.  What is the point of having health insurance that you can’t afford to use?  Small problems that could be easily treated with access to affordable care tend to become larger problems that require emergency room care when people can’t afford to see a doctor.  Something that was inexpensive to fix is suddenly a lot more expensive once it’s a full blown emergency.

According to Forbes, the sixteen countries with the best healthcare systems all have universal coverage.  These 16 countries have better outcomes, lower rates of obesity, heart disease, cancer, and longer life spans.  The US spends a much higher percentage of its GDP than all the countries listed.  What do we get for all this extra spending?  We get worse outcomes, unhealthy people, and an inefficient system.  We deliver healthcare in the stupidest possible way.  Wealthy CEOs get to line their own pockets and those of their shareholders.  Profit becomes more important than taking care of patients.  We’ve created an unnecessary system of middlemen.  The overhead costs of Medicare are 2% compared to 12% to 14% for private insurance companies.

According to a peer-reviewed study commissioned by Health Affairs, administrative costs in the US are higher than anywhere else in the world.  Every US-based doctor needs 10 different administrators just to keep their office doors open.   The 10 unnecessary administrators don’t do anything of value.  All they do is look for ways to deny health care to people.  That is what a decent percentage of your health insurance premiums go to.  You are literally paying money out of your own pocket to give a job to someone whose sole purpose is to prevent you from using your benefits.  According to Physicians For A National Health Program (PNHP), our healthcare system in the most expensive in the developed world and the worst in the developed world.  No other first world nation delivers health care using a for-profit model.  Every other first world nation has better healthcare than we do.

PVI spoke with some “boots on the ground” in Iowa in order to get a feel for the challenges providers and human resource personal face.  Gubernatorial candidate Cathy Glasson issued the following statement, “I was an ICU nurse for almost 20 years, so this issue is close to my heart. I’ve seen what happens when Iowans go without care because they can’t afford it, and end up in the emergency room with painful, debilitating, expensive conditions which could have been avoided if they had access to preventive care. Other wealthy nations understand that healthcare is too important to be controlled by corporations whose primary motive is profit. It’s an embarrassment that every other wealthy country in the world provides healthcare to all of its citizens while the United States does not. If Washington won’t act, I will fight for universal health care in Iowa.”

PVI spoke with 4th District Chair of the Progressive Caucus Amanda Malaski who said, “When I worked for a Human Resources provider, a huge amount of our time and energy went into managing health insurance for our companies. Employees would call us daily regarding issues with insurance payouts or deductions/withholdings. Business owners would call us looking for cheaper health care solutions. My own employer offered no health insurance at all, which deeply hurt our ability to recruit top candidates. Having health care handled by the government would free up a huge amount of time and energy for businesses that could be better spent on training, recruiting, safety, workplace wellness, etc. It would also force businesses to be more competitive in the wages and additional benefits they offer, as the trump card of health insurance would be removed.”

Well known activist and state employee Ruth Burgess Thompson said, “One of the first things that I learned when I began to study health care delivery systems is that Medicaid and Medicare have about a 3% overhead while insurance companies have about a 35% overhead. Here in Iowa, if you multiply that by three MCOs, wowza!  If the money that individuals, employers and both state and federal government spend on healthcare were combined, the US could easily cover everyone through either Medicaid or Medicare. And it’s highly likely that the US would have better health care outcomes for the money.”

The question is, who are we as a nation?  Do we take care of our sickest and our most vulnerable or do we see these people as mere items on a budget spreadsheet?  Can we really claim to be a Christian Nation if we treat our least fortunate as less than a few extra bucks in a billionaire’s bank account?  Are people more important than profits?  According to the Republican Party, the answer is no.  Profit over everything else seems to be their motto.   When will we stop treating political parties like football teams?  When will we stop voting for a party just because our parents did?  This is why we find ourselves about to destroy our healthcare system.  Fact-based reasoning and discussion have been replaced with tribalism.  If the other party supports it, I have to be against it type of thinking.  As a society, we do not have a “we’re all in this together” mentality.  Healthcare is a human right.  Ability to pay should not determine whether or not you get treatment.




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