Political Column #47 – Affordable Health Care

Affordable Health Care

Published April 4, 2019 in the RB News Journal & Poway Chieftain

Most of the nation believes that the government has some role in making sure that the people – all the people – have access to a reasonable level of health care, at costs that leave them able to pay for the other basic necessities of life. Once our elected officials accept this mandate from the public, perhaps we can stop politicking and do something about it.

Affordable Health Care

The affordability of health care is one of the top issues in our country today. While proposed solutions differ along party lines, there is general acknowledgement that the current cost of health care is putting even basic medical coverage out of reach of too many people. And those that can afford it are being asked to put too great a percentage of their income toward basic medical care.

Efforts to improve this situation via the Affordable Care Act (ACA) have delivered mixed results. More recent legislation has whittled away some provisions, which in turn have made it less affordable and sustainable. Yet, the political winds have drifted from overturning the ACA toward modifying it. While being less than perfect, there is wide acknowledgement that something of this nature is needed.

With the new Democratic House majority, we are hearing more support for a “single-payer system” also dubbed “Medicare for All.” Of course, opponents immediately label this as “socialized medicine,” and decry the enormous expense of such an initiative. Most of the objections appear to be from lobbying groups rather than legislators. Practitioners (doctors, hospitals, drug companies) and insurers lead the pack.

Why is there such resistance to this concept? I have long been a subscriber to a Part C Medicare Advantage policy, administered by an insurance company. I get above average coverage and quality care, paid for mostly by a large (but affordable) deduction from my monthly social security. Medicare payment rates are determined partially by total income; seniors with greater than average reportable income pay a larger amount. Insurance supplements are in addition. The insurance companies must love it. They advertize every hour for more business. Doctors and hospitals are able to provide care as needed and get paid for it. So what’s the problem?

Expanding coverage to the entire population does inject considerably more cost and complications. For example, a significant portion of non-seniors’ medical coverage is provided by employers, rather than individuals. How do we deal with such differences? What about those who don’t get employer coverage and can’t afford quality coverage on their own? What about areas of the country without competition?

In approaching this issue, we first must admit that medical costs are out of control and that effective medical coverage is out of the reach of way too many. We also must accept that no progress will be made without government participation.

All stakeholders must be drawn into the discussion of solutions. Doctors, drug companies, insurers, and hospitals must cease knee-jerk resistance to a public partnership for medical coverage. As proven by the success of Medicare and Medicare Advantage programs, there is no justification for not working toward a solution.

We need to evaluate several different approaches to universal health care. With at least 58 other countries that already have this, it shouldn’t be necessary to reinvent the wheel. Since too many people are not recipients of employer-provided coverage, perhaps one option would be to remove employers from the picture. The studies should include at least one model that includes employer-provided coverage. Such a model would require employers to provide effective medical coverage or pay into a fund that would provide similar coverage for people without employer-provided coverage. These models would define a minimum level of coverage while additional benefits could be available for those who could afford them.

Options should include models that involve insurers, as well as single-payer (government-sponsored and run systems). Obviously, the poor and unemployed will need subsidies. Emergency medical services are provided now, whether people can pay or not. In fact, such costs may be reduced through (currently inaccessible) preventative medicine.

The biggest issue with affordable health care is the staggering cost of medicines and treatments. No solution is possible without tackling these areas. It will be necessary to have the government address limiting profits and reducing costs though regulations or profit controls. The right to affordable health care must take precedence over free-market forces.

Structural changes to health care models should not be activated en-mass at once. Preferred models should be implemented in small areas, such as a single state, as pilot models. In that way, the models can be tweaked before replacing the existing systems.

We can move forward as soon as we stop politicizing ObamaCare and agree that the current status is unacceptable. Then we can commit to a model or models where everyone has access to reasonable health care. We cannot continue to be the only developed nation in the world to not consider affordable health care as a basic civil right.