Medicare For All Should Replace the Affordable Health Care Act

Addressing your first point; what do you mean by your statement "universal health care will not work"? If you define a working health care system by measuring the quality of care, accessibility, cost, and equity then our selective health coverage falls very short. According to Commonwealth Fund's report, "Mirror, Mirror On The Wall - 2014 Update: How the U.S. Health Care System Compares Internationally", the United Kingdom, Switzerland, Sweden, Australia, Germany, Netherlands, New Zealand, Norway, France, and Canada all have better health outcomes, better access, equity, and perhaps what has become the most contentious item - lower costs (1). I would like to take a moment and clarify my position. I am advocating for a single payer system. While single payer is by definition universal coverage, you can achieve universal coverage a number of different ways (2). I have focused on single payer because of my experience in the field. I am a computer technician who was hired about a decade ago by our town's doctor to replace the network in his clinic. I will never forget the day when Dr. Van Eaton came into my office and asked if I could replace not only his computers but the software that ran his business too. He looked somewhat upset and I could not help ask why he didn't just update his existing system. What came next took me by surprise. He starting ranting about how much money he had already invested and now the software company he was dealing with wanted $50,000 more just to upgrade his software. This was for a clinic that employed one doctor, a physician assistant, three nurses, a receptionist, and four employees that handled billing and insurance. What had angered him the most was the fact that he had not been paid for over 3 months which almost drove him into bankruptcy. There was a glitch in the software that caused all the forms he had submitted electronically to be rejected. Most people are unaware of the huge overhead expenses born by all health care providers large and small when dealing with multiple insurance agencies . The necessary software and people needed to keep things running smoothly, making sure claims are submitted correctly - if a field is left blank when it should have a code it can cause the claim to be rejected - has been adding significantly to overhead expenses long before the Affordable Care Act (ACA) was even thought up. A single payer system would simplify the complicated system we have today by having one agency handle all claims and payments saving up to $150 billion in paperwork (3). Another distinction between us the other ten countries mentioned in the Commonwealth Fund report is our health care system is for profit. The Affordable Health care Act allows private insurance companies to claim 15 percent to 20 percent overhead. Medicare overhead is estimated to be 1 to 1.5 percent. Let"s round up Medicare"s overhead to 2 percent and keep private insurance"s overhead to 20 percent because you know they will squeeze all they can out of the system. That leaves them with a healthy 18 percent profit margin. Now let"s put some numbers to it. For the sake of the argument, lets say an insurance company has 10 million policyholders (out of a possible 300 million) paying $12,000 per year in premiums. The gross collected from the premiums would be $120 billion, of which 18 percent would be $21.6 billion. That's $21.6 billion that is not going toward patient care. That's $21.6 billion a year that is instead being divided up between the insurance executives and their board members. What service do they provide for $21.6 billion a year? So you see your second point is just a canard and has no merit. Doctors have long been hard pressed to make due with the resources they have. The ever upward spiral of overhead expenses has driven many local doctors to close their clinics and join larger organizations. Look around. Do you see any neighbor clinics like we had in the 1960's? This is a symptom of our selective health care system which the ACA does very little to address. Over utilization of our emergency rooms have also driven many hospitals to merge with others to help control costs. The staggering savings we would gain from a single-payer system would go a long way to alleviate this crisis (3). You can also apply that to the myth of long wait periods. In countries that have non-profit universal health care experience some waits for elective procedures (like cataract removal), but maintaining the US"s same level of health expenditures (twice as much as the next-highest country), waits would be much shorter or even non-existent (3). The health care industry would not be the only ones to benefit by our scrapping the ACA and going to a single payer system - employers would no longer be responsible for providing health care insurance to their employees. It is without doubt that today that it is the highest expense that companies have to deal with. Starbucks spends more on healthcare benefits than coffee beans and GM (in 2005) spent more on healthcare benefits than steel (4). In my final argument for this round I would like to address the naysayers that contend a single payer system would be impossible to implement. First, Americans do not understand the definition of impossible. One only has to look to the great state of Vermont. The Vermont plan largely derives from Harvard economist William Hsiao, who described it in a 2011 Health Affairs paper. He estimated that single-payer would save 25.3 percent over current state health spending, cut employer and household health care spending by $200 million, create 3,800 jobs and raise the state"s economic output by $100 million (5). Aside from the savings we would gain from taking the private, for profit insurance companies out of the picture there is an assertion made by conservatives that seems counter to their religious belief they hold so dear. And that is to take care of only those who can afford to pay extortion to the almighty insurance cartel and leave those less fortunate to fend for themselves. I find this unacceptable as everyone has a right to health care. Vermont is the first state to take the necessary action to cover all their citizens - wealthy or poor - and with determination I aim to make Washington State the second. We need Medicare For All. (1) http://www.commonwealthfund.org... (2) http://www.forbes.com... (3) http://www.pnhp.org... (4) http://www.forbes.com... (5) http://www.kaiserhealthnews.org...