A Compelling Case for Medicare for All

The current UAW strike against the big three automakers offers an opportunity to show how Medicare for all would be a great benefit to both businesses and individuals. GM has stated that it pays approximately $1 billion annually for employee healthcare, or between $1,700 to $2,000 a month for each of its 48,000 employees. Using the $1,700 amount, the cost is $10.62 an hour for a 40-hour-a-week employee. With Medicare for All, the $10.62 could be added to the current $32 an-hour wage increasing the hourly rate to $42.62 which is a 33% increase. This shift would not raise the cost of manufacturing.

The Medicaid program is a shared cost program between the federal government and each state. Overall, Florida has a $74 billion budget, of which 65% ($48 billion) comes from state funds and 34% ($25 billion) comes from federal funds. With Medicare for all, Florida would not have this cost in its budget and could reduce the taxes on its citizens or reallocate these funds for other needed services. It was estimated that the insurance costs related to Hurricane Ian were around $67 billion. Since our governor and legislature have done virtually nothing to address the insurance crisis in Florida eliminating Medicaid costs with Medicare for all could go a long way to subsidizing the Citizens program to reduce homeowner insurance costs. The $48 billion saved would be saved every year going forward for the taxpayers of Florida.

Both sides of the political aisle have been complicit in supporting the profiteering of our health caste system to the detriment of all citizens. The profiteers and politicians care more about their wealth than your health. There is no free lunch in our health caste system consisting of 28 million uninsured, 65 million Medicaid, 44 million Medicare, and 167 million Privately insured people. This health caste system is a reprehensible example of income inequality. The unpaid and underpaid costs of service in the system drive up the costs for Private and government health insurance while healthcare corporate greed pushes the costs even higher.

Medical debt is a costly burden that weighs on millions of patients who seek life-saving care, it's the leading cause of personal bankruptcy in America and the largest source of personal debt among consumers. The current health caste system excludes 28 million people from coverage, places 65 million children, disabled and nursing home patients in the lowest paying insurance level, isolates 44 million medicare recipients into the highest cost population, and allows private insurance to profiteer on 167 million Americans.

In 1960 health care accounted for 5% of the gross domestic product (GDP) of the USA by 2020 health care accounted for 19.7% of our GDP. Healthcare costs do not bring revenue into the country; they take revenue from companies and individuals. The increase in health care costs has not been driven by individual provider (doctors, therapists, etc.) costs but administrative costs and corporate profits. Individual providers would benefit from a single-payer system that would allow them to significantly reduce the administrative costs of billing.

The cost of caring for a population is shared by each person in the insured population. When a homogeneous grouping occurs the risks and cost per individual may increase or decrease dramatically. The following data from the Kaiser Family Foundation illustrates the difference in per capita health care spending in 2019 by age group; 0-18 $2,426, 19-34 $3,484, 35-44 $4,694, 45-54 $6,734, 55-64 $10,203 and 65+ $13,016. There are 245 million persons below the age of 65 with health insurance and 44 million 65 or older on Medicare. When these two populations are combined the weighted average for health care spending becomes $5,800. When the politicians cry about the high cost of Medicare and the need for reform they are being disingenuous at best. With Medicare for All you level the healthcare playing field and spread the cost over a huge diverse population. With Medicare for All you have a single-payer system that will have the power to lower the overall cost of healthcare and improve the quality of care provided. The US healthcare system costs per capita are twice as much as any other developed nation while ranking 37 for quality of care by the World Health Organization.

Congress could significantly lower the pharmaceutical costs for all Medicare recipients today with one simple act. The federal government has already negotiated significantly reduced pharmaceutical rates that are used by the VA, qualifying hospitals, and Community Health Centers. Section 340B of the Public Health Service Act requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to healthcare organizations that care for many uninsured and low-income patients. Congress can mandate Medicare patient eligibility for a 340 B medication discount now instead of playing their current woe-is-me game. The pharmaceutical industry gouges the American public on the pretense that new drugs won’t be developed if they can’t maintain their price gouging. So why do they sell their drugs to other countries at a fraction of the cost they charge the American public? Are we that big a sucker to fall for this line of baloney? Please go to Pharmacychecker.com and compare Canadian drug pricing to US pricing to see the magnitude of the problem. Do you think the Canadian companies are selling the same drugs at a loss? The other boogeyman that the drug industry tries to scare you with is that there wouldn’t be any research for new drugs if they can’t have huge profits. Most of the drug research is carried out in major universities. If we expanded funding for this kind of research in the universities and paid companies to manufacture the proven products we would all be far better off.

Medicare Advantage plans are taxpayer-subsidized private insurance plans that escalate the cost of healthcare while generating millions of dollars in profits for insurance companies. The expansion of Medicare Advantage plans actually raises the cost of Medicare for the federal government and reduces the quality of health care for Medicare recipients. Three sources of revenue for Advantage plans include general revenues, Medicare premiums, and payroll taxes. The government pays a predetermined amount every year to private insurers for each Advantage member. These funds come from both the Hospital Insurance (HI) and the Supplementary Medical Insurance (SMI) trust funds. These companies are in business to make a profit. To offer $0 premium plans, they must make up their costs in other ways. The reality is that Medicare for all would eliminate the need for Medicare Advantage plans because the overall cost of healthcare would drop significantly enough to offer all the extra benefits provided by Advantage plans to all citizens in the US while still costing less than the totality of the current system.

The Affordable Care Act (ACA) allows low-income individuals and families to access Private health insurance with the assistance of federal subsidies for premium costs. The Affordable Care Act does nothing to lower healthcare costs and is a boon for the private insurance industry. The ACA does not eliminate co-pays and deductibles which can be significant. While this is a noble endeavor, Medicare for all would create access for all and have the power to dramatically lower the cost of healthcare.

Medicare for all would shift more than a trillion dollars back into the private employment sector by cutting the cost of healthcare in half. The money saved by industry could be used to increase profits and wages as well as make made-in-America more economically attainable. There are actually enough dollars to be saved in the current system to pay for Medicare for all while cutting the current cost in half. Some examples of cost eliminations and revenue reappropriations are; saving $616 billion by eliminating Medicaid, saving $9.7 billion by eliminating the Community Health Center program, saving $500 billion in excess administrative costs, $150 billion in medical device savings, $150 billion in excess drug costs, save billions of dollars through government bureaucracy elimination, save billions of dollars by eliminating private health insurance profits.

Ray Fusco
Manatee County