Medicare for All

The many uninsured Americans-47 million and rising-only begin to tell the story of our health care system's failures. Many more are underinsured, unable to receive coverage for routine care or their most costly medical conditions or to afford rising premiums, deductibles, co-payments and prescriptions; others suffer long lines at the emergency room and worsened care because our system of health care delivery focuses on sickness, not health. Lives and livelihoods are threatened by a haphazard private insurance system which places profits above people. The cure for such a system ought not to be a series of half-measures or non-measures, but a move to a universal single-payer health insurance system which removes profit as the primary motivation of the health care sector and improves upon and expands Medicare for all United States citizens.

In circumventing profit-seeking insurance companies and giving government the responsibility of financing health care, the current delivery of care through a combination of public and private non-profit providers is maintained. Patient choices of hospitals or doctors are preserved for those with coverage already, and greatly enhanced for the many without it. Coverage for well-visits and preventative care; prescription drugs and long-term care; dental, hearing and vision care; mental health care and other care often not provided by private insurers because these types of care are seen as unprofitable, would be covered in an improvement and expansion of Medicare for all that would recognize their importance.

With government as our health insurer, citizens will not only experience more comprehensive care, but will see enormous gains in how efficiently funding is spent. No more will funding be diverted for advertising and marketing costs of insurance companies, or for their efforts to reject financial (health) risks from their plans or deny patients coverage if they slip through, or for their immense administration costs with eight-figure salaried executives. With all citizens under one plan, the government has greater leverage to keep health care costs down, as the current Medicare system has shown success relative to private insurers. A shift in emphasis toward preventative care will, in the long run, avert many of the more expensive emergency situations that arise now from continual neglect of potential or chronic health problems.

When some opponents of a single-payer system advocate for an employer-based health insurance system, they fail to face the realities of today and tomorrow. Medicare exists now to provide to the at-risk senior population coverage which it is not expected to obtain through employment. While some seniors must still work to be able to close gaps in coverage-and this must be addressed-the same logic may be applied to children under the age of eighteen, who are also at-risk and who cannot reasonably be expected to obtain insurance through an employer either. The same holds true for those who are unemployed, and may, because of a persistent medical condition, remain so.

Yet a call for employer-based insurance also fails to recognize the changing nature of work. Many people will have a number of jobs/careers throughout their life, and their reliance upon an employer to provide insurance only worsens an environment of increasing insecurity. The trend has been towards raising premiums, deductibles, co-payments, and correspondingly shortening the breadth and depth of coverage, or dropping it outright. Thus, an improvement and expansion of Medicare for all would allow for both greater flexibility in our workforce in moving from job to job and greater access to jobs in general. Small businesses could better compete with big corporations in attracting workers, and providing goods and services on a more human scale. Workers could reassert their power in the workplace, or renew their own entrepreneurial spirit. The universal single-payer health plan I propose would, in short, ensure that every American, regardless of age, income or health condition-is given the opportunity to live out his or her life to fullest, to pursue a dream to its fulfillment.