This is the third and last installment from the blog…The Only Things Certain in Life Are DEATH AND TAXES! Thanks to my brother Isaac for his well thought answers and contribution to my blog!

Arthur, you asked “how would you save Medicare? How would you deal with Healthcare? How would you fix the Economy? Three questions that are inextricably tied together. In fact, there is no way to fix the economy without fixing healthcare and by “extension” Medicare.

“By extension Medicare” is a play on words, but extending Medicare to all American citizens would be, I believe, the fix America needs. Medicare is the most successful single-payer health system in the world. By availing it to everyone you broaden the contributor pool, spreading the cost over a substantially larger user pool, reducing the cost to all concerned.

One of the principle arguments against single-payer is that it is a “government run bureaucratic insurance plan” that will limit choices and dictate the care that people receive. I would argue that what we have now is a business run bureaucratic insurance plan that limits choices and dictates the care that people receive, that has the added burden of making a profit for its shareholders. The government would not be so burdened.

The Affordable Care Act actually corrects a part of the problem by limiting the amount that insurance companies can spend on administrative cost such as advertising, bonus’, etc. Think about it though, those costs affect what care the patient is able to receive. I was struck by the vehement opposition to the inclusion of a single-payer component in the ACA, principally by the insurance companies, who complain that the government has an unfair advantage, that people would flock to a Medicare for all system, but for me, that’s all the more reason to use it.

A single-payer, Medicare for all system would reduce waste and fraud. It would open up competition, not just with healthcare providers, but with pharmaceutical companies as well. It is a rarely discussed fact that currently Medicare cannot negotiate with pharmaceutical companies for lower prices for their products. It is insane that countries like Canada and the United Kingdom pay in some cases far less than Americans for the exact same medications.

Sometimes all you have to do is look at who lines up on which side of an issue to determine what side a person should stand. Those for single-payer include:

  • American Medical Students Association
  • The American College of Physicians

Even the American Medical Association, for its own reasons, such as payment of claims, supports some form of single-payer system. At “The Health Care Blog,” author Michael Millenson writes:

“A newly released study commissioned by the association found that insurance company bureaucracy and a “chaotic” claims process is draining time from patient care, diverting as much as 14 percent of physician revenue and costing “as much as $210 billion annually, without creating value.”

Mr. Millenson also references a statement from Physicians for a National Health Program (PNHP)” that says:

“Because the U.S. does not have a unified system that serves everyone, and instead has thousands of different insurance plans, each with its own marketing, paperwork, enrollment, premiums, and rules and regulations, our insurance system is both extremely complex and fragmented…With a universal health care system we would be able to cut our bureaucratic burden in half and save over $300 billion annually.”

The PNHP has a Single-Payer FAQ” page that is a must read if one wants to better understand what it is all about.

Those against single-payer are the healthcare insurance industry and the pharmaceutical companies. Hmm, I wonder why? The argument that it would ration care is not valid because healthcare is already rationed, by the insurance companies, by what you can afford. The argument that it would not save money is also not valid because it would reduce administrative cost, reduce overcharging and fraud. The argument that it would decrease compensation for providers is not valid too; what will occur is an increase in the pool of covered people, increased efficiency in payments to providers. The argument that the quality of care would decrease, “WHY?” The argument that it would take medical decisions away from doctors and patients is not valid because those decisions are currently being made by insurers now. That’s part of the problem we are dealing with.

The hard truth is that, economically, the costs related to healthcare are holding this country down in terms of growth. This is from

“Health expenditures in the United States neared $2.6 trillion in 2010, over ten times the $256 billion spent in 1980. The rate of growth in recent years has slowed relative to the late 1990s and early 2000s, but is still expected to grow faster than national income over the foreseeable future. Addressing this growing burden continues to be a major policy priority. Furthermore, the United States has been in a recession for much of the past decade, resulting in higher unemployment and lower incomes for many Americans. These conditions have put even more attention on health spending and affordability.

Since 2002, employer-sponsored health coverage for family premiums have increased by 97%, placing increasing cost burdens on employers and workers. In the public sector, Medicare covers the elderly and people with disabilities, and Medicaid provides coverage to low-income families. Enrollment has grown in Medicare with the aging of the baby boomers and in Medicaid due to the recession. This means that total government spending has increased considerably, straining federal and state budgets. In total, health spending accounted for 17.9% of the nation’s Gross Domestic Product (GDP) in 2010.”

The Affordable Care Act addresses some of these problems, things are better than they were, but in my opinion, it doesn’t go quite far enough. Single-payer, in conjunction with the ACA may solve many of them. Is this a perfect solution? No it isn’t. But contrary to Voltaire in his poem “La Begueule,” perfect need not be the “enemy of the good.”

Fixing Healthcare/Medicare requires a 99% solution. (Another play on words?) The fact is there is 1% of our population that does not have a healthcare problem. What we need is a solution for the rest of us. Solving the Healthcare/Medicare problem will go a long way toward fixing the Economy and pretty much whatever else ails us.

You can find more of Isaac’s writings at

The Only Things Certain In Life Are DEATH AND TAXES!

What A Great Breakdown On How Taxes Are Divided And Distributed!