National View: Is the time right for Medicare for all? Considering all costs, single-payer promises to be cheaper
Health care has been a hot-button issue in the U.S. for decades. Families struggle to afford increasingly expensive insurance premiums and higher out-of-pocket expenses. The status quo — a deeply broken privatized, for-profit health care system — simply can't last.
Medicare for all is a smart solution to address our nation's health care crisis and one that is rising in public acceptance. More than 70 percent of Americans, including more than half of registered Republicans, support the idea of a single-payer plan that would expand the current Medicare system to cover everyone.
The Affordable Care Act made strides in addressing our modern health care crisis, expanding insurance coverage to millions. Yet more than 10 percent of the country remains uninsured, a figure set to go up next year when the Republican repeal of the individual mandate goes into effect.
What's needed now isn't another piecemeal step forward, but bold, visionary policy.
Sen. Bernie Sanders has led the charge for Medicare for all before and since his 2016 presidential campaign. With a recently elected Democratic majority in the House of Representatives — including vocal proponents of Medicare for all like Alexandria Ocasio-Cortez — prepare for health care to take a central role in forthcoming congressional debates.
Efforts to undermine Medicare for all have been lackluster at best. For instance, you may have heard that it costs money.
A report from the right-leaning Mercatus Center estimated that over 10 years, a transition to universal health care would cost $32.6 trillion. This statistic was cited by Republican politicians, including House Speaker Paul Ryan, and echoed across right-wing and mainstream media alike.
Buried below this startling figure, however, was a much more important point: Medicare for all would actually cost $2.054 trillion less than our current system over the same time.
Now, dollars tabulated in the trillions admittedly are hard to comprehend, but the point here shouldn't be missed. According to a right-leaning think tank's own research, Medicare for all would expand health care to every person in the country and save a ton of money.
That same Mercatus study found a typical family could save about $6,000 over a 10-year period. A recent Rand Corporation study looking just at New York found that most individuals in the state would save around $3,000 per year.
Among the major cost savings of switching to a universal health care system is the potential to reduce bloated administrative expense associated with private health insurance. Overhead for traditional Medicare is just 1.1 percent while all of Medicare — including its private plans — is just over 7 percent.
Private insurers' administrative cost is nearly double, at 13 percent. This could have something to do with the fact that, as Axios points out, the 64 top health care CEOs made a combined $1.7 billion last year.
To quote Sanders directly, "The United States has the most expensive, inefficient, and bureaucratic health care system in the world."
The U.S. remains the only country in the industrialized world that doesn't guarantee health care as a human right to all its citizens. And we pay more than anyone else for the broken patchwork system we have now.
The transition to Medicare for all would be a lot less complex than you might imagine. Steffie Woolhandler, David Himmelstein and Adam Gaffney of Physicians for a National Health Program laid out how it could work in a recent article for the Nation. Spending on things like premiums, copays, and deductibles would simply shift to tax payments that would fund an expanded Medicare system, they explained.
"For instance," they wrote, "the $10 trillion that employers would otherwise pay for premiums could instead be collected as payroll taxes." As would the $7.7 trillion households currently pay annually for premiums and the $6.3 trillion currently paid in out-of-pocket expenses.
If this idea of a universal system sounds crazy, consider the fact that every other industrialized country has already made this transition and seen both improved health outcomes and reduced costs.
Medicare for All is an idea whose time is coming.
Josh Hoxie directs the Project on Taxation and Opportunity at the Institute for Policy Studies in Washington, D.C. He wrote this originally for InsideSources.com.