Health care policy inspires a lot of passion and emotion -- particularly in the United States. Well, sometimes you come across an article that spares the hyperbole and is just spot on:
The idea that the ACA is a logical precursor to single-payer, in which the government would be the source of all medical reimbursement, has been gaining traction as key thresholds for healthcare reform approach. The biggest milestone is the Oct. 1 launch of open enrollment for the health insurance exchanges that will offer individual insurance starting Jan. 1.
Last month, Senate Majority Leader Harry Reid made that point in a Nevada news broadcast, calling the ACA "a step in the right direction" but adding that the U.S. would have to "work our way past" private insurance-based healthcare. "We're far from having something that's going to work forever," he said.
"There isn't a popular groundswell yet" for a single-payer plan "because most people haven't seen the ACA at work in detail yet," says David Himmelstein, a professor of public health at the City University of New York and co-founder of Physicians for a National Health Program, the leading advocacy group for single-payer healthcare. But he anticipates that discontent will start in October "and accelerate through the winter."
While the Affordable Care Act (i.e. ObamaCare) will do a lot of good, when the private insurance corporations inevitably screw people over -- or just screw up due to their labyrinth bureaucracy -- people who have purchased their insurance through the 'exchange' won't just be upset at Aetna or Cigna, they'll also be upset at the government. There is a better path forward. It's a single-payer plan that even Sarah Palin and Mitt Romney go to epic lengths to defend from cuts:
But the U.S. does offer a healthcare program that resembles single-payer. It's Medicare, the broadly popular health plan that covers all Americans over 65. Medicare's administrative costs are only about 2%, and its size gives it the clout to extract large discounts from doctors and hospitals. That's why one oft-proposed version of single-payer is "Medicare for all" — simply expand its coverage beyond the 65-plus.
Yup, Medicare. That efficient, glorious program that no (sane) politician will dream of attacking. Compare its -- more or less -- 2% administrative costs to big-profit private insurers:
Add those, and the overall administrative costs embedded in the U.S. healthcare system come to 31% of all spending, according to a 2003 article co-written by Himmelstein for the New England Journal of Medicine. Administrative and clerical workers accounted for nearly 44% of all employees in doctors' offices, they calculated.
What do Americans receive in return for all this overhead? Practically nothing. The insurance industry says its role is to hold down costs by negotiating for preferential fees from doctors and hospitals and trolling for abuses, but the truth is they're totally ineffective at cost control.
Just last year I reported on an admission by Aetna and United Healthcare, two of our biggest insurers, that they had been snookered to the tune of $60 million by one chain of small surgical clinics in Northern California. That happened because the insurers didn't hire enough staff to give the claims from those clinics decent scrutiny — in other words, their administrative costs, high as they were, didn't buy adequate oversight.
The result, to cite just one example, was that United paid the chain more than $97,000 for a kidney stone operation that it usually covers for $6,851.
"Private insurance is a parasite in the system," says Arnold S. Relman, the former editor of the New England Journal of Medicine and an advocate of healthcare reform. "It adds nothing of value commensurate with its cost."
Private insurance isn't just a parasite in the system, it's an absolute failure. Our health
care costs are so
insanely high in the USA because the thousands of private health insurance plans make negotiating low costs with providers -- and massive for-profit hospital chains -- near impossible. Only a strong single-payer plan covering almost everyone can discipline hospitals charging insane amounts of money for salt water or aspirin tablets.
There's not too much more to say about this article -- it's just a well-written, well-argued piece laying out the critical need for our society to expand Medicare to everyone from birth. Read it -- and please do share.