Washington Health 'Reform' A Vehicle For Continued Wealth Transfer Upward

More than ever, the need for public single-payer insurance -- “Medicare for All"
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The Washington “swamp” amounts to the corporate buyout of our institutions resulting in subversion of democracy. Corporate media is more interested in the outrageous antics of a would-be president, than reporting the illicit election process - overlook, not oversight of huge voter purges since at least 2000 - over one million purged in 2016 alone due to Operation Crosscheck, not counting other efforts at voter suppression. It is absurd to hear both Republicans and Democrats parroting “Elections have consequences..” It follows then, that “Illegitimate elections have illegitimate consequences...” - effectively, the U.S. has experienced a corporate coup d’etat. In no way should we normalize the political charade or the pretense of democratic process. The military and medical industrial complexes wield the money and the power to write policy.

That said, Washington health care “reform” has become one more vehicle for the continued 40-year wealth transfer upward. Recent Republican proposals offer $600 B in tax cuts for the wealthiest, paid for by $840 B in Medicaid cuts for the low-income. To advocates of so-called “free-market” health care, health is a commodity to be negotiated at the hospital door. Lower-cost high-deductible plans are euphemistically branded by the political right “consumer-directed.” More aptly known as “swiss cheese” policies due to many holes in coverage, high-deductible policies are likely to leave the insured vulnerable when they most need health care.

"Freedom" to Republicans means freedom from health care access.

Republican reforms once again move toward shrinking risk pools, e.g., isolating the higher-cost chronically ill in smaller, less efficient high-risk pools, as well as moving people into smaller state health plans. Both options deny the economies of scale achieved by a single large risk pool (single payer) that creates a fiscally sustainable, truly universal health care model.

Washington health reform proposals, including the Affordable Care Act, are built around the most costly, inefficient model – that is, multiple commercial insurances that drive wasteful complexity and high administrative costs. Commercial multi-payer health insurances rely on public subsidies to preserve private insurance profits. The private health insurance and pharmaceutical industries together siphon off tens of billions of public dollars annually to boost their profits.

Note: Other Washington efforts to transfer wealth upward and enhance the pharmaceutical industry’s bottom line include Medicare Part D in 2003 and the Affordable Care Act in 2010 - both prohibited Medicare negotiation of bulk medicine costs.

Commercial health insurers further protect their bottom line by increasing premiums, copays and deductibles, while limiting benefits and shrinking provider networks - thus shifting costs and risks to the insured. Health insurance middlemen practicing “Denial Management” deny and delay claims in order to cut costs and increase their profits, while greatly adding to billing costs for providers, who too often are required to submit a single claim multiple times. The uncertainty leaves too many Americans one illness or accident away from financial disaster.

Public Single-Payer Insurance a Boost for the Entire Economy

Dozens of studies over the past 30 years have demonstrated that a single national health insurance – modeled on traditional Medicare - provides the most sustainable, comprehensive, universal health coverage. By covering everyone in one large risk pool, single-payer insurance can best leverage economies of scale to cut costs by negotiation of global budgets and bulk medicine rates.

Furthermore, single-payer insurance provides first-dollar coverage, eliminating copays and deductibles while reducing administrative costs, saving up to $500 billion annually – enough to cover the uninsured and fully cover the under-insured. Analysts estimate that another $150 billion would be saved by negotiation of bulk medicine rates by Medicare, as the VA now does.

At 18 percent of GDP in 2015 and growing, U.S. health costs average almost twice as much as other countries that all report better health outcomes.

Organization for Economic Cooperation & Development

U.S. health spending is crowding out most other segments of the economy – including education, housing, infrastructure and pensions - and reducing consumer purchasing power and wages.

Properly done, single-insurance health reform could boost all segments of the U.S. economy, saving as much as $1 trillion annually in overall health spending, based on the experience of other countries whose health expenditures are almost half as much as that of the U.S. Businesses, state and local governments, and families would all realize savings. U.S. businesses would be more globally competitive, eliminating the high health costs that now inflate the price of U.S. goods, including thousands of dollars added to every U.S.-made car.

A traditional Medicare model insurance would relieve businesses of the time and cost of managing employee health plans. Jobs will be retained in the U.S. when high health costs no longer induce insurance companies and self-insured firms to use medical tourism to send patients abroad for medical procedures.

We have seen the benefits of increased Medicaid coverage in states like Colorado, where reduction of uncompensated care has stabilized rural economies, contributing to job growth and permitting hospitals and clinics to remain viable. The more sustainable, cost-efficient traditional Medicare model, improved and extended to all, would benefit everyone and be a boon to the entire economy.

Everybody does better when everyone is covered.

Contrary to political right narrative, Medicare is not "socialized medicine" – insurance by nature is "socialized." Only a traditional Medicare model (Medicare Advantage plans are private insurances) assures full choice of private or public providers; whereas, commercial insurers shrink their networks in order to cut costs, thus limiting provider access. Some assert that Medicare is “free,” nevertheless all working people invest in Medicare through payroll deductions. Like the Fire Department, all contribute according to their means in order to ensure health care is available when each of us needs it.

The government already underwrites over 60 percent of all health costs, much of it to subsidize the insurance and pharmaceutical industries, while also partially or completely funding congressional, VA and public employee health coverage. An innovative proposal for consolidation of the health insurance industry would permit the federal government to “buy out” commercial health insurances, with a projected payback period of two years, a much shorter time than banks took to pay back their TARP loans during the great recession. Read U.S. Healthcare Financing Reform: The Consolidation of the Health Insurance Industry.

Call it Medicare “E” - for Everyone.

Disclosure: The author is part of the Health Care for All Colorado Foundation working committee that created the Consolidation proposal. A version of this piece was previously posted on CommonDreams.org.

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