Amid tangle of Obamacare, consider single-payer health care

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With private insurance covering most of the employed and 48 million uninsured, the United States has seen health care costs skyrocket for many decades. Something had to be done, so Congress passed the Affordable Care Act (Obamacare) in 2010. Apparently, the House suddenly awakened to that fact and wanted to shut down the government to reverse history to when George W. Bush was president.

CONTRARY TO THE social media hysteria being sent out, the ACA is not a left-wing socialist program. It is built on a flawed conservative Heritage Foundation proposal that was the basis for Romneycare in Massachusetts. As opposed to what the demagogues spout, the ACA simply expands the private insurance system to cover everyone, a right-of-center concept. Until relatively recently, that was exactly what the Republican Party was advocating, per Bob Dole when he ran for president.

Regardless of the hypocrisy, the pundits are correct that the ACA will increase total costs; fail to cover tens of millions of people (partly because of the refusal of many red states to expand Medicaid because of party politics); and perpetuate the self-interested stranglehold that private insurance companies have on our health care system. And the delays in implementation, many because of politics, should tell all of us how hard it will be to install.

So what is the best alternative?

Medicare is a well-established program beloved by most Americans – Republican, Democrat or independent. It is easy to understand why that support is so strong. Go back and look at what existed before it was enacted: the free market, with older Americans thrown to the wolves.

The Darwinian notion that we simply can return to the bad old days is out of touch with modern society. The radical philosophy of Ayn Rand, formed as a reaction to the communist threat nearly a century ago, is behind the Paul Ryan/GOP health care proposals of today.

In the 1960 presidential debates, Richard Nixon called national health insurance for the elderly “socialism.” Right or wrong, even our right-leaning seniors now love it. Remember the Tea Party placards in 2009 at town hall meetings – “Keep the government out of my Medicare”?

THERE IS TREMENDOUS voter resistance to cutting entitlements (earned benefits, say some) via a Ryanesque Medicare voucher program that takes away the government guarantee of health insurance for the elderly. Having an inevitably decreasing federal ‘‘premium support,” which will
be tied to Washington partisan budget politics, should give few citizens younger than 55 little comfort.

I am a capitalist and a former Republican elected official, but we are going in the wrong direction with the simplistic Ryan approach. Health care is different than other economic markets. The “rational economic man” theory, wherein the buyer can evaluate quality and costs in a perfect world of readily available data, is just not applicable.

We should be setting up regulatory mechanisms to control costs, as other developed countries with more effective national health care systems do. That includes universal budget-setting with control of payments to providers, ensuring that compensation is equitable but not excessive.

The most efficient way to accomplish this goal is single-payer Medicare for all, funded primarily via payroll tax shared by employers and employees. The best place to find out more about single payer is from the Physicians for a National Healthcare Program:

• Private insurance companies have 31 percent administrative and marketing costs vs. 3 percent for Medicare;

• Medical bills are a major cause of bankruptcies in the United States, although most folks going broke had health insurance;

• The current breakdown of payers is not what you might think – 60 percent government; 20 percent private; and 20 percent out of pocket;

• We currently pay more per capita in taxes for government health care (Medicare/Medicaid/Veterans Adminsitration and so forth) than most nations, but we still have tens of millions uninsured.

LET’S ASK OUR politicians to finally put their ideologies aside and do what works for many other developed nations: single payer, universal Medicare.

(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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deestafford
28602
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deestafford 10/27/13 - 08:36 am
2
1
What a bunch of horse squeeze and liberal clap trap!

I mentioned just a few days ago that there would be a cry from the liberals that since obamacare is not working the only thing to do is go to a single payer. This is out right socialism of taking from the producers and giving to the moochers who don't work, ain't never worked, and don't want to work. It's right in line with Obama's redistribution policy. We currently have 49.2% of the population drawing some type of assistance from the government and this figure does not include Social Security and military requirement or the 200 billion per year put out by the states. Since Obama has been in office over $3 trillion has been spent on 86 welfare programs.

To site Dole and Romney as examples of conservatives is really off base. The only conservatives the Republicans have run for president in the last 50 years have been Goldwater and Reagan. All others have been "moderates".

There is nothing, and I mean nothing in The Constitution which justifies a single payer program. The healthcare system has never operated on a free market system because of government interference. If there were no mandates and people could purchase across state lines as they do with car insurance they cost would go down. Tort reform would further reduce costs.

