Bob Englehart, The Hartford Courant

We All Need Health Care Now

National Health Insurance Saves Money in the Long Run

Wednesday, July 30, 2014
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Happy birthday, Medicare, which celebrates 49 years of service today. In a 1995 essay in the journal Health Affairs, Robert Ball wrote that those who helped develop Medicare saw it as a first step toward universal national health insurance. Covering only seniors was a fallback position because that is all that could be expected to pass Congress at the time. Sound familiar?

Medicare is not perfect, but political fights over ideology and special interest profits have blocked improvements that would increase efficiency and effectiveness. Otherwise by now we would have national health insurance, have better outcomes, have no uninsured nor financial barriers to care, and would be spending much less on administrative overhead, like the rest of the industrialized world.

The Medicare Advantage program — your Medicare dollars given to private insurers who of course need to make a profit — promised reduced cost and expanded coverage, but instead increased costs (15 percent more costly to the Medicare fund than traditional Medicare) and decreased choice of physicians.

Part D, subsidized drug prices but prohibited negotiating prices or importation, thus keeping prices artificially high.

And now, instead of folding Medicare, Medicaid, employer-provided insurance, and individual insurance into one Medicare-for-all plan, we have added Obamacare, which multiplies the administrative complexity and inefficiency of both public and private insurance plans. It still leaves over 30 million people without health insurance with an indefinite wait time for all but emergency room care.

Don’t misunderstand the above as a call for repealing Obamacare, which has provided affordable coverage to millions more people. My point is that if we could get beyond the ideological fighting, beyond corporate desire for ever-increasing profits and look only at efficiency and effectiveness, we could have national health insurance for everyone at no additional cost and save money now and in the long run.

Logically, fiscal conservatives should embrace a reform such as Medicare for all because, factually, it would save all of us money — government, individuals, and businesses. But it is hard to even get some progressive politicians who think Medicare for all is a good idea to champion it for fear of conservative backlash. The time is not right, some say.

Logic and facts may not be in fashion, but the time is right to organize, organize, organize. So if you think Medicare for all is a good idea, support one of the many groups backing the idea. When the parade of supporters gets big enough, the politicians will scramble to get to the front.

In the end, it is up to individuals, businesses, medical professionals, and organizations of all types to act. The movement exists. You need to join it to make it succeed.

Peter Conn is outreach coordinator of Health Care for All — Santa Barbara.


Independent Discussion Guidelines

As long as there is money in politics, and as long as it comes mostly from Libertarians, rational, humane healthcare will never happen.

Ironic, % coverage is going up in all states except for those that opted out of ACA.

tabatha (anonymous profile)
July 30, 2014 at 3:57 p.m. (Suggest removal)

That's interesting you say that, Tabath, given the poor showing of the Libertarian Party in election results.

billclausen (anonymous profile)
July 30, 2014 at 7:54 p.m. (Suggest removal)

People who follow libertarian philosophy do not usually run as Libertarians. Look at Ron Paul and Rand Paul.

"Rep. Paul Ryan (R-Wis.), Mitt Romney's new running mate, has been hailed as the closest thing to a libertarian on the Republican ticket since Rep. Ron Paul (R-Texas). "Ryan is going to be very attractive to the broad libertarian voters," the Cato Institute's David Boaz told Buzzfeed."

Most Republicans are free market Libertarian-leaning. The Tea Party certainly is 100% Libertarian.

They are elected as Tea Party or Republican congress members.

The famous Fed chairman, Alan Greenspan, was a die-hard Ayn Rand and Libertarian follower.

I thought the above was common knowledge.

tabatha (anonymous profile)
July 30, 2014 at 8:22 p.m. (Suggest removal)

Tabatha: While I generally don't agree with you, I acknowledge your intelligence, and as such can communicate to you on that level. Most Americans however, are ignorant of what goes on around them. (Let's face it, when Rap is considered "art" and Redneck reality shows are the norm...)

