It’s time to educate ourselves about Medicare-for-All, which has passionate and growing support in our country. Most Americans, 64 percent in a recent Kaiser poll, like the general idea. Energetic and caring citizen groups promote it, such as SPAN Ohio (Single Payer Action Network). In the middle of our health care debates, we should pause to look closely at Medicare-for-All. We need more clarity for smart decisions.
I’ve been reading Medicare-for-All explanations by legislators, doctors, public interest groups and journalists. I’m no expert, but the fundamental concepts are coming clear to me. Here is some central information for those who wonder how Medicare-for-All would work in America.
Who would be covered? For what kinds of health care?
Everyone would be covered. The current Senate proposal, “The American Health Security Act” (S. 1782, soon to be updated), promotes “universal entitlement” and outlines plans to register everyone in this country, starting at birth.
Both House and Senate full-text proposals specify complete coverage for all health-care categories (except cosmetic procedures). They include care typically left out of general health insurance. Dental, vision and prescription coverage are named early in the House proposal, “Expanded and Improved Medicare for All Act” (H. R. 676). Both proposals offer complete maternity and child care, which could remedy Ohio’s “near the bottom” rates of infant mortality.
Vital screenings for cancer and STD/HIV belong with the promised diagnostic tests in these proposals. There is pressing need. In Ohio, 80,000 men and women are tested yearly by Planned Parenthood. Addiction and substance abuse treatment, mental health care, home and hospice care, and prosthetics are among an abundance of named services.
People would choose their own providers. Doctors and hospitals would remain independent. There would be no premiums, deductibles, or co-pays.
Who would pay for all this coverage?
The Senate and House proposals, state government bills, and Physicians for a National Health Program – all envision a Medicare-for-All that is affordable.
To reach real affordability, we need to exclude profit-making health insurance companies. Cut the cord of their power over costs. In ACA exchanges now, health insurers increase costs. Even with this handicap, the ACA has taught us for years what affordability feels like. That’s why so many cling to the ACA. One in four Ohio hospitals believes that without the ACA, they would close.
Medicare-for-All, the next step from the ACA, offers complete affordability. It would appropriate funds from Medicare, Medicaid, CHIP, ACA, and other federal health programs. It would leave health insurance giants behind, saving another $350 billion to $500 billion yearly. Medicare-for-All would have negotiating clout with Big Pharma.
Without premiums and deductibles and co-pays, people could afford a few modest taxes to help with funding. Maybe a health income tax, small for most, larger for the top 5 percent of incomes. A limited, progressive excise payroll tax would help, as well as a tax on securities transactions – a few hundredths of a percent of fair market value.
If we adopt Medicare-for-All, what risks are we taking? Might health care be rationed? Would we have long waits? Ballooning costs?