Tag: Single Payer health insurance

The New York Analysis of Policy and Government concludes its review of Medicare for All and single payer health plans.

A Gallup poll found that 5% of Americas cite healthcare as their key political issue.

The two parties are widely split on how to address it.  The Democratic Party platform supports what it terms “Universal care:”

“Democrats believe that health care is a right, not a privilege, and our health care system should put people before profits. Thanks to the hard work of President Obama and Democrats in Congress, we took a critically important step toward the goal of universal health care by passing the Affordable Care Act, which has covered 20 million more Americans and ensured millions more will never be denied coverage because of a pre-existing condition. Democrats will never falter in our generations-long fight to guarantee health care as a fundamental right for every American. As part of that guarantee, Americans should be able to access public coverage through a public option, and those over 55 should be able to opt in to Medicare. Democrats will empower the states, which are the true laboratories of democracy, to use innovation waivers under the ACA to develop unique locally tailored approaches to health coverage. This will include removing barriers to states which seek to experiment with plans to ensure universal health care to every person in their state.”

Republicans believe a universal health care system would result in reduced care for all.  They believe seniors would be particularly hard-hit:

• “More and more Democrats have endorsed the idea of a single-payer healthcare system, which would destroy Medicare as we know it, and eliminate the Medicare Advantage program for upwards of 21 million recipients… Medicare Advantage plans offer a popular, “lower cost alternative” to traditional Medicare plans.
  • Medicare Advantage enrollment is estimated to hit an “all-time high” of 22.6 million participants in 2019.
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  • Since President Trump took office, premiums for Medicare Advantage programs have decreased by 12%.
  • Under President Trump, premiums for Medicare Advantage programs are expected to decrease by six percent bringing the premium cost to only $28.
• Medicare already faces challenges with doctors facing lower reimbursement rates and stringent rules, which has resulted in the departure of physicians that accept Medicare.
  • A single-payer system would put immense pressure on the current Medicare system by drastically increasing the number of patients in the system, leaving current Medicare beneficiaries in competition for services they once easily accessed.
• A single-payer system would also worsen the quality of care delivered to current Medicare recipients.
  • With the “unwanted and unnecessary oversight by government in health care decisions” health care recipients face potential cuts in what are non-revenue generating services provided by physicians.
• Democrats have signaled that illegal immigrants would be included in their single-payer healthcare program, meaning if “Medicare for all” is enacted American seniors would be competing with illegal immigrants for health care benefits. 

Bernie Sanders’ may try to deceive voters that government-run healthcare will save them money, but with a $32.6 trillion price tag, it is anything but affordable.”

In an editorial published in USATODAY, President Trump outlined his opposition to “Medicare for All” and “Single Payer” plans:

“Throughout the year, we have seen Democrats across the country uniting around a new legislative proposal that would end Medicare as we know it and take away benefits that seniors have paid for their entire lives.

“Dishonestly called “Medicare for All,” the Democratic proposal would establish a government-run, single-payer health care system that eliminates all private and employer-based health care plans and would cost an astonishing $32.6 trillion during its first 10 years…Democrats have already harmed seniors by slashing Medicare by more than $800 billion over 10 years to pay for Obamacare. Likewise, Democrats would gut Medicare with their planned government takeover of American health care… The Democrats’ plan means that after a life of hard work and sacrifice, seniors would no longer be able to depend on the benefits they were promised. By eliminating Medicare as a program for seniors, and outlawing the ability of Americans to enroll in private and employer-based plans, the Democratic plan would inevitably lead to the massive rationing of health care. Doctors and hospitals would be put out of business. Seniors would lose access to their favorite doctors. There would be long wait lines for appointments and procedures. Previously covered care would effectively be denied. In practice, the Democratic Party’s so-called Medicare for All would really be Medicare for None. Under the Democrats’ plan, today’s Medicare would be forced to die.

“The Democrats’ plan also would mean the end of choice for seniors over their own health care decisions. Instead, Democrats would give total power and control over seniors’ health care decisions to the bureaucrats in Washington, D.C… the Democrats’ commitment to government-run health care is all the more menacing to our seniors and our economy when paired with some Democrats’ absolute commitment to end enforcement of our immigration laws by abolishing Immigration and Customs Enforcement. That means millions more would cross our borders illegally and take advantage of health care paid for by American taxpayers.”

Missing throughout the discussion lately has been the road not travelled—solutions to the high cost of health insurance and the coverage of the uninsured that do not involve the establishment of a vast enlargement of state or federal governments with all the inefficiencies and overlooking of individual needs that entails.

One of the key reasons health insurance is so high is the relative lack of competition.  Insurers can’t cross state lines to give potential customers a wider selection of choices.  Unfortunately, Obamacare and other government proposals ignore that reality.

