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Why support Medicare for All?

Published: 2/14/2020 6:00:27 PM

Modified: 2/14/2020 6:00:14 PM

Medicare for All promises to be a major issue in the primaries that began in Iowa on Feb. 3. If Bernie Sanders becomes the Democratic nominee for president, it will continue to be a hot topic throughout the general election campaign.

The medical profession is now making its views known. In a recent edition of the Annals of Internal Medicine, the American College of Physicians, the second largest medical organization in the country, stated theirs: “Major changes are needed to a system that costs too much, leaves too many behind, and delivers too little.”

In the Medicare for All Act of 2019, health care is expanded to include complete dental care, hearing exams, hearing aids and vision care including eyeglasses. Mental health problems and substance abuse would be treated, home and community-based long-term care would be covered, along with reproductive and maternity care. Inpatient and outpatient services would be available.

Medicare for All would take over our payment for prescription drugs if a limit of $200 a year was reached. If adopted, the U.S. would arguably have the best health-care system in the world.

Opponents of this plan rely on several arguments. One is that Americans who can afford insurance under Obama’s Affordable Care Act are happy with their coverage and don’t want to be “forced onto a government-run plan.” If a study had been made that actually backed up this claim, readers would have seen it on the front page of the New York Times.

After listening to several Democratic presidential candidates discuss health care, one wonders whether they have any idea how our present system functions. For example, they falsely claim that Medicare for All will not allow us to choose our primary care physicians or select our hospitals “like we can now.” Don’t they know that most plans require us to choose physicians or hospitals that are part of a plan’s “network?”

When Obama’s ACA was first proposed, it contained a public option, or a less expensive, publically-funded Medicare-type plan. If enough people opted for it, it would be expanded to cover everyone. But guess who lobbied to have the public option dropped from the ACA proposal?

The present system is not an “only-pay-for-what-you-need” set-up. The actuaries — the risk managers —who work for the insurance industry have it all figured out as to who will be taking the risk. Insurers are guaranteed a profitability that we see reflected in the stock market.

In selecting a plan we are forced to gamble on what our health care needs will be in any given year. We might choose a plan, say, with a low co-pay for each visit to a health care provider but find the plan has a large deductible — maybe as steep as $16,000 — before insurance kicks in for a lengthy hospital stay. With Medicare for All, we wouldn’t have to worry like MGM casino patrons about whether we had placed a bet on a wrong number.

Rather than paying fees to an insurance company, under Medicare for All, we would pay taxes to our government. This is how the tax would be calculated: the first $29,000 of income would be tax exempt. On a yearly income of $60,000, for instance, only the remaining $31,000 would be taxed at a 4% rate. This would work out to be a tad more than $100 a month.

Medicare for All would provide the same comprehensive benefits for each of us whether we were homeless or housed, abled or disabled, young or old, rich or poor, gay, straight or transgender, employed or unemployed, moving to another state or to another job or starting a small business.

No one would go bankrupt because of medical bills. No one would die because health care was not accessible. The general health of the population would improve, benefiting our society in a number of ways like reducing absenteeism and decreasing our infant mortality rate of 5.748 deaths per 1,000 live births to rival Sweden’s 2.2.

Why not change to a plan that reduces costs, covers everyone, and delivers the care we need?

Mary L. Wentworth lives in Amherst.

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