By Fred Mayer, R.Ph., M.P.H.
Drug Topics: Voice of the Pharmacist, May 10, 2015
As healthcare professionals, pharmacists do not want to see anyone refused services for lack of health insurance. That is why in California 250 national organizations have united to support “The Expanded and Improved Medicare For All Act,” H.R. 676, which will guarantee healthcare for all Americans through a universal single-payer healthcare plan.
Rep. John Conyers Jr. (D-MI) reintroduced H.R. 676 on February 3, 2015. The original bill was introduced in 2003 and has been reintroduced in every Congress that followed. At present, H.R. 676 has 48 co-sponsors.
The Expanded and Improved Medicare For All Act would establish a publicly financed, privately delivered healthcare system that would extend the already existing Medicare program to all residents of the United States and U.S. territories, and ensure that everyone, regardless of employment, income, or health status, will have access guaranteed by law to cost-effective healthcare services of the highest quality.
More than 40 million U.S. residents are uninsured and another 50 million underinsured. The time has come to change our inefficient, costly, and fragmented non-healthcare system and replace the insurance industry, managed care organizations, and pharmacy benefit managers (PBMs) with a single payer.
Who is eligible?
Once they enroll at the appropriate location, every person living in the United States and U.S. territories, including the undocumented, would receive a United States National Health Insurance (USNHI) Card and ID number. Social Security numbers will not be used when assigning ID cards.
Covered healthcare services
This program will cover all medically necessary services, including primary care, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, long-term care, mental health services, dentistry, eye care, chiropractic, and treatment for substance abuse. Patients will have their choice of physicians, pharmacies, pharmacists, providers, hospitals, clinics, and practices. No co-pays or deductibles will be permissible under this act.
Administrative cost savings
Our fragmented private insurance bureaucracy consumes 31% of U.S. healthcare spending. Elimination of the private insurance industry, managed care organizations, and PBMs could save enough administrative overhead costs to provide comprehensive healthcare to all residents of the United States.
At present, $3.2 trillion dollars are spent annually on administrative overhead; 21% to 31% of that could be saved, with results comparable to the 3.2% spent by Medicaid, the 3.9% spent by the VA system, the 4.2% spent by the Kaiser system, and the 4.8% spent by Medicare. More than $800 billion per year could be saved in administrative costs alone.
Proposed funding
Maintain current federal and state funding for existing healthcare programs; levy an employer payroll tax of 3% on incomes less than $53,000 and an employer payroll tax of 6% on incomes more than $53,000, in addition to the already existing 1.45% for Medicare; establish a 6% healthcare tax on the top 5% of income earners with incomes greater than $225,000; and tax stock transactions by .005 % (half of 1%).
The time has come
It’s time for the U.S. government to save lives and save money by moving to single-payer, universal healthcare coverage for all Americans. And it is time for pharmacists to wake up and save our profession. We can take an important step by joining the national movement and partnering with the 250 organizations that have endorsed H.R. 676 in support of healthcare for all.
Fred Mayer has been a member of Drug Topics’ editorial advisory board for 25 years and a pharmacist for more than 50 years. A past president of the California Public Health Association and a former pharmacy owner, he is president of Pharmacists Planning Service Inc. (www.ppsinc.org), a nonprofit consumer/public health/pharmacy education organization in San Rafael, Calif. Contact him at ppsi@aol.com.
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