While poorly performing hospitals and doctors should be forced to pay dearly for their malpractices, the reality is that many lawsuits are without any basis, brought under the concept that merely paying off an agreed upon sum is cheaper than going to trial.  Tort reform could lessen this burden, which greatly increases medical costs, but trial lawyers are key political contributors so this was ignored.

Nurse practitioners could perform far more routine medical services than they currently do, but this threatens the AMA’s monopoly, and like the trial lawyers, they have great lobbyists, so this approach to reducing costs never got very far.

There were other common sense ideas, but none provided the vast patronage mill and jobs-for-politicians that government schemes such as single payer, Obamacare, or “Medicare for All” do.

A final thought: if “Medicare for All” is adopted, will all the funds collected by American workers who paid into medicare throughout their working lives be refunded the amounts collected, since now even those who never paid a penny will receive equal benefits?

Photo: Pixabay

The cost of medical care is an issue that is essential for almost all Americans. Unfortunately, rather than concentrate on viable and realistic solutions, far too many politicians have offered proposals which are neither practical nor affordable.

The concept of free care provided by the government is childlike in its simplicity, an adult version of a fairy tale.

A RAND study notes that “Care would not be free in a single-payer system—it would be paid for differently. Instead of paying insurance premiums, people would pay taxes, which would be collected by a government agency and used to pay for health care on behalf of the population... Many single-payer proposals, including Sen. Bernie Sanders’ “Medicare for All” proposal, cover a comprehensive range of services with no or very low co-pays and deductibles. While common in many proposals , a single-payer system would not necessarily eliminate all out-of-pocket expenses. In fact, the current Medicare program, which some consider a form of single payer, has deductibles and co-pays.”

Betsy McCaughey Ross, who has intensively studied the issue, stressed in a New York Post editorial  that “…politicians would rather walk on hot coals than tell you what Medicare for All costs: a whopping $32 trillion over 10 years. To raise that, all taxpayers, not just the rich, would have to hand a gut-wrenching share of their paychecks to Uncle Sam, based on Congressional Budget Office revenue tables. A single guy earning $82,500 a year, and currently paying a 24 percent marginal rate, would be hit with a 60 percent tax rate ­instead. A couple reporting $165,000 in income would also see their marginal rate soar to 60 percent from 24 percent. No more dinners out or family trips. Goodbye to your standard of living. And to America’s current medical standard of care. Liberals want to keep the name Medicare but change everything else. The result will be stingy care for all.”

, New York State is considering establishing a statewide system of single payer health care or Medicare for All. Entitled the New York Health Act. It would be a one-state experiment of the proposal many Progressives advocate for the nation as whole.

Supporters / describe it: “The NY Health Act (A4738 / l is a universal single-payer plan that would expand and improve our current healthcare system for every New York resident: those on Medicare, those on Medicaid, those that are uninsured, those on Obamacare, the middle class, and more. No deductibles, no copays, no premiums.”

The idea is not new. It was originally introduced in 1992 by Assembly Health Chairman Richard Gottfried.  The legislation has passed the Assembly in each of the past four years and now has support in the Senate, which has a newly installed Democrat majority. The system would be financed through extensive additional taxes.  That’s going to place a significant burden on a state which is already losing population and business due in significant part to high taxes.

A state think tank, the Empire Center, is critical of the concept, for reasons that would be applicable to the nation as a whole, It’s analysis notes: “…the costs and risks of single-payer would be much greater, and the benefits much smaller, than its proponents claim. Sweeping and coercive even by international standards.

“Consider just a few of the ramifications:

• A system that covers more people and gets rid of existing cost controls—without slashing provider fees—would unavoidably drive health-care spending up, not down.
• Given the exorbitant tax hikes required, a significant fraction of New Yorkers would pay more for coverage than they do now, and many if not most of those people would be low- or middle-income.
• Even if overall spending were kept stable, the switch to state-controlled prices would disrupt revenue flows for the entire health-care industry—representing almost one-fifth of the economy—with a destabilizing effect on access and quality.

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“Meanwhile, single-payer would put vastly more power and money into the hands of a state government notoriously prone to corruption and inefficiency. Health care would dominate Albany’s time and money to the exclusion of other priorities, such as education and infrastructure. Ironically, the push for single-payer comes at a time when New York’s uninsured rate has dropped to a historic low of 6 percent. Many of the 1.1 million who still lack coverage would qualify for free or subsidized coverage under existing government programs. This means the vast majority of the money, effort and disruption required to implement single-payer would be devoted to people who already have insurance—and who would be forced to change it whether they want to or not. State lawmakers looking to improve the health-care system should focus on measured, practical solutions targeted at clear-cut needs—and not the costly and risky radical surgery of single-payer.

The Report Concludes Monday

Photo: Pixabay