How Medicare for All Would Fix Both Public Health and the Economy
Emergency expansion of Medicare, to Medicare for All, would be a huge economic stimulus as well as saving lives. Photo: Molly Adams, CC BY 2.0, cropped from original.
Big problems demand bold solutions. The Labor Campaign for Single Payer is calling on Congress to expand Medicare coverage to everyone in America for the duration of the crisis.
All Medicare deductibles and Part B premiums should be waived for the duration and Medicare should be empowered to negotiate all drug and medical equipment prices, to put a lid on profiteering.
Additional funds should also be allocated to the Veterans Administration and the Indian Health Service to allow these hard-pressed single-payer systems to adequately serve their constituencies.
Such a proposal should be a centerpiece of the next round of emergency relief legislation. It would immediately free health care providers from the onerous administrative responsibilities of dealing with private insurance, while assuring them that they would be paid for delivering needed care.
Sick people would be more likely to seek early treatment if they knew there were no financial barriers. By cutting out the insurance company middleman and regulating price gouging, we could save 10 to 15 percent of total health care costs while making sure the benefits flow to those who need them.
ECONOMIC SHOT IN THE ARM
Emergency expansion of Medicare, to Medicare for All, would also be a huge economic stimulus. The elimination of co-insurance, deductibles, co-pays, and out-of-pockets would be an economic shot in the arm for all working families, both employed and unemployed.
Employers would be temporarily relieved of the obligation to pay for private insurance, creating an incentive to keep workers on the payroll rather than lay them off. Hard-pressed state and local governments would also be freed from the burden of employee and retiree health care costs.
Since the federal government already pays 60 percent of all health care costs through Medicare, Medicaid, CHIP, Tri-Care, federal employee health benefits, and other programs, the costs of such an emergency expansion are manageable.
Even assuming a huge increase in demand over 2019 levels, the additional federal obligation would be about $150 billion for each month the crisis continues. If the crisis lasted for a full year, new federal expenditures would still be less than the $2+ trillion committed under the March 27 CARES Act with all its corporate bailouts, or the $2.3 trillion that the Federal Reserve announced it would pump into the economy to stabilize the bond market and buy corporate debt.
As the crisis abates, the nation should debate what kind of health care system we should transition into to permanently meet the needs of everyone in America.
It is pretty clear who would win that debate. Not a single country in the world has ever voluntarily chosen to exchange a health care system that treats health care as a public good for one that treats it as a commodity delivered through a private insurance system linked to having a job.
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During the transition, we could phase in longer-term financing mechanisms for Medicare for All, such as an employer-paid payroll tax and additional income and wealth taxes on the top 5 percent.
Ex-mayor Rahm Emanuel of Chicago, speaking for neoliberals everywhere, famously said, “Never let a crisis go to waste.” Well, this is our time.
Working people are the heroes who are tending the sick, keeping the wheels turning, and making sure we have the necessities to keep everyone safe in their homes. We are paying with our lives because our dysfunctional health care system is unable to deliver the care we need.
When this is all over, we must not rest until health care is guaranteed to everyone in America through expanded and improved Medicare for All.
What the Pandemic Reveals About Our Health Care System
Nothing like a pandemic to reveal the shortcomings of our for-profit, employment-based health care system that treats health care as a commodity for sale in the marketplace rather than as a public good.
- The lack of coordination in our fragmented and inefficient health care system makes it hard to get resources where they are needed. Six weeks in, New York Governor Andrew Cuomo finally stepped in to organize all the state’s health care resources under a single authority and ordered an increase of hospital capacity in highly stricken areas. Under Medicare for All, coordination would have been in place from day one.
- Providers are saddled with the need to comply with all the complex requirements of a private system. Hundreds of thousands of administrative and insurance workers are required to work solely for the purpose of submitting and approving private insurance payments. This work has no impact on health care outcomes. It slows down health care delivery and endangers these workers’ health. They should be sheltering in place or redeployed as frontline caregivers if they have the skills, training, and equipment to do so.
- Linking health care to employment was never a good idea. Thirty-five million workers are about to lose their employment-based health insurance as they lose their jobs. Even those eligible for Medicaid or who can afford to buy their own insurance will experience huge disruptions in their access to care and in their family budgets as they face weeks-long waits to enroll.
- A market-based health care system amplifies inequality. While Wall Street brokers work remotely from their second home in the Hamptons, low-wage and frontline workers must work under appalling conditions, often commuting in overcrowded public transport. Communities already experiencing public health crises—environmental asthma sufferers in poor communities of color, Black Lung victims in Appalachia—are particularly vulnerable. Medicare for All would establish a single standard of care for all Americans and prioritize the direction of resources to communities that are now underserved.
- Giant steps are possible: When the very foundations of capital are threatened, trillions of dollars can be found overnight to ease the pain. The Federal Reserve has announced that there is no limit to the dollars that it will pour in to maintain the liquidity of the stock, bond, and currency markets.
And through the FFCRA and CARES bills, nearly half of all U.S. workers have now gained access to paid leave, and unemployment insurance has undergone its greatest expansion since the 1930s. However, Congress only intended these improvements to be temporary. Will we let them take these gains away when the crisis is over?
Mark Dudzic is national coordinator of the Labor Campaign for Single Payer.