We need to get the able bodied out of the wagon and get them pulling their weight and not sitting in it telling those pulling to pull faster.

ymnbde
10015
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ymnbde 10/27/13 - 08:56 am
3
1
another "vast right-wing conspiracy?"

wrapped in a "vast right-wing conspiracy?"
that is what this writer would have you think
what an exceedingly poorly written article
"The Darwinian notion that we simply can return to the bad old days"
oh, i get it... people who disagree with you are neanderthals
"Ayn Rand, formed as a reaction to the communist threat nearly a century ago,"
her ideas were formed as a reaction to the threat of BIG government
where intellectually "superior" buearucrats try
to control all aspects of our lives, including health care
when a main supporting statement in your essay
includes a sign at a tea party rally (probably by an opposition liberal)
you don't have a very good argument
this writer actually displays the reasons it won't work
simply an article pasted from government talking points
by a bureaucrat worshiping at the "alter" of big government
(yes, it is misspelled but government it does like to "alter" reality)
the only way to get better health care is to have more doctors
if we're really a good society that should not be so hard
it's quite telling that government chose the way of more government
heck of a job brownie
your own closed minded idealogies have been nicely asserted

carcraft
26955
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carcraft 10/27/13 - 10:17 am
2
1
We could have health care

We could have health care like Henry Ford had mod A's, "you can have any Color you want as long as it is black "! The sign at the TEA PARTY rally refers to the fact that Obama is taking Billions ($716 billion) and cutting reimbursement for medicare services to pay for Obama Care. The problem is physicians and some hospitals already limit Medicare patients because of low reimbursement levels. Equating this sign to love of Medicare is deceitful. The individual with the sign seemed to want to protect people already on medicare!

dichotomy
34325
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dichotomy 10/27/13 - 01:41 pm
2
1
Oh yeh, Medicare ALREADY has

Oh yeh, Medicare ALREADY has about $40 trillion dollars of unfunded liability. Yeh, lets throw another 48 million people into that briar patch and see which way the rabbit runs.

Everywhere they have a single payer system they have broken budgets, delayed care, limited procedures, long wait times, and evaluation procedures to deny high cost medical procedures to the elderly who have a low return on investment.

Before we started with this Obamacare crap 85% of the population had good health insurance and high quality health care. The rest had SOME KIND of health care even if it was going to the Emergency room. I can live with that compared to what Obamacare is doing to us. AND WE WILL STILL HAVE 30 MILLION PEOPLE WITHOUT HEALTH INSURANCE AFTER DESTROYING WHAT WE HAD AND WE WILL BE PAYING MORE FOR IT.

What a deal the Democrats had for us.

Polemics
6
Points
Polemics 10/27/13 - 02:37 pm
1
1
A Capitalist and a Republican?

Jack Bernard has spouted that he is and has been a Republican for years as he writes his crap about how wonderful Obamacare is. He usually cites something from a communist organization to tell us all how wonderful it is. Maybe his goal is to be on the "team" with the rest of Obama's czars. Bernard spouts socialist/communist ideas and hopes we believe that as a "Republican" he is just so much more enlightened than the rest of us. He writes these articles for newspapers all over the country and they are all the same. The evil Republicans just won't let something as good as ACA happen. Well, we can see how wonderful it is working. Millions losing good health insurance they have had to get on Obamacare with large deductibles and higher premiums. For those already on government assistance it is nothing more than more people on Medicaid! Yes, Jack, another handout to those that don't work and won't work on the back of those of us that do!

Willie Loman
267
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Willie Loman 10/27/13 - 08:28 pm
0
0
Personal responsibility

A single payer system is what the Affordable Care Act is designed to provide. The problem is, most young people realize that they are being asked to fund the poor lifestyle choices and train wreck health problems of a minority of the population. Their response? Opt out. that puts a big monkey wrench into the plans of the architects of this "great" social experiment. I still think all people ought to pay for the services they consume, whether cable, cell phones, electricity or health care. Most people have no idea what their care really costs. If people had to pay up front then be reimbursed some percentage of their care, it might open thier eyes. Personally, it boggles my mind that the pharmaceutical industry continues to thrive in this down economy. Why? Cause they are making a killing! Notice all of the Walgreens and CVS stores popping up on every street corner? They are selling drugs(and charging insurance companies) at 300-1000% what it costs them to carry a given drug. Criminal? No. Immoral? Probably.