The mantra of the New Right is "we're Libertarians", uh-uh, not by a long shot. Does Paul Ryan unequivocally oppose the War on Drugs? Does he oppose the Patriot Act and the National Defense Authorization Act? Does he oppose NAFTA? Is he for cutting corporate welfare? Is he for ending the cash flow to foreign despots?

OK, YOU know what I'm talking about, I think many of the bloggers do as well, but to the average party-line Republican voter, bringing up these points would make their heads explode.

These ersatz "Libertarians" give libertarianism a bad name.

billclausen (anonymous profile)
July 30, 2014 at 9:22 p.m. (Suggest removal)

P.S. Whether you agree with my choice or not, or even if I'm right or wrong, I actually VOTED Libertarian in this last election. (Gary Johnson)

I'm not one to talk the talk then run and vote for whoever the RNC regurgitates.

billclausen (anonymous profile)
July 30, 2014 at 9:23 p.m. (Suggest removal)

I vote for the person that I hope wins.

LOOKINGFORAGOODREAD (anonymous profile)
July 30, 2014 at 11:25 p.m. (Suggest removal)

I've tried explaining to tabatha that the Koch brothers are corporatists and not really libertarians and completely co-opted and destroyed the real libertarian movement that should be based on peace, sound money, free markets, protecting the environment and civil liberties but she won't listen.

The reason health care is so expensive is because the government got involved back in the 70s and ended up corporatizing it. Corporations themselves are actually government entities and are not libertarian, but don't tell tabatha because she believes that the big corporations actually PROMOTE libertarianism..

The government was concerned that not enough people had health care insurance and so they decided to give tax incentives to corporations to give their employees health insurance. These incentives were overwhelming and almost everybody strove to get health insurance through their company so they could get it cheaper - but ultimately more money was going toward the health insurance companies and the medical industrial complex. This ended up raising prices in the market severely because over time eventually almost nobody was shopping for the best quality AND prices in healthcare, and nobody was shopping for insurance because it came with your job.

Before all of this people used to have extremely low health care premiums and health insurance was very affordable. Increases in technology has improved health care in many areas and while this technology is expensive to develop, like everything else prices should come down eventually and these devices should ultimately reduce the cost of health care. Only industries that have heavy influence of government end up raising prices over time, decrease the quality and destroy the market mechanisms that make it all work.

Make no mistake, if we go full-on government run health care it will end up costing us even more money, quality and availability will go down severely. A few people will be making a lot of money.

What, you don't think people will be making money if health care is government run? The military is government run and we got Halliburton and all these huge bloated defense contractors. Same thing will happen with health care, and we won't have any say in where the money goes because instead of letting us get to spend it, it will be spent by the government.

loonpt (anonymous profile)
July 30, 2014 at 11:37 p.m. (Suggest removal)

That's right loonpt,
Cut the government budget. Repeal the 16th Amendment.
Vote for a person who will not be persuaded by corporate lobbyists.
In Santa Barbara, that's only three different people.

LOOKINGFORAGOODREAD (anonymous profile)
July 31, 2014 at 12:08 a.m. (Suggest removal)

"That's right loonpt," how many times does that phrase come up in polite conversation:?

Ken_Volok (anonymous profile)
July 31, 2014 at 12:45 a.m. (Suggest removal)

Peter Conn, wishful thinking...

dou4now (anonymous profile)
July 31, 2014 at 5:30 a.m. (Suggest removal)

I hope this includes mental h ealth care.

dolphinpod14 (anonymous profile)
July 31, 2014 at 6:09 a.m. (Suggest removal)

Rather often actually, loonpt carries a pocket mirror and frequently talks face to face with his own little buddy.

nomoresanity (anonymous profile)
July 31, 2014 at 6:55 a.m. (Suggest removal)

Why do people think that government involvement in the healthcare system will make healthcare cheaper? Of course healthcare will become more expensive, just like everything else the government touches.

