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Politicians ignore Medicare for all

By F. Douglas Stephenson, LCSW
Gainesville (Fla.) Sun, Jan. 11, 2017

In the current Affordable Care Act debate, the mainstream media has ignored a solution standing in plain sight. It is a more efficient and affordable system for universal coverage in the public interest: single-payer national health insurance. Instead, we are being led by politicians beholden to big-money interests serving the greed of today's medical-industrial-Big Pharma-Big-Insurance complex.

The Republicans want to repeal much of the ACA and replace it with something similar. The Democrats want to preserve ACA pretty much as it is. From the global perspective, we'll still be left with a highly dysfunctional health care financing system that will not cover everyone while perpetuating inadequate coverage for many of those who are insured.

Our health-care financing system is still in shambles. Tens of millions remains uninsured. The insured have increasing difficulties in obtaining care in the narrow provider networks, while facing financial hardship because of the insurers shifting ever-more risk onto the patients. Both political parties want to make this a choice between protecting the shambles versus making them even worse through Republican replacement policies that would further weaken health-care coverage.

The true replacement choice needs to be between accepting or tweaking a system in shambles or moving on to a well-designed single payer system -- an improved Medicare for all that would provide affordable, accessible health care for everyone.

The ACA could be replaced by a publicly financed national health insurance program like the one outlined in H.R. 676, a bill filed in the last Congress. This legislation would fully cover health/medical care for all Americans, and significantly lower costs by eliminating the private health insurance industry with its massive overhead and immense profits.

H.R. 676, "The Expanded & Improved Medicare for All Act," would establish a unique American universal health insurance program with single-payer financing. The bill would create a publicly financed, privately delivered health care system that improves and expands the existing Medicare program to all U.S. residents, and all residents living in U.S. territories.

The goal of the legislation is to ensure that all Americans will have access, guaranteed by law, to the highest quality and most cost effective health care services regardless of their employment, income or health care status. In short, health care becomes a fundamental human right, with no financial barriers or financial harm resulting from seeking care.

With at least 20 million uninsured Americans, and many millions more who are underinsured, the time has come to change our inefficient and costly fragmented non-system of health care. The current for-profit health care system in the U.S. is not financially sustainable over the long run, hence the need for a unique nonprofit, universal single-payer health care system.

University of Massachusetts economics professor Gerald Friedman estimates that under the single-payer system created by H.R. 676, "the U.S. could save an estimated $592 billion annually by slashing the administrative waste associated with the private insurance industry ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion)."

He wrote that in 2014, the savings would have been "enough to cover all 44 million uninsured and upgrade benefits for everyone else. No other plan can achieve this magnitude of savings on health care. Specifically, the savings from a single-payer plan would be more than enough to fund $343 billion in improvements to the health system such as expanded coverage, improved benefits, enhanced reimbursement of providers serving indigent patients, and the elimination of co-payments and deductibles in 2014."

A Medicare-for-all system would vastly simplify how the nation pays for care; improve patient health; restore free choice of physician, mental health and other health professionals; eliminate co-pays and deductibles; and yield substantial savings for individuals, families and the national economy.

As Dr. Robert Zarr, past president of Physicians for a National Health Program, a nonprofit research and educational group of 20,000 doctors nationwide, said: "The global evidence is very clear: single-payer financing systems are the most equitable and cost-effective way to assure that everyone, without exception, gets high-quality care."

F. Douglas Stephenson, LCSW, LMFT, BCD, is a retired clinical social work psychotherapist in Gainesville.

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