Gage Creed
17855
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Gage Creed 10/28/13 - 07:52 pm
1
0
Five letters to the editor

Five letters to the editor over a 2 year period... each more laughable than its predecessor... The citizens of Monticello must be so proud....

lsmith
105
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lsmith 10/28/13 - 09:34 pm
0
0
He says his single payer
Unpublished

He says his single payer system would be funded through employment taxes and shared with employer. I do believe that health care should be offered through employment, however who's going to pay the insurance for the millions who can't/won't work? Oh.......medicaid? The proverbial sacred cow that has the countries best doctors and hospitals running from because the reimbursements as so low and........slated to get even lower because of AFA. Ask Britains how their National Healthcare's working out? As Canadians who can buy drugs cheap but come to the states to avoid the long wait periods for treatment and surgeries.

ccrider27
9
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ccrider27 10/29/13 - 02:49 pm
0
1
Ad Hominems Abound

Being a new member here, I'm surprised at the low level of debate presented in the comments.

Most of the commenters seem to have a collection of insults that they throw out whenever this subject comes up. But insults and name calling simply indicate that the commenter has no grasp of the issues or the facts.

So deestafford, ynmbde, carcraft, dichotomy, … I suppose either you already have or soon will opt out of Medicare? Is that right? Really?

And please, not the urban legend that Obama is taking $716 Billion out of Medicare so he can put it in Obamacare. That's the old Romney talking point that was totally exposed back during the 2012 campaign. Not an ounce of truth to it. The fact is that ACA institutes $716 Billion in cost savings reducing the cost overruns of the Medicare Advantage, bringing its costs more in line with Medicare Parts A and B. It also reduces reimbursements to hospitals that do not meet certain efficiency measures.

But again that's just an example of the level of 'debate' here.

Mr. Bernard is not 'advocating for Obamacare' by any stretch of the imagination. Did you even bother to read the article.

I don't think anyone understands what Single Payer really is.

We all agree (believe it or not) that Obamacare is a travesty. But the reason is that it tries to achieve universal coverage while dragging along the 30% overhead introduced by the fat cat health insurance conglomerates.

The main problem with Obamacare is not that it puts the government in charge, but rather that it puts us at the mercy of ever consolidating (read less and less consumer choice as a result of 'free enterprise') health insurance corporations that create very narrow choices in terms of doctors and hospitals for the sick consumer.

If businesses truly want to get out of providing health insurance to their employees (and they certainly should), then the only choice is the one that provides better outcomes for half the price that we are now paying in this country in terms of the overall cost of health care. We should adopt the model used by every other industrialized country in the world that provides better, and universal care at half of the overall price - Improved Medicare for All, aka Single Payer.

Gage Creed
17855
Points
Gage Creed 10/29/13 - 09:05 pm
1
0
" Improved Medicare for All,

" Improved Medicare for All, aka Single Payer".... surely you jest?

390 words for that? Next up... carbon taxes (palm to forehead)

Darby
26871
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Darby 10/30/13 - 11:20 am
1
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"CONTRARY TO THE social media hysteria being sent out,

the ACA is not a left-wing socialist program."

.
When you begin your column with an outright lie such as this.... you can only go downhill from that point..

Darby
26871
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Darby 10/30/13 - 12:08 pm
1
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These are the same people who repeatedly tell the world

that Republicans fought against the 1964 Civil Rights Act, even though it was Republican leadership that partnered with LBJ to get it through in the face of Democrat filibusters by the likes of Al Gore Sr., and Robert Byrd.

Recently, the disgraced tax cheat Charlie Rangel (D) announced that Republicans vote en mass against Medicare. He said the "Not one single Republican voted for it."

When told that 81% of Republicans supported and voted for the bill "Goodtime Charlie" just shrugged it off.

Lying is second nature to Democrats, given that they know full well that their allies in the media will NEVER call them on it.

ccrider27
9
Points
ccrider27 11/03/13 - 11:32 am
0
0
"It's Nothing But Pure Socialism"

So lets get rid of all police departments, fire departments and the Dept. of Defense.

They all work on that same principle.

Wake up people.

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