Reviews | It’s time to replace deadly ‘Wile E. Coyote Healthcare’ with life-saving Medicare for All

Medicare for All legislation is introduced Thursday by Bernie Sanders in the Senate and Pramila Jayapal in the House of Representatives. This life-affirming legislation, not because it assures a “domestic supply of infants” (to use a newly coined expression), but because it guarantees that every infant, as well as every child, adult and elderly person, will receive the medical care they need when they need it.

Instead of sacrificing lives to a god of free market insurance, this legislation is saving lives while retraining people from my old industry for the vital jobs of the future.

Life is complicated, but the case for Medicare For All is simple: it will save lives and money while increasing productivity, human emotional fulfillment, and physical well-being. It will make a popular and successful program accessible to everyone, while making it even better by providing vision and dental care coverage and eliminating co-payments and deductibles. Medicare For All is backed by more than two-thirds of voters and 22 studies have found it would save money.

A study published in the medical journal The Lancet estimates that “ensuring access to health care for all Americans would save more than 68,000 lives and 1.73 million life years each year compared to the status quo” . (Emphasis mine.) Amid so many deaths — from Covid-19, drug addiction, alcoholism, and suicide — passage of Medicare For All legislation would be life-affirming.

Wile E. Coyote Healthcare

I’ve worked in the for-profit health insurance industry for many years, so I know something else: its value proposition is as simple as Medicare For All. Mutuals make money by refusing care. It’s so simple. It’s their open secret. Premiums are set based on expected costs. If they provide less care at lower cost than expected, they win. Most often, this also means you lose.

This is the part they don’t tell you. This is the part that Medicare For All cuts out.

Here’s something else they don’t tell you. As Wall Street investors increasingly buy into the healthcare delivery chain, along with its financial institutions, the more our so-called “healthcare system” looks like a Road Runner cartoon. For-profit providers attempt to maximize their profits by increasing the unit costs and volume of services provided. Like Road Runner, they roam the medical landscape, racking up charges as fast as they can. Health insurance companies come up with increasingly complicated rules and contraptions to catch these Road Runners, no matter how much necessary medical care is denied in the process.

I know. I used to design some of these contraptions. They weren’t just unnecessarily complex. They were weapons too, catching innocent bystanders between the Road Runner and his opponent’s rocket or a giant flying boxing glove or whatever the courier brought from the Acme company. The encroachment of for-profit insurance on Medicare, including Medicare Advantage and the “ACO Reach” program, is another attack on our health and safety by Acme-like for-profit programs and contraptions.

Medicare For All puts an end to that. By eliminating private health insurers from the process, it also eliminates all the complicated processes they insist on, such as usage review, pre-authorization, lists of approved and disapproved providers, retroactive charges and denials. unexpected complaints. It also means that patients will no longer have to spend countless hours dealing with insurance company bureaucrats.

A Copernican turn

At the hospital level, the new legislation replaces this caricatural system by what are called “global budgets”. This too is basically simple. Instead of using elaborate systems to track diagnoses, treatments and supplies – a system that is routinely manipulated by all concerned to the detriment of patient health – each hospital will negotiate a budget that will cover all of its projected costs for the year to come. (Hence “global”, meaning it covers everything.) If costs suddenly change, due to a pandemic, natural disaster or other unforeseen events, the budget can be adjusted accordingly .

It is not just a change in administrative processes. It’s a philosophical shift in how health care is funded. Instead of using “incentives” to manipulate behavior, an institution receives the funds it needs to continue providing services for the next year. It is a Copernican shift away from the false free market ideology of the current system, towards a much simpler approach: giving the hospital the resources it needs to provide care.

A just transition—that doesn’t kill anyone

Legislation introduced provides for a smooth transition from current insurance to the new Medicare For All system. It also provides for a just transition for workers who would be displaced by the elimination of our current labour-intensive system.

Opponents of Medicare For All often argue that it should be opposed because it would kill health insurance jobs. This is something the new legislation addresses with recycling and outplacement. In any case, this argument has always been more bizarre than it seems, because it trades the lives of some for the livelihoods of others.

Here’s the math: An industry tracker reports that the health and medical insurance field employs about 600,000 people. Other estimates range up to a million jobs or more. But this system kills people. If we take a high estimate – say, 1.2 million people employed in health insurance – and divide it by the number of unnecessary deaths this system causes to each other, we are sacrificing one human life per year to 17 or 18 jobs. It’s a scenario more appropriate for Shirley Jackson’s The Lottery than for a modern health care system.

Instead of sacrificing lives to a god of free market insurance, this legislation is saving lives while retraining people from my old industry for the vital jobs of the future.

Equity for all

The new law also establishes an Office of Health Equity to ensure health care is equally available to all population groups, including groups that have disproportionately borne the burden of illness and disease. dead. These categories include, but are not limited to, race, ethnicity, tribal affiliation, national origin, primary language, immigration status, age, disability, incarceration, homelessness and socio-economic status.

The Office will also be responsible for examining barriers to access to health care, including income, education, housing, food insecurity (including availability, access, use and stability), employment status, working conditions and conditions related to the physical environment (including pollutants and population density); as well as lack of trust and awareness, transportation, geography and other factors.

The importance of this cannot be overstated. In a nation that is supposed to be founded on the right to “life, liberty and the pursuit of happiness, lack of equity in health deprives everyone of these fundamental rights.

life over death

Our people are tired. We have seen so much death and suffering. Covid-19 alone has killed a million people in this country. For perspective, it killed “almost as many Americans as each American war between 1775 and 1991 — nearly 1.2 million people — according to Department of Veterans Affairs data.” More than 150,000 people have already died of it in 2022.

And this is not the only suffering we have experienced. American life expectancy was already falling before the pandemic hit. So-called “deaths of despair” from suicide, alcoholism and drug overdoses were already rising, and overdose deaths continued to break all records in 2021.

People are looking for something positive in their life. In the 2020 Democratic primaries, polls showed more than two-thirds of voters (69%) supported providing Medicare to every American. Among Democratic voters, whose enthusiasm will determine the Party’s prospects in November, that figure is 88%. Medicare for All could electrify this race. Instead, it is about ending the Public Health Emergency (PHE) provisions that have been enacted to deal with the pandemic. The Kaiser Family Foundation reports that more than 15 million enrollees, nearly half of whom were children, have been added to government health programs since the program began. The Democratic Party should expand health care, not let it collapse on millions of vulnerable people.

Medicare For All is a call to reason. It is a call to morality. Above all, it is a call to reaffirm life in the midst of loss and grief. In difficult times, it calls us to give the best of ourselves.

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