Republicans should back a single-payer health-care system

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My party, the Republican Party, has staked out amazingly naïve positions on two of the key domestic issues facing us: immigration and health reform. These issues are intertwined.

Health Affairs, one of the most influential professional health care journals, has published a new Medicare study, conducted by Harvard and City University of New York researchers. It found that immigrants were responsible for 8 percent of Medicare expenditures – no surprise there.

What was astounding to me and many others was that nearly 15 percent of Medicare trust fund collections came from this same group of people. In other words, immigrants put in nearly twice the amount of money that was paid out to them.

In 2009 alone, the net gain to Medicare from immigrants was $13.8 billion, whereas native-born Americans had a deficit of $30.9 billion. Much of this difference can be accounted for because of low birth rates and the aging of our U.S.-born population, while immigrants are a much younger cohort. Further, immigrants cost Medicare less on health care because of a variety of reasons.

The bottom line: We need immigration to balance the books for Medicare, as is also true with Social Security. Without it, we will either have to cut benefits or dramatically raise taxes on a proportionally smaller and smaller work force.

So, at least for these programs, the fiscal side is clear. Immigration is a net plus.

What about the political side?

MANY GOP strategists finally are seeing what I have said all along: In 2012, the party shot itself in both feet regarding immigration. Pandering in primaries may win you the nomination, but advocating for ridiculously impractical positions will not win the presidency. In any case, the deportation of 11 million people is something that will never happen, no matter who is president.

By opposing true immigration reform, including a path to citizenship, the uncompromising right wing of the GOP has accomplished two things. Both are long-term negatives for the party.

First, these “nativists” alienated legal immigrants and their families for generations to come. Hispanic voters are being driven to the Democrats, which will cause increased losses in key swing states, such as Texas and Georgia, over time.

Second, as U.S. Sen. Marco Rubio of Florida has correctly stated, by blocking congressional action the right-wingers are in effect continuing unrestrained immigration. Since there has been no national progress on immigration reform, including border security, the illegal problem just gets worse and worse.

Similarly, Republicans have staked out a losing long-term health-care position: Just repeal the Affordable Care Act (Obamacare) and simply let competition reign. But voters are skeptical of the same old worn-out GOP slogans: Medicaid block grants, Medicare vouchers and weakened regulations.

None of these measures will significantly stop rapidly escalating systemic health-care costs or control premiums. Most simply shift risk and/or expenses to the patient or the states – something voters do not like.

THIS IS NOT to say that the ACA is the solution for our ills. The financial basis for universal care via private insurance is the unpopular requirement that everyone buy insurance or be taxed. It is questionable as to how many healthy young people will actually buy insurance, mandate or not. And many “red” states have not agreed to add more Medicaid patients to their roles, citing dubious fiscal issues.

Obamacare does not deal with a key root problem – the private health-insurance model itself. Family premiums already are at $15,000 per year and rising, with a greater proportion picked up by employees every year. The voter will see his/her premiums, copays and out-of-pocket costs increase dramatically as the insurance companies continue to maximize their profits under Obamacare.

Health care as a proportion of gross national product – already completely out of control – will continue to rise. The government will see greater red ink along with growing deficits, while tens of millions remain uninsured.

Richard Nixon once called Medicare “socialism,” but now it is supported by almost all Americans. Further, Medicare administrative costs are 3 percent while private insurance is more than 20 percent.

What should be proposed by the GOP to contain costs and improve access? My advice to my fellow Republicans is to employ your reason vs. your ideology.

Government health insurance is the solution, not the problem. The GOP should promote a single-payer system – Medicare for all.

(The writer is a retired senior health care executive with several national for-profit firms, and was the state of Georgia’s first director of health planning. He lives in Monticello, Ga.)

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Gage Creed
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Gage Creed 06/23/13 - 02:36 am
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The premise for this column

The premise for this column is that the unauthorized immigrants use less Medicare dollars than they pay in via payroll contributions.... Given we are talking about unauthorized immigrants, how can the payroll contributions be calculated?
More stacked deck statistics from a retired health care executive affiliated with national for-profit firms.

myfather15
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myfather15 06/23/13 - 05:53 am
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@Gage

Noticed he didn't use the term illegal immigrants;

"In 2009 alone, the net gain to Medicare from immigrants was $13.8 billion, whereas native-born Americans had a deficit of $30.9 billion."

Now, since he didn't provide the source of this information; I suppose we are to take his word for it. It appears this guy might be a RINO, but that's just my opinion. He never touched on how ILLEGAL immigrants, using ER's as their personal doctor's is HELPING skyrocket health care costs; thereby greatly assisting in destroying the system.

2 Corinthians 11:14 "And no marvel; for Satan himself is transformed into an angel of light."

The word "transformed" in the greek can be translated into disguised and it would be accurate. They disguise themselves as the "TRUE" republican conservatives, to make the "far right" seem out of touch. Just like liberals attending Tea party events; disguising themselves as Tea party members, then acting like idiots to hurt the Tea party's reputation.

