How to Pay for Medicare for All

Whether we call it Medicare for All, universal coverage, Medicare Available, the time has come for the U.S. to join the rest of the world in recognizing health care as a right.

What we spend now every year on health care

As a nation, we spend more than twice the average of the world’s thirty-five advanced economies on health. The average spent per person in other advanced countries is $5280. Yet we rank 28th in the quality of healthcare among the nations of the world. Americans are sicker, our lives are shorter, and we have more chronic illnesses than in any other advanced nation.

If we divide the current population of the United States (327 million) by our total spending, it comes out to $11,347 per person. Although 27 million Americans have no health insurance, the average annual premiums of health insurance in 2019 are $7,188 for single coverage and $20,576 for family coverage. Deducting the 70% employers pay of their employees’ health insurance, employers are paying $14,403 per employee with family coverage. Some 45,000 Americans die each year from a lack of medical insurance

While employers pay about 70% of the cost of their employees’ health insurance, employees are paying more in deductibles, and for co-insurance. Americans would be covered for medically necessary services including primary and preventive care, mental health care, reproductive care, vision and dental care, long-term care, and prescription drugs. There would be free medical, dental and vision care with no premiums, deductibles or co-payments, balance billing, or copays for most drugs

How desirable it would be for family spending on health care to vanish!  Instead of having trouble paying medical bills, being bugged by collection agencies, suffering lower credit ratings because of medical bills, and many being driven into bankruptcy.

16 million Americans can’t afford to treat a broken arm costing $500 at the present time. 44 percent of adult Americans claim they could not come up with $400 in an emergency room visit without turning to credit cards, family, and friends, or selling off possessions.

The total economic cost of caring for Americans with some form of dementia is expected to exceed $2 trillion dollars, far beyond the resources of families.

How can we reduce the cost?

We simplify the system and save half a trillion dollars a year in overhead and executive bonuses. Instead of the 15% overhead for-profit insurance companies, Medicare’s overhead is 2%. Overhead is used to deny claims, advertising, exorbitant executive pay with million-dollar bonuses, incompatible computer systems plus the delays that come from doctors and hospitals not being able to seamlessly communicate with one another.

Would insurance companies go out of existence? Probably not, they could transform themselves into contractors for Medicare, offer boutique coverage for medical procedures like cosmetic surgery, sports medicine, acupuncture and other alternative medical care not covered by Medicare. Their workforces would no doubt go down and job retraining could be offered to all displaced employees.

How can we finance Medicare for All?

There are choices:

  • A 4% payroll tax on top of social security. Sanders says this would amount to $844 a year (after taking a standard deduction) for a family of four earning $50,000 a year. Families earning less than $29,000 a year would pay no premium. Families with $100,000 a year income would pay $2840, far less than the $6173 difference in employer coverage.
  • Tax on marijuana comparable to how cigarettes are taxed
  • Maintain current state and federal government funding, which includes payroll taxes, taxes on social security – about two trillion dollars
  • Employers could continue to pay their employees’ annual premiums but they could be non-deductible expenses.

We need a more efficient health insurance delivery system for financial reasons alone, but the larger benefits are a healthier more productive workforce, greater income equality, and the needless loss of life because people cannot get or afford health care.

We need a more efficient health insurance delivery system for financial reasons alone, but the larger benefits are a healthier more productive workforce, greater income equality, and the needless loss of life because people cannot get or afford health care.

They’re Killing Us Off

They’re Killing Us Off – the sum total of the actions of the Trump Administration are devastating the lives of tens of millions of Americans. Many are losing health care, others deported, others thrown into poverty, middle class people are being economically harmed, financial inequality is rising while the economy looks shakier as the federal debt reaches new highs, environmental and climate damage gets scarier, the impact of these forces on health, the use of drugs and addiction, the effects of heat and cold the plight of many senior Americans, the less America as a land of opportunity becomes more distant, resulting from people in power just people don’t care. What needs to be done to restore the middle class, and what you can do.