Regarding the March 18 editorial “M4A isn’t the only way to go,” put all the facts on the table and there should be no room left for agnosticism. A well-designed, single-payer, improved Medicare for All system does the following:
It is truly universal, meaning everyone is included automatically, for life.
It dramatically reduces profound administrative waste, recovering enough funds to pay for care for the currently uninsured and underinsured.
It addresses the problem of excessive prices by using publicly administered global budgeting and price negotiation, covering legitimate costs while eliminating gouging.
It improves equitable allocation of healthcare resources through central planning and separate budgeting of capital improvements. Everyone would have reasonable access to care.
It makes the financing of healthcare equitable by replacing premiums and cost-sharing with progressive taxes based on ability to pay. The financing of the universal healthcare risk pool is totally separated from the delivery of healthcare such that nobody is ever denied care because of the inability to pay for it.
Publicly administered programs are much more effective in reducing the trajectory of healthcare costs to sustainable levels (compare Canada’s spending curve to ours), ensuring that, well into the future, healthcare will be affordable for each of us and for society as a whole.
Our current system has twice the average per capita costs of other wealthy nations while we fall short on universality, effectiveness, equity, resource allocation, access and quality. The Affordable Care Act left this extremely inefficient system in place, so building on it or compounding its complexity with the addition of a public option (expanding Medicare to the few who can afford it) cannot begin to correct the profound, expensive dysfunctions in our system.
Do we want a public service model designed to take care of patients, or shall we continue with a private business model designed to enrich the vested interests? There should be no question that it’s time to end equivocation and get on with enacting and implementing a model that actually would work: single-payer Medicare for All.
Dr. Don McCanne
Senior health policy fellow
Physicians for a National Health Program