This is ridiculous; no conservative is in favor of the government FORCING citizens to purchase health insurance or be punished. This is going to be a disaster, period!! Yes, the healthcare system needs reform, but certainly not from federal government bueaucrats!!

RMSHEFF
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RMSHEFF 06/23/13 - 06:30 am
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His solution is more

His solution is more government, more illegal immigrants and higher taxes. He does sound like some of the republicans now days.
It is amazing that people use deception to sell amnesty. Most of the cost of illegals are born by state and local government, many which have been pushed to the point of bankruptcy. In California both schools and hospitals are loosing millions have to deal with these cost.

RMSHEFF
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RMSHEFF 06/23/13 - 06:38 am
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MyFather15

I was wondering the same thing. I have no idea where this medicare claim comes from. No one is complaining about legal immigrants and since illegals can't get medicare I have no idea what he is referring to. This whole letter sound a little "off the wall" to me.

Riverman1
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Riverman1 06/23/13 - 07:07 am
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As others noted, he is

As others noted, he is talking about LEGAL immigrants. I think Republicans want health care reform. Obamacare is not what's wanted, however.

soapy_725
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soapy_725 06/23/13 - 07:31 am
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Shifting focus: PBS, undereducated illegals is real issue....
Unpublished

Shift the focus. We've moved beyond the fact that they are illegal and therefore lawbreakers. Now we must deal with their lack of education and medical needs. Totalitarian techniques at their best.

In other countries they would be called "economic refugees". They would be repatriated on that fact alone.

deestafford
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deestafford 06/23/13 - 09:15 am
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I can't believe how much horse squeeze was condensed into

one relatively short column. Congratulations on creative writing while seeing though rainbow lens.

If one wants to see what an influx of illegals do to a state just take a look at California. What was once a land of plentiful growth and a wonderful education system is now a basket case where the producers are leaving in droves as the moochers pour in.

There is nothing wrong with legal immigration where everyone goes through a central processing point and are screened as to what positive they can contribute to America. If they can't contribute positively to America, they don't come in.

As to the idea of basing an immigration decision on immigrant political voting patterns and what is best for the ones in the "shadows" is ludicrous. Decisions should be made on what is best for America. I never hear a pro-immigration politician talking about what is best for America...only what is best for the immigrants and the political parties.

If Romney would have got 100% of the Hispanic vote he would still have lost the election. Hispanics by a margin of 80% to 20% believe in a strong central government and high taxes. There is nothing in the background of most of them that support democracy. They basically want the same type of government from which they flee. They are the only group of immigrants in history who have refused to assimulate after three generations. I believe the same thing is happening with many of the muslim immigrants coming from African countries.

There is no reason for us to have this concept that everyone in the world has a right to immigrate and live in the USA.

The solutions to the medical problems do not lie in more power given and used by the federal government. The answer lies in less power in the hands of the federal government in a unknown concept in DC...it's called the free market. Allow people to buy insurance in an ala carte manner across state lines with no ridiculous state mandates such as hair transplants, acupuncture, and pregnancy coverage for a 70 year old woman. And the daddy of all reforms is tort reform.

If the column writer is a Republican, his picture would be in the dictionary next to the definition of RHINO.

Fiat_Lux
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Fiat_Lux 06/23/13 - 02:11 pm
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Darby
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Darby 06/23/13 - 02:37 pm
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Another John McCain

(Liberal/Rino) Republican heard from....

Darby
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Darby 06/23/13 - 02:44 pm
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But voters are skeptical of the same old

worn-out GOP slogans: Medicaid block grants, Medicare vouchers and weakened regulations."

.
Oh yeah, this guy is a Republican alright. He has to be. Didn't he say he is??

.
By the way, I'm still looking to sell the Brooklyn Bridge. I will take $200 cash and provide you with a deed to the property.

Trust me. I wouldn't lie to you. I'm a liberal Democrat. We don't lie.

Polemics
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Polemics 06/24/13 - 10:50 am
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Socialist, not RINO

This guy was a county commissioner in Jasper County that was all about what he could do to help himself. He wanted ZERO deductible for employee health insurance, which he got for about 3 years. He ran as a republican, but is a socialist and cites socialist groups for his 'statistics.' You can't believe anything he puts up. He wants FREE everything, and promotes all this stuff, but he doesn't plan to pay for it. The working man will, not him. RINO is too conservative for this guy. SOCIALIST is the word.

prov227
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prov227 06/25/13 - 04:04 pm
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Too many labels ...

Democrat, republican, RINO, socialist, communist, etc., etc. However, this guy does remind me of a BUREAUCRAT. Bureaucrats really run our government. Bureaucrats, like government "solutions" and hate competition.

Bantana
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Bantana 07/31/13 - 05:08 pm
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how does zero deductibles

how does zero deductibles serve the interests a for-profit health care executive?

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