Medicare-for-all option would cover everyone, reduce costs

New Hampshire Union Leader
Friday, Aug. 21, 2009

Speaker Pelosi has pledged to hold a floor debate and vote on single-payer health reform this fall. This vote on an amendment to HR 3200 (the 1,000-plus page bill favored by the House leadership) would substitute the 27-page HR 676 as the new health care policy of the United States.

This is good news after months of suppression of a bill that should be the gold standard for comparison of plans. This is important to everyone because passage would bring simplicity and stability into your health care planning.

For about 4.5 percent of income, matched by your employer, you would receive a lifetime policy with no co-payments, no deductibles, no out-of-pocket expenses and, most important, no pre-existing conditions exclusions. Your policy would cover your choice of physician and appointments with them, hospital care, diagnostic imaging, laboratory tests, prescriptions, vision care, preventive care, dental care, chiropractic care, emergency care and ambulance transportation, podiatry, speech, physical and occupational therapy, mental health care, substance abuse care, health education, hospice care, adult day care, skilled nursing care, long-term care and dialysis. This policy would be portable, continuous and never could be canceled regardless of your employment status.

Please note that passage of this plan covers everyone with the same basic policy. Medicaid would be eliminated; Medicare would be considerably improved. Medical bankruptcy would be eliminated, and the President's goals of universal, affordable, choice and cost controls would be met. the dreaded doughnut hole in Medicare D would be an unpleasant memory.

Costs would be contained by dramatically reducing administrative expenses, global budgeting, bulk purchasing of prescription drugs, medical supplies and equipment, mandating transparency in pricing and reducing fraud. No other plan has cost controls built in and, therefore, would be much more expensive.

Although the President keeps saying you can keep the insurance you have, it is the small businessman buying this policy for you. And with insurance premiums rising every year way above the inflation rate, providing this coverage for many is not possible anymore. A fixed percentage of payroll would be a much more affordable option.

The city of Portsmouth paid $9,615 for a family policy in 2000, and this year it's $24,145, representing 10 percent of the property tax bill. Without reform, similar increases of this magnitude would lead to a premium of $60,362 in 2020 and $150,906 in 2030. This clearly demonstrates the need for reform.

Doctors are complaining about insurance company interference with their practice of medicine and the paperwork related to this oversight. This is minimally present in Medicare today and would disappear in the single-payer program.

Please visit Physicians for a National Health Program's Web site,, for more information. Don't discount the Medicare-for-all option without a full understanding of this program. Our principles are automatic enrollment, comprehensive coverage, public financing, eliminating administrative waste, maximum choice of physician and hospital, and delivery through a nonprofit, privately controlled system. What does your ideal system look like?

Don't be put off by the lies and distortions blaring across your radio and television. HR 676 covers you for life; it is affordable; and it is simple to understand and implement. And it pays for itself. What does your plan do?

Dr. Thomas Clairmont is an internist in Portsmouth.