Expand Medicare to cover the uninsured.
By Jack Bernard and Dr. Daniel Blumenthal
Atlanta Journal Constitution
Tuesday, August 25, 200
A Harvard study recently found that, despite the intense disinformation effort by those against change, Americans still view health care as one of their highest public priorities. Insurance premiums are going up four times as fast as workers’ wages, but only 28 percent of Americans rate our existing health care system as good or excellent. Our per capita health care spending is double that of any other developed country, while our health care system ranks 37th in the world, behind Costa Rica.
Yet, every day we view outrageous images of protestors disrupting town hall meetings called to discuss health care reform.
This campaign of disinformation is confusing our citizens and causing frightened members of Congress to kowtow to a shrill minority. The result is likely to be inaction, or a bill that makes only marginal adjustments to the current system. This will neither control costs (the top concern of most Americans) nor provide health care access for all (Americans’ second most important concern). What can be done?
The solution is clear: expand Medicare to cover everybody.
It is hard to attack a program almost everyone understands and that outperforms private insurance in satisfaction surveys. With universal Medicare, costs can be controlled, quality improved and access assured.
Almost every other developed country covers all its citizens with a program that resembles our Medicare, sometimes with supplemental private insurance.
In the U.S., we spend $6,714 per capita on health care annually, as compared to $3,040 in France, $3,371 in Germany, $3,678 in Canada and $2,999 in Australia. Yet all these countries have better morbidity and mortality statistics than we do.
We hear tales of foreigners who come here for medical care because of treatment delays in their home countries. Yet we rarely hear about the 750,000 Americans who went abroad for health care in 2007.
There are those who complain that the U.S. government cannot effectively run anything. Yet this is the government that put a man on the moon and operates the strongest military in the world. This is also the government that runs a health insurance program — Medicare — far more efficiently than does the private sector. Private insurance companies spend 20 to 25 percent of the premium dollar on marketing, administration, shareholder dividends and exorbitant CEO salaries. Medicare operates on an overhead of about 3 percent. The savings generated by changing to universal Medicare would literally be sufficient to cover all the uninsured.
Adding to the inefficiency of our system are the billing costs incurred by health care providers. Every hospital and medical practice must maintain massive billing departments to submit (and resubmit) claims to dozens of insurance companies with hundreds of different insurance plans. Providers in other countries typically need no more than a handful of billing staff.
Our system of providing very expensive private insurance through our employers has a deleterious effect on U.S. industry. American automobile manufacturers, struggling to survive, must pay insurance premiums for their employees. Their Japanese competitors do not have this burden. General Motors pays more for health care than for steel.
Medicare is an insurance program and all insurance programs, private or public, ration care to contain costs. The big difference is that Medicare must be responsive to the citizens because it is a public program. For example, because of public demand, Medicare added a prescription drug reimbursement benefit two years ago.
If we want to catch up with the rest of the world regarding quality, cost and access, let’s hope that more senators and representatives wake up before we are left with the status quo and our children have to deal with disaster.
Jack Bernard is a retired health care executive from Monticello. Dr. Daniel Blumenthal is associate dean at Morehouse School of Medicine.