by James Wallace Harris, Friday, September 15, 2017
I’m surprised Christians can call America a Christian nation when looking at our healthcare system. It’s greed over compassion. Our current system is built around profiteering on misery. The poor are left to die of neglect, and folks in the middle-class are being extorted at scalpel point. And rich get richer on the sick and dying. Big Medicine, Big Pharma, and Big Insurers are in cahoots with Congress to produce Big Billionaires while avoiding any kind of Christian or humanistic values and forcing doctors to corrupt their Hippocratic Oath.
The rising cost of healthcare is going to bankrupt society, both individually and collectively. Republicans are hell-bent to keep this Ponzi scheme going at all costs. It’s time to rethink the rules of the game.
I’m reading An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal. She reports, “Medicare uses 98 percent of its funding for healthcare and only 2 percent for administration.” Private insurers are nowhere near this efficient. And Rosenthal’s book gives a history of how private healthcare insurance corporations are escalating medical costs for both individuals and for the GDP.
Many people are now talking about Medicare-for-All. Of course, politicians have no idea how to fund it or phase it in. I suggest we do it slowly, two years at a time. One year at a time for children while concurrently pushing the traditional enrollment age for adults earlier one year at a time. This would give private insurers time to either come up with a truly competitive system or be phased out. If in 20 years private enterprise can’t provide an effective alternative we go 100% government run.
The schedule would look something like this, phasing in these age groups:
| 2020 | 1 | 64 |
| 2021 | 2 | 63 |
| 2022 | 3 | 62 |
| 2023 | 4 | 61 |
| 2024 | 5 | 60 |
| 2025 | 6 | 59 |
| 2026 | 7 | 58 |
| 2027 | 8 | 57 |
| 2028 | 9 | 56 |
| 2029 | 10 | 55 |
| 2030 | 11 | 54 |
| 2031 | 12 | 53 |
| 2032 | 13 | 52 |
| 2033 | 14 | 51 |
| 2034 | 15 | 50 |
| 2035 | 16 | 49 |
| 2036 | 17 | 48 |
| 2037 | 18 | 47 |
| 2038 | 19 | 46 |
| 2039 | 20 | 45 |
JWH
Auxiliary Memory 
The United States pays the most for healthcare than any other country in the world. Yet the health of Americans is just so-so. You’re right about the influence of money on healthcare. Extending Medicare to all citizens is garnering increasing support.
One of my book club members is sure she’s read the story but can’t remember title or author, but she vaguely thinks it might be a Brian Stableford story. You can find all his work listed here: http://www.isfdb.org/cgi-bin/ea.cgi?556 – but it’s a lot. Scroll down to the Short Story section. If you click on a story it tells which anthologies its been in. This database is wonderful for tracking down info.
The extended phase-in you describe is a truly bad idea. Go look at the history of successful transitions like Medicare in the US and Canada and the NHS in Britain. All quite rapid. And lacking the Rube Goldberg complications of the ACA, which was designed to placate corporate interests, not to be workable (US Medicare has been amended and degraded in the years since it was introduced). An extended schedule allows way too much opportunity for political sabotage, fragmentation of public support, and hardening of institutional interests. And regardless of what you may have heard, there is no shortage of ideas about how to fund an improved system. (Not that we have any trouble funding decades-long, illegal wars – but never mind that.)
Also, simply extending age coverage of the current US Medicare system doesn’t go nearly far enough to solve our problems, as that would preserve all the defects that are now wrecking US healthcare, i.e. deductibles, 80/20 coinsurance, lack of ocular & dental care, for-profit hospitals, third-party private insurers for basic care, etc. What we need is IMPROVED Medicare For All or if I could choose, an NHS/VA style system. (I believe both our politics and our healthcare industry are too corrupted and profit driven at this point for a more complex private/public system such as the French, German, or Swiss to be workable here.) Please don’t be fooled by bait & switch proposals.
An addendum:
In regard to paying for an improved system — this is mostly a dishonest debate anyway. The truth is that Americans already spend two to three times per capita what other developed nations do. In fact, even in just what is currently spent by the government, the US already equals or exceeds most other countries. And they provide near universal coverage for that, while we have literally tens of millions either entirely uncovered or with limited access. And in terms of outcomes, we are currently ranked about 35th worldwide – no, we are NOT number one or anywhere close.
So the debate isn’t necessarily about finding new funds, it’s more about shifting and redirecting what is already spent. Including eventually reducing the portion taken by provider costs. US doctors, hospitals, drugs, and equipment are considerably more costly than in other countries without being of higher quality. Note that the shortcomings of other countries’ healthcare systems (the ones that aren’t mythical at least) could mostly be fixed by expanding their healthcare budgets. If they spent what we already do, most of their issues would evaporate. It’s will we lack, not means.