By Karen Rubin
Perhaps you haven’t heard: Trump solved the health care crisis, also the Big Pharma crisis, also the opioid criminal conspiracy that has taken 200,000 lives. You know that because at a rally in North Carolina, before spurring his Deplorables to chant “Send her back,” he said, “And we have all night, we’re going to have a lot of fun tonight, and I have nothing to do, nothing, nothing.”
And what is Trump’s solution? Pricing. Making hospitals, doctors and drug companies post their charges in advance – after all, as HHS Secretary Alex Azar, a former Big Pharma exec, said, you can negotiate with a car dealership over the sticker price of a car, you should be able to negotiate with the pharmacist. He misses the fact these are near-monopolies with control over life-and-death treatment and medications, giving new meaning to capitalism’s “supply and demand” equation. How much is your child’s life worth?
Each of the Democratic candidates who are vying to replace Trump, meanwhile, has come out with detailed plans to actually solve the most serious concerns affecting our day-to-day ability to live and address the financial insecurity and anxiety over health care costs.
Sanders makes the argument that 30,000 people a year die prematurely for lack of access to affordable health care and 530,000 Americans declare bankruptcy each year because of medical expenses.
“The current debate over Medicare for All really has nothing to do with healthcare. It has everything to do with greed and the desire of the health-care industry to maintain a system which fails the average American, but which makes the industry tens and tens of billions of dollars every year in profit. It is about whether we maintain a dysfunctional system which allows the big drug and health insurance companies to make over $100 billion in profits last year, while the top CEOs in that industry made $2.6 billion in total compensation – all the while one out of five Americans cannot afford the prescription drugs their doctors prescribe.”
Amazingly, Democrats who raised their hand in support for a pure single-payer system replacing for-profit insurance are accused of handing the election to Trump, who has done nothing but sabotage access to health care but tars them as Socialists who will destroy liberty. Imagine the sin of seeing health care as a right, not a privilege.
In 2016, I decided that Hillary Clinton was the better candidate than Bernie Sanders because of her more pragmatic progressive plan for universal health care. In 2020, health care could again determine the nominee and the president. Now Bernie is back with intensified attacks on anyone who doesn’t support Medicare-for-All as if they were paid off by the industry.
Attacking anyone (ie. Joe Biden) who opposes Medicare-for-All is somehow in the pocket of the mega-billion healthcare industry. It is Bernie’s modus operandi and why his only success in his 30 years in Congress has been to destroy the Democratic Party and hand the reins of government over to the most inept, corrupt occupier the U.S. has known. Sanders seems ready and willing to do it again in 2020.
All the Democratic candidates have the same goals. But there is an argument to be made to improve upon the Affordable Care Act, which is already in place when presidents going back 100 years failed. Adding a public option would enable people (including non-citizens) to buy into Medicare, expanded and improved to cover necessary services like dental, hearing and eye care. Just as now, Medicare premiums would be related to income but set separately from income taxes. Cutting out the middleman of for-profit insurance companies would slash at least 20 percent from what people pay now. My guess is that over time, more and more people would gravitate toward the public option – isn’t that the essence of capitalism’s competition? – especially as in the past decade, fewer and fewer employers even offer health benefits.
At the same time, just as ACA imposes limits on the profits of for-profit insurance (80 percent of premiums must be spent on actual patient care), Congress can set up rules that govern medical care and prescription drug costs and fees, much like what is already done with other utilities and monopolies essential for life, like water and electricity. If 180 million Americans who now have private insurance (debatable whether they love their private insurance company or rather their doctors) and think they don’t want to change, then a public option is an excellent transition. It should be made clear that under Medicare for All or a public option, patients still can choose their doctors or services, just as now, but then private insurance companies dictate which doctors, which hospitals, what drugs are covered, and as has become tragically apparent, too many people can’t afford anything but the most stripped down insurance policies, so they can’t afford necessary services anyway.
Given that medical science is moving toward making it possible for people to live for 120 years (how does anyone stock away enough to afford 60 years of retirement?), the Obamacare focus on wellness, early diagnosis and treatment, which would reduce health care expenses to individuals and society, is essential. Also, expanding the number of medical professionals, clinics, e-medicine, Advanced Precision Medicine is needed.
Just as Medicare is not free, Medicare for All is not free though it will likely reduce total outlay compared to insurance premiums, deductibles and co-pays. And just as with Medicare, the likelihood is there would still be a market for private supplemental insurance, as well as for VIP/concierge doctor programs, just as now).
The Democratic candidates will have another chance to make their pitch for health care at the second round of debates July 30-31.
