Medicare for All FAQ
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“What is Medicare for All?”
Answer: Medicare for All is a demand for a universal national health insurance system in which a public agency organizes health financing, but delivery of care remains largely private. Under a universal public healthcare system, all Americans would be covered for all services covered by a medical professional, including: primary care, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.
“How will we keep drug prices under control?”
Answer: When all patients are under one system, the payer wields a lot of clout. The VA gets a 40% discount on drugs because of its buying power. This “monopsony” buying power is the main reason why other countries’ drug prices are lower than ours. This also explains the drug industry’s staunch opposition to universal national health insurance.
“Won’t Medicare for All Lead to Long Wait Times and Rationing of Care?”
Answer: No. It will eliminate the rationing going on today. The U.S. already rations care based on ability to pay: if you can afford care, you get it; if you can’t, you don’t.
At least 30,000 Americans die every year because they don’t have health insurance. Many more people skip treatments that their insurance company refuses to cover. That’s rationing.
Excessive waiting times are often cited by opponents of reform as an inevitable consequence of universal, publicly financed health systems. They are not. Wait times are a function of a health system’s capacity and its ability to monitor and manage patient flow. With a universal healthcare system - one that uses effective management techniques and which is not burdened with the huge administrative costs associated with the private insurance industry - everyone could obtain comprehensive, affordable care in a timely way.
“I Have Good Health Benefits Through My Work, Why Would I Want Healthcare Reform?”
Answer: Many with excellent workplace health insurance have found that a serious illness or injury may cause them to lose their job, and subsequently their health insurance. Furthermore, employers pay the full cost of health insurance out of reduced wages, and health care costs are devastating municipal, state, and federal budgets, cutting into vital public services like education and infrastructure. Switching to a universal healthcare system means health security that cannot be taken away by misfortune; savings for households, employers and government; and the ability to control cost growth into the future.
“Will This Put The Government Between Me and My Health Care Provider?”
Answer: No. Right now, many health decisions are made by corporate executives behind closed doors. They determine which physicians and hospitals you are allowed to see, imposing deductibles and co-payments that often make appropriate treatments impossible, and refusing to pay for care that your providers, non-medical professionals who are only concerned with their company’s bottom line, deem necessary. Their interest is in profit, not providing care, and as a result 32 million have no insurance, tens of millions more are underinsured, and most are at risk of financial disaster should they become seriously ill. Under Medicare for All, every resident would have full choice of provider, we could eliminate cost barriers to recommended care, and all medical decisions are made by doctors and patients together, with the health of the patient as the only factor determining treatment. No one will go without care.
“Would Medicare for All Drive Up My Taxes?”
Answer: Medicare for All would replace high, unpredictable premiums with lower, stable taxes. Unless you are among the top 5% of income earners, the bill is expected to reduce your total healthcare costs.
Currently, about 65% of our health care system is financed by public money: federal and state taxes, property taxes, and tax subsidies. These funds pay for Medicare, Medicaid, the VA, and coverage for public employees (including police and teachers, elected officials, military personnel, etc.). There are also hefty tax subsidies to employers to help pay for their employees’ health insurance.
“How can we afford to cover everyone/won’t it be too expensive?”
Answer: No, We already pay enough for health care for all – we just don’t get it. Americans already have the highest health spending in the world, but we get less care (doctor, hospital, etc.) than people in many other industrialized countries. Because we pay for health care through a patchwork of private insurance companies, about one-third (31 percent) of our health spending goes to administrative overhead (also known as “transaction costs”).
Replacing private insurers with a national health program would recover money currently squandered on billing, marketing, underwriting and other activities that sustain insurers’ profits but divert resources from care. Potential savings from eliminating wasteful profit-driven costs such as an overbloated bureaucracy and adopting proven effective cost saving measures have been estimated at $400 billion per year. Combined with what we’re already spending, this is more than enough to provide comprehensive coverage for everyone. It turns out that it is much more expensive to keep patients away from health care in our current fragmented, market-based system than to provide care to all under an administratively simple universal healthcare system.
“Won’t Medicare for All just be another bureaucracy?”
Answer: The United States has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc. 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.
The Medicare program operates with just 3% overhead, compared to 15% to 25% overhead at a typical HMO. Provincial universal plans in Canada have an overhead of about 1%. It is not necessary to have a huge bureaucracy to decide who gets care and who doesn’t when everyone is covered and has the same comprehensive benefits.
“What about medical research?”
Answer: Most breakthrough medical research, for example basic drug development, is already publicly financed through the National Institutes of Health (NIH). In fact, according to the NIH web site, of the last 30 Americans to win the Nobel Prize in medicine, 28 were funded directly by the NIH.
Medical research does not disappear under universal health care system. Many of the most important advances in medicine have come from single-payer nations. Often, private firms enter the picture only after the public has paid for the development and clinical trials of new treatments. The HIV drug AZT is one example. On average, drug companies spend more than half of their revenue on marketing, administration and profits, compared with 13 percent on research and development. Negotiating lower prices will allow Americans to afford drugs without hurting research.
“I or my partner/family-member/friend works in the insurance industry. Will they lose their job under Medicare for All?”
Answer: A universal national health system will still need some people to administer claims. Administration will shrink, however, eliminating the need for many insurance workers, as well as administrative staff in hospitals, clinics and nursing homes. More health care providers, especially in the fields of long-term care, home health care, and public health, will be needed, and many insurance clerks can be retrained to enter these fields. Many people now working in the insurance industry are, in fact, already health professionals (e.g. nurses) who will be able to find work in the health care field again. But many insurance and health administrative workers will need a job retraining and placement program. We anticipate that such a program would cost about $20 billion, a small fraction of the administrative savings from the transition to national health insurance.
“How much of the health care dollar is publicly financed?”
Answer: Over sixty percent (60.5 percent) of health spending in the U.S. is funded by government.