Medicare for All: Been There

With all this talk about Medicare for All going on, I thought now is a good time present this.

It is a myth that “Medicare For All (MFA)”, will cost more. If you do the math, it would actually cost less. Gone will be high paycheck deductions and employer contributions to private insurance companies. Any additional taxes will be much less.

I have practiced medicine both in Canada and the USA. Canada has a MFA health care system. Canadian doctors enjoy much more freedom and autonomy as to how they practice medicine compared to American doctors. 

The American patients that I see are presenting with much more serious levels of illness, and the amount of time I am given to see them is less. I witnessed how high out of pocket costs to consumers and reduced access to primary care are deterrents to getting care in a timely manner. The intense workload American doctors are expected to work under is overwhelming. 

The typical American response to MFA is that “it is a form of socialism and Canadians have prolonged waitlists for this and that.” Contrary to those beliefs, the large majority of Canadian doctors are actually in private practice and self-employed. Canadian patients are not limited to which doctor they can see. There are no HMO’s in Canada. Meanwhile, in the United States, our “waitlists” are our preauthorization, appealing of denials of care, denial of care and inability to afford the deductible and/or copay. No matter how much Americans fear a Canadian-like health care system, the bottom line is Canadians live longer and are happier people than Americans.

Private health insurance companies control financial health dollars and physicians are caught in the middle between insurer and patient. This results in burned out doctors and dissatisfied patients. 

The American healthcare system feels more “socialist” than the Canadian. Millions of Americans pay into an insurance “pool” of multiple private health insurance companies. This creates an inefficient system with high overhead costs and long non productive hours to handle the unnecessary bureaucracy and administrative chaos. Corporations dictate how doctors practice medicine and what patients can and cannot receive for medical care. The spin on “it’s socialism” comes from those who gain profit from the status quo. Large corporate entities have created fear in patients and doctors that a single payer system would be catastrophic.

But data shows Medicare is our most efficient system. Americans with government plans are more satisfied than those with private plans. If anything, private health insurance companies delay care by prerequisite amounts of paperwork and creating disincentives that deter people from getting care.

Canadians spend 50% of what Americans pay for health insurance.  If we implemented a similar single payer system, the amount we would save per year would be about 1.5 trillion dollars. We are paying double and NOT covering 44 million people.

MFA has transparency. The reimbursement fees and costs are public information. The game of hidden costs can be abolished. 

Employer savings and a healthier workforce will make us more competitive in the international market. Expanding Medicare will also help it stay solvent for our current seniors and for future generations. With MFA, the substantial savings are obvious.  Yet there continues to be powerful rhetoric against the cost savings.
Let MFA compete with private, for-profit insurance companies. Let the consumers decide which option is best for them. No one will be forced to use a single payer plan, but it gives all of us more choices. One suggestion is to slowly lower the age to qualify for Medicare. For example start by lowering it to 64 years old, then after a set period, lower it to 63, etc.

Another option is to provided health care to all veterans and their families.

Let doctors be independent and work for our patients and not private corporations. Our economy will gradually absorb the change. Change is our only constant.

References

1. Berg, S. (2019, Jan 24). Physician burnout: Which medical specialties feel the most stress. Retrieved from https://www.ama-assn.org/practice-management/physician-health/physician-burnout-which-medical-specialties-feel-most-stress?&utm_source=BulletinHealthCare&utm_medium=email&utm_term=012519&amp
2. Gordon, S.F. (2018, Oct 25). Why Canada’s Docs Never Burn Out. Retrieved from https://opmed.doximity.com/articles/why-canada-s-docs-never-burn-out
3. * This is evolving, something phone are reminebured by some insurance companies but not consistently 

(3)  Brody, B. Is Medicare Cost Effective? (2003, Jun13). Retrieved from https://www.hopkinsmedicine.org/about/Crossroads/06_13_03.html

(4)  Archer, D. (2017, Feb 8). America’s Public Medicare Program Costs Less and Is More Efficient Than Private Health Insurance. Retrieved from https://scholars.org/brief/americas-public-medicare-program-costs-less-and-more-efficient-private-health-insurance

(5) Riffkin, R. (2105, Nov 6). Americans With Government Health Plans Most Satisfied. Retrieved from https://news.gallup.com/poll/186527/americans-government-health-plans-satisfied.aspx

(6)  Torrey, B.B. and Haub, C. (2004, Nov). Why Do Canadians Outlive Americans? Retrieved from https://www.prb.org/whydocanadiansoutliveamericans/

(7)  Gonzales, S. and Sawyer, B. (2017, May, 22). How does U.S. life expectancy compare to other countries? Retrieved from https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/#item-start

(8) World Happiness Report (2019). Retrieved from https://s3.amazonaws.com/happiness-report/2019/WHR19.pdf

(9) Farley, R. (2018, Aug 10). The Cost of ‘Medicare-for-All”. Retrieved from https://www.factcheck.org/2018/08/the-cost-of-medicare-for-all/

(10)  Remen, R.N. (2001, Jan). Recapturing the soul of medicine Physicians need to reclaim meaning in their working lives. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071213/