Medicare for all would cut health costs

By Johnathon Ross, M.D.
The Blade (Toledo, Ohio), Letters, April 21, 2015

Your series on preposterously variable health-care prices usefully pointed out one of the key symptoms of our sick health-care system (“The cost of care,” April 5, April 12). Sadly, making prices transparent will not help to control costs, because there never will be a normal market for most health-care services.

For most goods and services, higher prices control cost and are somewhat markers of quality. If the price is too high, you just walk away. In health care, the most expensive services are often the least optional and most needed. If you walk away, you may die.

Only occasionally do patients have the time or knowledge to shop for services. And services are ordered by clinicians, not patients.

Uncertainty and danger create an abnormal market. Expensive tests often help to sort dangerous from innocent symptoms.

Most economists agree that for health care, there is a market failure. How can skyrocketing costs be controlled?

When markets fail, regulation of prices is the second best solution. Medicare uses regulated prices to control costs more successfully than the rest of the health-care profession.

Multiple studies confirm that the simplicity of an improved Medicare-for-all system could save about $400 billion and would save about 30,000 lives yearly. These savings would cover all uninsured people and improve benefits for the rest of us.

Systems similar to Medicare have been used worldwide to control costs while providing good access to services, for about half of what we spend.

It will be a huge political fight to get profiteering middlemen, such as insurers, out of the way. But no change comes without a demand. We must demand it of our leaders and lawmakers.

Just knowing the prices will never work. An improved and expanded Medicare for all would save lives and save money. It is the right thing to do.

Dr. Johnathon Ross is past president of Physicians for a National Health Program. He resides in Ottawa Hills.