Despite the fact that this bill has over 100 Congressional co-sponsors, you probably have not heard about H.R. 676, The Expanded and Improved Medicare for All Act. This legislation would:
• guarantee access to comprehensive, high quality, affordable health care to all U.S. residents;
• allow you to go to doctors and hospitals of your choice (unlike private insurance, which often forces you to use their list of doctors and hospitals);
• not require you to pay copayments or deductibles;
• not surprise you with huge unexpected medical bills.
Impossible fairy tale? No, just a much better use of existing resources. H.R. 676 would establish a “single payer” national health insurance program in the United States. The bill would create a publicly financed, privately delivered health care system that starts with the existing Medicare program while improving and expanding it to cover all U.S. residents.
This efficient structure would replace the nation’s private insurance companies, eliminating wasteful administrative costs, profits and exorbitant executive salaries. This administrative change alone would save the nation about $500 billion per year that could then be used for actual health care.
Additional funding would be obtained through a combination of existing federal and state health care spending, surtaxes on very high income earners, and a modest payroll and income tax based on ability to pay. However – and this is important – for most people these taxes would be fully offset by a steep reduction in health insurance premiums and the elimination of out-of-pocket expenses. Finally, H.R. 676 would help contain rising health care costs through streamlined administration, bulk purchasing and system-wide budgeting.
The Affordable Care Act (“Obamacare”) was an important step forward when it was implemented in 2010. It expanded health insurance coverage to millions of additional Americans by making it more affordable and by prohibiting private insurance companies from overcharging or excluding certain groups of people.
HR 676, The Medicare For All Act, is the next logical health reform which fixes some of the major deficits of the current Affordable Care Act (or its anticipated successor under the current administration). Even if fully implemented in 2022, the Affordable Care Act (ACA) will leave tens of millions of Americans uninsured or underinsured, but The Medicare For All Act would provide health care to all from birth.
The ACA leaves the private health insurance industry intact, diverting hundreds of billions of dollars every year from health care to administration. The Medicare For All Act consolidates all health insurance administration in a single public entity, saving about $500 billion a year to be used for health care rather than overhead. The ACA allows private health insurers to deny or restrict medical care, and forces people to use certain doctors and hospitals. The Medicare For All Act would allow people to go to any health care provider or facility they want.
Does this sound too good to be true? It isn’t. In fact most western nations have a health care system that looks much more like The Medicare For All Act than our current system based on private health insurance. Not only that, generally their health care is better than ours and they are happier with their health care systems than we are.
For example, a study sponsored by the National Institutes of Health in 2013 found that “for many years, Americans have been dying at younger ages than people in almost all other high-income countries.” The study determined that one of the main reasons for this startling finding is that the system of American health care is deeply flawed:
“Unlike its peer countries, the United States has a relatively large uninsured population and more limited access to primary care. Americans are more likely to find their health care inaccessible or unaffordable and to report lapses in the quality and safety of care outside of hospitals.”
In sum, we as a nation can do better. An improved health care system like The Medicare For All Act would allow our national health to catch up to our international peers.
For more information about HR 676 and related issues, visit Physicians for a National Health Program at http://www.pnhp.org/
Lawrence Weiss is UAA Professor of Public Health, Emeritus, creator of the UAA Master of Public Health program and author of several books and numerous articles.
