We’ll All Breathe Easier

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Imagine a world without co-pays, deductibles, premiums, Explanations of Benefits, pre-existing conditions, tiers, in-network and out-of-network providers.

I talked to two Capitalists the other day, one in favor of Medicare for all, one on the fence. I initially wanted to talk to small businesses in Philadelphia about Medicare For All and their challenges with our current healthcare system. Some ran off screaming. Some apologetically replied that they didn’t know enough about it. Many just flat out ignored my request. It’s clearly a delicate matter, fraught with agita and fear.

But COVID happened, and I watched how countries with national healthcare systems responded. Israel and New Zealand imposed swift, strict measures to contain the spread of the virus. Their leaders masked up and respected the admonition to socially distance. Their healthcare infrastructures, though strained, were better equipped to handle the flood of COVID victims. Their people didn’t worry that their healthcare system, driven by profit and plagued by inefficiencies, would bankrupt them.

Millions of Americans lost their jobs in 2020. When they lost their jobs, they lost their health insurance. The unemployed could choose among several bad options: go into hock to buy a plan, buy a crappy mini-med-type plan that’s pretty useless if you have a significant medical problem, or go without. 

Both Israel and New Zealand have public health systems with an option to supplement with private insurance. Their citizens do not lose their marbles   - or their lives - if they lose their jobs. 

I decided it was time to get educated about Medicare For All, also known as single payer. Over the past two months, I’ve studied it, done a TV show about it, interviewed labor people, insurance brokers and small business owners to get a pulse on how people feel about a single payer system for the United States.

“We can’t go on the way we are now,” says Susan Thomas, a retired Fortune 500 HR director, who lives in Philadelphia and currently consults. “We’re in a mess right now. It’s a disgrace the way things operate in this country. I’m a business person. I’m very much a Capitalist. I’m not a Socialist, but healthcare is a basic human need. Why shouldn’t we, as a nation, provide it less expensively? There’s a lot of waste in the system. Every doctor needs 90 clerical employees to handle the variety of plans. Certain things are better done in a centralized way. Medicare runs beautifully. There’s no reason you couldn’t extend it to the rest of the population.” When HR experts like Susan Thomas speak, people like me listen.

The other Capitalist, my friend Doug, is very uneasy about Medicare For All, even though, he admits, his experience with Medicare as a senior is great. “What I wouldn’t want to see,” he says “is removing private insurance companies from the mix. I don’t believe that the government and bureaucrats run things efficiently. Healthcare is better controlled with competition in the private sector.” Furthermore, says Doug, the countries that have a single payer system, have had years of experience implementing it. “It will take decades for us to figure out how to do it. This country doesn’t know how to do it. We will screw it up!”

I don’t buy Doug’s argument, simply because we already have a single payer system in the U.S. that’s working just fine. People over 65, including Doug, love it. It’s called Medicare. Just because it takes time to implement it, doesn’t mean we shouldn’t do it.

My husband and I both run our own businesses. We pay $1,500/month for our policy. We wonder, painfully, resentfully, what we could do with $18,000/year. I rarely use my health insurance. When I do need medical attention, I go the alternative medicine route. Herbs, exercise, chiropractors and acupuncture usually do the trick. But, of course, they’re not covered. 

Businesses, especially small businesses, would get huge benefits from a single payer system. Susan Thomas explains: “Small businesses who cannot afford to, and aren’t required to, provide health coverage, wouldn’t have to worry about it. It’s not only that health insurance is very expensive, often 35% of a company’s budget, it’s also the fact that you need time to administer it…clerical support. It’s a lot of work!”

I ask Susan to address the strong resistance from the Medical-Industrial Complex (Big Pharma, hospital chains and private insurers), who send battalions of lobbyists to Washington to fight single payer: “Big Pharma could still do well because as a society you still need the same number of drugs. You just don’t have as many intermediaries. The big insurance companies would be contracted by the government because they have the expertise in claims administration.”

Ultimately, our taxes would go up, but our overall costs would go down. I’d opt for a model like the one in Canada or Spain. In both of these countries, citizens get a basic plan, provided by the single payer (the government), and people can buy additional coverage if they want additional kinds of care.  

I don’t want to move to Canada or Spain, though I’ve been tempted. I simply want a healthcare system that works.