When the 112th Congress gets underway with their attempts to dismantle, defund, replace and/or repeal, oh yeah, and destroy the President's so-so progressive healthcare legislation, the Affordable Health Care Act which probably not as affordable as it ought to be, maybe it's time for progressive Dems in the House to rev up the public option or Medicare For All again. After all the drama about fiscal austerity and reducing the deficit, one of the best ways to reduce the deficit is to get healthcare costs under some kind of control by expanding Medicare thereby saving Medicare.
As a healthcare provider who gets paid by private insurances, third-party payers, Medicare, Medicaid, and cash patients, I and others like me have an understanding of how the system operates. Payments from private insurers (much larger than Medicare and Medicaid) provide a payer mix that is quite beneficial for the hospitals and doctors; it makes up for the lower-paying public insurers and the patients who don't pay their bills. It is all baked-into-the-system and into the costly, and still-rising health insurance premiums that individuals and businesses pay for health care insurance.
The costly premium pays for the profit-taking of hospitals, health care providers and the private insurance companies and at the same time, the premium pays for their losses due to indigent patients or lower-paying public insurers. So it is already a quasi "socialized" medical system, but one that guarantees profits if and only if, businesses and individuals can pay the high premiums. However, millions of Americans go without insurance of any kind or they are underinsured. Struggling small businesses do not offer full-time jobs because of the cost of premiums. And the Affordable Health Care Act with all of its provisions seems likely to be deconstructed along the way and not provide what is really needed, and that is health care for all.
I believe health care is a right and not a privilege. The Affordable Health Care Act needed to be simple and understandable (KISS-Keep It Simple Stupid) and it failed in that regard. A single-payer system is what we needed and what most of the public wanted. Expanded Medicare For All with modest progressive payroll deductions would fit the bill nicely thereby maximizing the risk pool and revenue.
Yes, there are some physicians who don't see Medicare patients. Perhaps they will go to totally cash payments if there was a single-payer system. There are more and more doctors practicing concierge medicine and the wealthy will always get their medical care regardless of whether there are private insurers or not. However, even the wealthiest still get on the Medicare bandwagon when they turn 65. I know because I have been their provider.
It's time the Progressive House Dems have that "adult" conversation with the Republicans and hammer it home, over and over, KISS, the only way to reduce our long-term deficits is a single-payer system, Medicare For All, which would save Medicare and provide health care for all.