Botany (anonymous profile)
July 31, 2014 at 7:23 a.m. (Suggest removal)

Far more worrisome than the costs of US health care is the failure to provide quality health care no matter what ot who pays for it. Much like what has happened in our schools. California now has the top paid teachers in the nation, yet ranks a dismal 45 in educational quality.

All the focus was about spending more on education and no one cared about what that money was buying, or in this case just as in fighting over spending the health care dollar, what that money is not buying. US health spending is number one in the world, exceeding by twice the second highest country Switzerland. Yet US health care outcomes ranked number 37, barely outscoring many under-develeped nations.

Time to focus on outcomes, not costs or who pays because it is stupid to keep paying anything for a system that works as badly as the US health care system.

JarvisJarvis (anonymous profile)
July 31, 2014 at 8:48 a.m. (Suggest removal)

an important letter, Peter, thank you. ACA has at least covered many more millions of Americans, and that is a very good thing.
A huge issue, e.g. Jarvis' whining above, is getting "beyond corporate desire for ever-increasing profits" -- possibly insurmountable in a "late capitalistic" land like USA. The Guardian's Geo. Monbiot wrote on 7/30 (title "The Rich want us to believe their wealt is good for us all") -- "the richer the elite becomes, the harder it tries to capture public discourse and the political system." With mouthpieces like Jarvis, the disgusting plutocratic News-SupPRESS, Sentinel, MJ...the people are propagandized right/left/center. We desperately need thoughtful public comments like Mr. Conn's.
Another e.g. of pushback is Nick's terrific column (Angry Poodle this week): what the hell kind of so-called Christian country and caring COUNTY (SB) is this when many folks say "just send the 58,000 kids back to Guatemala" or wherever. Chris Mitchum with the smiling face and antique capitalistic hard hard heart says, 'just throw 'em away.' Where is sacred DRI and all our smarmy non-profits in this town? Where are their voices and actions? Oops, they're at the country club for another benefit for abused dogs or failing golf courses.

DavyBrown (anonymous profile)
July 31, 2014 at 10:37 p.m. (Suggest removal)

Conn is a single-payer guy. When he can get the costs and the mechanics of ithis worked out, he might be on to something. Obamacare has nothing to do with single-payer, remains a total debacle and not even implemented as to its original plan because it is so unworkable.

UCSB is not even taking parents health care policies on their students if their insurance plan requires doctors more than 30 miles away so even the age 26 extension is not working. Anyone can subsidize health care for everyone. This is not a plan. This is a giveaway. And Obama could not even manage a free giveaway. Of course he could always use the VA as his working model for national health care delivery. Be well and thrive.

JarvisJarvis (anonymous profile)
July 31, 2014 at 11:22 p.m. (Suggest removal)

Obama got bluffed into eliminating single payer as a choice under ACA. Just another of his incompetent moves. I've been on Medicare for 5 years - works great. I pay for a supplement policy and Drug policy. My cost is less than 20% of my wife's private plan. So someone please tell me how Obamacare is anything more than another income transfer program....

JohnLocke (anonymous profile)
August 1, 2014 at 10:06 a.m. (Suggest removal)

You have been on Medicare for a lot longer than 5 years. You have been paying into Medicare throughout your working life.

Your current monthly Medicare insurance charges (approx $200 a month for A and B) are on top of what you already paid into the system during your pre-1965 working career.

This is a very different funding mechanism than single payer or Obamacare since Medicare requires those not presently recieving Medicare benefits to pay for those who do receive Medicare recipients.

JarvisJarvis (anonymous profile)
August 1, 2014 at 10:27 a.m. (Suggest removal)

Medicare is an income transfer program too, but it is one of the last government programs I would consider would be more like a phase-out that I think we could get to occur organically if we started by allowing the private market to function so that prices on medical services could begin to come down to more affordable levels. Then you could allow young people to begin opting out and getting their own catastrophic coverage and increase their income drastically so they can begin saving on their own for retirement.

loonpt (anonymous profile)
August 1, 2014 at 10:28 a.m. (Suggest removal)

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