The public wants universal coverage

Times are hard. Major changes are needed. In this vein, more Americans are coming to see the benefits of reforming our healthcare “nonsystem.” Public-spirited Americans have been trying to do this for the past 75 years but have been thwarted by special interests.

Although strongly in favor of universal coverage, President Franklin D. Roosevelt decided national healthcare insurance was too controversial a topic and de-emphasized it in favor of pushing through Social Security. The insurance, physician and hospital lobbies, which still exist today, were simply too strong. Since then, initiatives were put forth by several other administrations to establish national healthcare insurance. The only real legislative successes were Medicaid and Medicare under President Lyndon Johnson and the State Children’s Health Insurance Program under President Bill Clinton, whose broader reform effort was sunk by the insurance industry and self-interested others.

According to Harvard economist David Cutler, about 20,000 Americans die each year due to lack of insurance. Is this the America that we want to pass on to our children?

As caring human beings, we have to look at solutions, not repeat the empty negative rhetoric we hear on talk radio or at political conventions. I am a former Republican elected official, but I know that the public wants universal coverage right now and demands a simple way to receive it. If politicians of both parties continue to oppose real reform, Congress will continue to lose taxpayer confidence, and deservedly so.

Now is the time for universal health insurance to finally be enacted. How? We have an obvious solution to the worsening healthcare access crisis: expand Medicare to cover all.

Private providers will continue to deliver healthcare and physician relationships will be preserved, as they are for Medicare recipients right now. It is not "socialism," the outlandish charge made by fanatics when a single-payer system is discussed, any more than the Veterans Administration hospitals are communism. And, do you know of any patriotic older Americans who are so unhappy with “socialistic” Medicare that they want to give it up?

Why? Because Medicare works. When combined with supplemental private policies, it currently provides a base level of coverage for those over 65, plus more coverage as desired. Why not expand it to all age groups?

Some say total costs will go up; this charge is largely unfounded. Cost-shifting is not the same as cost increases. And if total costs do go up somewhat, isn't it money well spent versus the disaster in Iraq?

Medicare administrative costs are much lower than the private insurance sector, which spends about one-third of our premium dollars on marketing-related costs. Cost savings will be achieved. Further, if current Medicare efforts regarding determining best medical practices are expanded under a single-payer system, more cost savings can be obtained and largely offset any increased systemic costs needed to cover those between jobs, early retirees and the uninsured working stiff left out in the cold by an employer that fails to provide that option.

Yes, there will be cost-shifting from businesses to government. This will make our industries more competitive with foreign manufacturing, which does not pay health benefits to its employees. That’s a real stimulus for American car manufacturers.

And there will be cost-shifting from state and local government, which are now picking up part of the tab for indigents and its employees, to the federal government where it belongs. This may not solve our state budget crisis, but it sure won’t hurt.

As someone who has made his living as an executive in the for-profit healthcare system, I understand well “the dirty little secret” why many healthcare-related businesses, professionals and organizations are opposed to expansion of Medicare: it may lower their earnings. For this reason, the extent of lobbying by these groups cannot be underestimated. However, healthcare providers and political figures must do the right thing to regain the confidence of the public. And that is Medicare coverage for all!

Jack Bernard

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