David Hart: What Medicare for All is, and is not

(Susan Walsh | AP file photo) There are a variety of Medicare for All proposals but they share some general similarities.

There are a variety of Medicare for All proposals but they share some general similarities.

Medicare for All is a publicly financed, privately delivered health system, not socialized medicine or a government takeover. The role of government will be to make sure everyone is covered and has access to quality health care at an affordable cost to both individuals and our society at large.

The government will not own or manage hospitals or employ doctors. You can pick your own doctors, hospitals, clinics, etc. There will be choice and competition, i.e. capitalism.

There will be no “out of network” problems. You will be covered if you change jobs, lose your job, go to school, retire, etc. You will get bills from only one source. It will simplify billing for doctors and decrease much of the endless paperwork of medical workers. The simplicity of a single-payer system will save billions because the overhead for Medicare is about 2% versus about 15% to 20% for private insurance. Also, Medicare for All is not “one-size-fits-all” because there will be options about coverage and prescription drugs.

Why don’t people try to explain how this all will be paid for? Because it’s complicated.

An employer whose company “pays” for their workers’ health insurance is taking that money out of the employee’s compensation package. The total yearly cost of health coverage for a family of four, including insurance premiums and out of pocket expenses is about $18,000, the largest part of which is insurance premiums.

Your taxes may go up because taxes pay a large part of Medicare. If companies would no longer be required to pay their part of your health insurance and they give you that money back in your paycheck, your total expenses for medial care, paid mostly by your taxes will likely go down because your pay increase will more than cover the increase in taxes. This money could largely pay for Medicare in its present form and the millions of uninsured. Today’s Medicare itself is not free, and those on Medicare pay deductibles, co-pays, etc. like any health insurance.

My wife and I have experienced employer health insurance, COBRA (extended employer health care) for after I retired and before I got on Medicare at 65, and the Affordable Care Act (Obamacare), which my wife was on before she turned 65. And we have experienced Medicare itself. From our experience with all of these, Medicare is the least expensive and, by far, the easiest to work with.

The largest adjustments will come in the form of the hundreds of thousands of workers in the private health insurance industry as their jobs get phased out. Some of these workers will shift to Medicare and some will still work in a much smaller private insurance industry which will largely cater to the rich.

Realistically, Medicare for All in its pure form, that some Democrats want, will not happen in the near future. There will be a long political transition. But, with about 1 in 15 Americans being uninsured and our medical costs at about twice that of any other advanced country, health care as it exists now is unsustainable.

Private health insurance companies will fight this transition tooth and nail. Keep in mind, they will be fighting for their lives, not yours.

David Hart

David Hart, Torrey, is a former physics teacher at Skyline High School and former junior high counselor. He has degrees in physics, education and social work. He now is retired and lives near Capital Reef National Park.