Americans are increasingly rating health care as the top concern in the 2020 elections, write Kevin Berninger and Kevin Williams in politics for CNBC, while having a more general discussion on expanding Medicare.
Not all the proposals of the candidates are alike. Bernie Sanders advocates a version of Medicare that applies to all, and an estimated cost of $32 trillion in government spending over 10 years.
Sen. Kirsten Gillibrand, Sen. Kamala Harris, Julian Castro, and Hawaii Rep. Tulsi Gabbard have all come out in favor Medicare for All.
Other candidates say the realities of politics and government spending require a less extreme approach to increasing healthcare areas.
Cory Booker signed on to the Sanders’ idea but does acknowledge that his main concern for access for everybody is paramount, but is willing to consider extending Medicare down to age 55.
Sen. Sherrod Brown of Ohio and Minnesota Sen. Amy Klobuchar would prefer to lower the age to 50, but just want something that will work now, allowing Americans to voluntarily buy into this program, hoping to have a positive effect on the whole system with that addition.
To add to the noise, Rep. Pramila Jayapal (D-Wash) has unfurled an expansive new Medicare for All bill. The only problem, the plan does not have a cost estimate, nor does it
indicate how the overhaul would be paid for. I know. More taxes.
Star Parker, a columnist and president of the Center for Urban Renewal and Education, writing for Urban Cure, says that President Trump was principled and politically astute to address, in his State of the Union, the horrors taking place now in Venezuela, and then to declare: “Tonight we renew our resolve that America will never be a socialist country.”
America’s relationship to socialism has changed and Americans today are more
likely to identify socialism with “equality” than with government ownership
or control.
In any discussion of Medicare and Medicare For All, the word socialism appears.
Merriam Webster defines socialism “as a system, in which private property and the distribution of income are subject to social control,” but the conception of that control has varied, from statist to libertarian, from Marxist to liberal.
In the modern era, pure socialism has been seen only rarely and usually briefly in a few communist regimes.
Far more common are systems of social democracy, now often referred to as democratic socialism, in which extensive state regulation, with limited state ownership, has been employed by democratically elected governments, such as Sweden and Denmark, in the belief that it produces a fair distribution of income without
impairing economic growth.
I am seriously trying to not be an advocate for either political party as I write about health and pharmacy, but sometimes they seem to be intertwined. This is evident from the headlines of articles on the subjects I write about.
Examples are: “Stop calling universal healthcare socialized medicine.”
An example of socialized medicine is the care delivered through the Department
of Veterans Affairs, where medical professionals are government employees
and the facilities are paid for by we the people. In contrast, single payer
and Medicare for All are universal health insurance, not socialism.
Robert Pear, writing in the New York Times on Feb. 23, under a headline of “Healthcare and Insurance Industries Mobilize to Kill ‘Medicare for All,'” notes how even before the Democrats have finished drafting bills to create a single-payer health-care system, the healthcare and insurance industries have assembled a small army of lobbyists to kill the Medicare for All idea.
More than 155 million Americans have employer-sponsored health coverage. They like it, by and large, and should be allowed to keep it. The message of the lobbyists is “the Affordable Care Act is working reasonably well and should be improved, not repealed by Republicans or replaced by Democrats with a big new public program.”
Most physicians whom I have asked about this subject seem to agree that every American should be covered under a health-care program, but not one that takes away from what is already offered but does improve and expand coverage.
Single-payer national health insurance, also known as Medicare for All is a system in which a single public or quasi-public agency organizes healthcare financing, but the delivery of health care remains largely in private hands.
A single-payer health system establishes one health risk pool consisting of the entire population of a geographic of political region. It also establishes one set of rules for services offered, reimbursement rates, dug prices and minimum standards for required services.
Wikipedia notes that “the standard usage of the term, single-payer healthcare, refers to health insurance, as opposed to healthcare delivery.” To date, there are no less than 32 countries with some form of universal health coverage, the first of which was Norway in 1912.
According to Very Well Health, the U.S. Census Bureau shows 28.1 million
Americans without health insurance in 2016, a sharp decline from the 45.6
million who had been uninsured prior to the implementation of the Affordable
Care Act.
In contrast, there are no uninsured Canadian citizens; their government-run
system provides universal coverage. Thus, Canada has universal health
coverage, while the United States does not.
In most cases, universal coverage and a single-payer system go hand-in-hand
because a country’s federal government is the most likely candidate to
administer and pay for a healthcare system covering millions of people, but
it is possible to have universal coverage without having a single-payer
system and numerous countries around the world have done so.
This is called a two-tier system with the government providing basic health care and secondary coverage available for those who can afford a higher standard of care. Denmark, Israel and France have such a system.
Medicare operates similarly in the U.S. The supplement Medigap coverage provides that coverage and is managed by a private health insurer rather than the government.
Experts have suggested that the United States should incrementally reform its current health-care system to provide a government-funded safety net for the sick and the poor, an expanded version of the Affordable Care Act Medicaid expansion while requiring those who are more healthy and financially able to purchase their own policies.
In the political climate of today, can you really imagine any proposal gaining enough traction to pass any bill that would construct a system providing universal coverage and having multiple payers?
Bertram Drachtman
Great Neck
