By Jack Bernard
The Florida Times-Union (Jacksonville), June 30, 2014
My party, the GOP, is running for election this year on the slogan “repeal and replace Obamacare.”
I agree, but the question is “what will be the replacement?” My answer is Medicare for all.
From a moral standpoint, due to expansion of access to health care, the Affordable Care Act is clearly better than what we had previously. The Medicaid expansion provision, which unfortunately was made voluntary by a politicized Supreme Court, does a lot to help very low-income people who cannot afford insurance premiums.
On the other hand, of the 8 million who signed up for Obamacare nationally through the exchanges, many just switched from existing “limited” insurance policies.
In Georgia (my home), 22 percent of the population (one of the highest rates nationally) was uninsured before Obamacare.
Expanding access
Even if all 8 million had been uninsured, tens of millions are still without insurance and will be for the near future. This fact is especially true in red states like ours that have inexplicably chosen to turn back federal money to expand Medicaid, a purely political decision.
Further, because the Affordable Care Act is built on the defective private insurance model, it will never be very effective or efficient.
And with no Affordable Care Act public option, insurance companies will take advantage of consumers. For example, in the Albany, Ga., area, there is only one insurance company available via the exchange, Blue Cross. Incredibly, rates there are higher than they are in Beverly Hills, Calif.
Thus, many experts believe Obamacare does little to contain costs, the “affordable” portion of the Affordable Care Act, because private insurers are at the core of the program.
As opposed to my fellow Republicans, I do not believe that politically we can just repeal it and go back to what we had.
It is also unrealistic to propose simply doing away with Medicare and Medicaid in their current form as the plan by U.S. Rep, Paul Ryan and others in the GOP propose.
Advocating for this policy will just ensure that the GOP becomes a regional party, permanently losing national elections.
As a proven fiscal conservative, I generally do not like high taxes, especially when public money is going to the wrong places and programs.
Reducing costs
So why do I want to see more government involvement in our health insurance system via Medicare expansion to everyone? Because as opposed to many government programs, Medicare works well. Based on their experience, taxpayers (especially senior citizens like me), like Medicare.
And it is efficient, cutting out marketing and overhead expenses. Medicare has overhead expenses of only 3 percent compared to 20 percent-plus for private insurance companies.
Adding a younger and healthier cohort will automatically lower overall Medicare utilization per patient.
Another factor is the strength that being a single payer gives you in the marketplace. This has proven to be true in Canada, which spends much less than we do per capita and has better outcomes.
Obama, by nature a cautious moderate, made a major mistake in abandoning his previous support for Medicare for all. I believe that he should reverse course and establish a presidential commission to determine the exact benefits and costs of converting our current non-system to single-payer.
Before his retirement, Jack Bernard was a senior health care executive with several national firms as well as the former director of health planning for the state of Georgia.
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