Sparked by Bernie Sanders’s “Medicare-for-All” introduction on the 2016 presidential campaign trail, the issue of free or nearly free health care continues to be discussed. What is Medicare-for-All (MfA) and how might it affect the quality, cost and delivery of health care?
A poll conducted since 1998 by the Henry J. Kaiser Family Foundation (KFF), reports that 56 percent of Americans surveyed favor “a national health plan, sometimes called ‘Medicare-for-All,’ where all Americans would get their health insurance from a single government plan.”
KFF identifies varying levels of support based on nomenclature and perceived impacts. The bottom line is that semantics, details and messaging matter.
At 53 percent, “Medicare-for-All” emerges as the most positive moniker, followed by “guaranteed universal health coverage” at 44 percent; “single-payer health insurance system” at 21 percent; and “socialized medicine” at 22 percent.
The poll also identifies how specific factors influence participants’ degree of support: health insurance as a guaranteed right for all Americans (71 percent); removing all health insurance premiums and reducing out-of-pocket health care costs for most Americans (67 percent); eliminating private health insurance companies (37 percent); requiring most Americans to pay more in taxes (37 percent); threatening the current Medicare program (32 percent); and causing delays in people getting some medical tests and treatment (26 percent).
Seventy-seven percent favor a Medicare buy-in plan for adults between ages 50 and 64; 75 percent support a Medicaid buy-in plan for people who don’t receive health care through their employer; and 74 percent like the idea of an optional Medicare-like program for those who want it.
“Medicare-for-All and/or universal health care would benefit the country as a whole by taking the power out of the hands of for-profit insurance companies and big pharma companies,” said Jessi Hans, executive director at The Coalition for Compassion and Justice (CCJ) in Prescott. “Taking the focus from insurance to how we can create the best working healthcare system would dramatically affect how we look at care.”
Medical care in the United States is heavily influenced by health insurance companies and the negotiating power of individuals with the medical professionals who serve them.
“When billing drives service, we cannot possibly have the focus necessary on best practices for the patient,” Hans explained. “More and more, insurance drives services in both medical and mental health care, dictating what people receive instead of relying on the most effective best care practices or being allowed the liberty to create new treatments, opening the window to new methods.”
Leslie Horton, director of Yavapai County Community Health Services, identified advantages for people who can rely on insurance to help with costs. Her data show that people in in low-income neighborhoods are less likely to have access to healthy foods or adequate space for physical activity, and that their children are more likely to become victims of violence and use tobacco, alcohol or drugs.
“When people have health insurance coverage, they are more likely to attend preventative physicals, utilize preventative screening options and catch illnesses sooner than those who do not have medical coverage,” Horton explained. “Catching illnesses early, before they become serious, can save costly emergency room visits, allow for early treatment and often cure potentially life-threatening illnesses.”
Horton urges uninsured citizens to investigate current systems, such as the ACA or the state’s Medicaid program Arizona Health Care Cost Containment System (AHCCCS). People often fail to fully comprehend the importance of medical or dental insurance, she added, until hit with serious illness and significant medical bills.
Concerns about future systems such as MfA often include potential shortages of medical professionals, lack of access to services when needed, emergence of a two-tiered system where privately insured individuals obtain quicker care, and how to pay for it. The Journal of the American Medical Association, for example, states that six percent of reporting patients in the U.S. waited more than two months to see medical specialists, compared to 19 percent of British and 39 percent of Canadian patients.
On a positive note, MfA in the U.S. “easily could be paid for if every level of income was taxed at the same rate or percentage,” Hans said. “There are nations that have adequate [health] resources for all citizens… it is not a pie in the sky dream.” QCBN
By Sue Marceau, QCBN