Several years ago, I sat next to a colleague at a conference. She was CEO of a much-larger-than-SOS behavioral health software company. We were listening to a presentation on costs and duplication of services to chronically mentally ill Medicaid recipients, and the efforts of community mental health organizations to provide needed services with limited Medicaid dollars. We looked at one another and agreed that the only way all of us, including the most vulnerable populations, are ever going to get reasonably priced high-quality healthcare services is when we have a single payer system.
Many of you know that I have spent the past eight years as primary caregiver for my elderly mother. A result of that process is significant experience with the Medicare system. My mother used traditional Medicare: doctors billed for services provided. Medicare and a Medigap policy paid for all covered services. Medicare Part D paid about 60% of medication costs. Our experience with the Medicare system was nothing but positive. Mom paid her extremely reasonable Medicare, Medigap and Part D premiums and she received all the care she needed from caring, outstanding providers.
This morning, I read my issue of FierceHealthPayer. They reported that a new study from Physicians for a National Health Program shows that we could save approximately $592 billion in healthcare expenditures next year if Medicare were extended to all. Gerald Friedman, Ph.D., a Professor in the Department of Economics at University of Massachusetts at Amherst details how these savings could be accomplished through a single payer system proposed in HR 676: The Expanded and Improved Medicare for All Act.
Dr. Friedman’s focus is on administrative costs. You know about those. They include your costs in meeting the requirements of myriad insurers in order to get paid for the services you render to your clients. Those costs include software, claim forms or clearinghouse fees, staff salaries and benefits, long distance charges for hours spent on hold with insurance carriers to verify coverage and object to claim rejections, to list only a few. These costs include insurer’s expenditures for their side of those same processes…and employers costs to shop for, administer, and pay for coverage.
Don’t think about other countries and their health care systems. Think about our 48 years with Medicare. Maybe Dr. Friedman and Rep. John Conyers, Jr. (D-Michigan), author of the bill, are onto something.
Laura Morrison says:
Kathy, I totally agree. I was a member of PNHP for some time, especially during the health care debate. I’ve seen the comparisons and the numbers, and they’re staggering. I even put together information packets for my clients.
But the Congressional debate reeked of corruption, and, although I think the Affordable Care Act is a good thing in general, it’s worse than an elephant designed by a committee. I finally gave up on campaigning for single payer; insurance companies were paying congressmen $1 million per day during the debate. There’s no way good sense can compete with that kind of greed. But sometimes I still hope and dream that the country will come to its senses and single payer will happen. Thanks for bringing up the issue again. Laura
Kathy says:
Thanks for your comment, Laura. Certainly no one could argue that ACA is a good plan; there are so many flaws, but it opens up the possibilities. I don’t know if we will ever come to our senses about a single payer system. So many people are so misinformed about what would be involved. It is very sad to me that greed rules the decision-making on issues like this that affect all of us. I will just hope they do not destroy the Medicare system; we cannot let them do that!
Susan Hasselle says:
No doubt we need a National Health Program, Medicare for all. . . Most American’s are so misinformed about National Health Care because of the lobbying of insurance companies buying politician’s votes. My daughter is a dual citizen (UK/US). . . We had the opportunity to visit with her MP at Parliament a few years ago. . . He assured us “hands down” their most popular program is their National Health Care. . . .
Kathy says:
Of course, all we ever hear is complaints about the national health care systems of other countries. The biggest complaint is long wait times for surgeries and procedures. Of course, those who complain always rush back to their home country so they can get their healthcare since it is usually free or very low in cost. If we keep the crazy patchwork system we have now in the U.S., the waits will eventually occur here too. We already have a shortage of physicians; without big system modifications, we are all in for long waits and ever-rising prices. If we eliminate the 15% profit margin of the insurance companies, we are talking about an immediate reduction in costs! Thanks for sharing your experience, Susan.
Peter says:
Consider joining Physicians for a National health program.
http://www.pnhp.org
Kathy says:
Thanks for sharing the link, Dr. Kaplan.