Georgia cost-control bill means well, but is naive

By Jack Bernard
Atlanta Journal-Constitution, March 22, 2012

Co-sponsored by Rep. Paul Broun of Athens, the bill is a well-meaning but naive and misguided attempt to control state and federal expenditures.

It is similar to Rep. Paul Ryan’s plan for radical Medicare reform through vouchers, legislation passed by the House last year and soundly rejected by the Senate.

Controlling Medicaid expenses is clearly needed for national deficit reduction, and to lessen the fiscal burden on states like ours. From 2006 to 2009, Georgia Medicaid expenditures rose from $3.9 billion to $5.6 billion. However, balancing the budget on the backs of 2 million of Georgia’s poorest residents by cutting the care they receive (which is what will happen) is not the way to go.

A much better, more comprehensive solution is to do away with both Medicaid and the Affordable Care Act (i.e., Obamacare) by expanding Medicare to cover all ages and people, including national elected officials. With Universal Medicare all costs can be controlled and complete access assured. Medicare has overhead expenses of about 3 percent, one-tenth of the overhead costs of private insurers. Further, one part of the ACA that should be kept is the Medicare Independent Payment Advisory Board, set up to make sure that costs do not escalate.

Under Universal Medicare, the savings can be spent reimbursing doctors and other providers for direct care, taking care of sick people, versus buying second homes and yachts for insurance company CEOs who are making millions of dollars each year in bonuses, stock options and ridiculous salaries.

Medicare is one of the few programs that taxpayers enthusiastically support, even many of the tea party’s gray panthers. It is hard for anyone to attack a program almost everyone understands and generally likes. In other words, if Medicare is good enough for granny, then it’s good enough for me and my congressman. Now, that is a political slogan that Joe Sixpack can get behind.

Medicare must be responsive to the voters because it is a publicly funded program authorized by our elected representatives. Who elects the CEOs of health insurance companies? What real power does the individual policy holder have when denied a claim (otherwise known as rationing)? Almost none.

The benefits of Medicare for all, as well as costs relative to existing private programs, have been established by a national group, Physicians for a National Health Program. (Their website — — contains information on single payer systems.)

Unfortunately, PNHP and other progressive groups were virtually shut out of the political process when reform was discussed in Washington in 2009. The insurance lobby was, and still is, one of the strongest in our capital.

Block grants — effectively cutting health care to poor people — are not the answer to our problems. Neither is going backward, dumping the ACA and relying on the “free market” to cure our ills. A recent Gallup survey shows that the insurance problem is getting much worse in our state and the nation. In Georgia, the number of uninsured is increasing rapidly, from 19 percent in 2008 to 22 percent in 2011. That rate is even faster than the U.S. rise from 15 percent to 17 percent. In fact, only five states have a higher rate of uninsured than Georgia. .

A single payer program covering all Americans should have been passed in 2009 — and it will be, in future years when the true financial and human costs of misguided reforms like the ACA, Medicaid block grants and Medicare vouchers are clear.

Jack Bernard, a senior health care executive for 25 years, serves on the Jasper County Board of Commissioners.