Debunking the Myths About National Healthcare

An analysis of the Myths of National Healthcare Constipating Real Reforms
Myth #1 A government run healthcare program eliminates your
private insurance

 No,
this is incorrect and a good example of a government run healthcare program is
Medicare, which has been around for over 50 years. Medicare is made up of several parts; Part A which is for inpatient coverage, Part B, which requires a monthly
premium provides outpatient coverage, Part C, which is the Medicare
Advantage Plan-a somewhat integrated health plan, and Part D, the prescription drug coverage added by President George
W Bush. This was back in the day when Republicans wanted to provide benefits
for people rather than take them away. Private insurance companies’ partner
with Medicare to lower cost-sharing for seniors, improve drug coverage, and increase
access to specialty care, and these are known as Medicare supplements. Though
this may seem a convoluted way to get the various components of healthcare met,
it does work. Medicare also is very effective for several reasons.

  1.  All seniors, persons age 65 and up are covered
    on Medicare, which is also a group that private insurance companies are glad to
    have the government insure. This is a demographic group that is highly likely
    to need healthcare services and whose access to healthcare would not be
    possible without government healthcare.

Myth #2 A government run health plan will cost too much

This assertion is also incorrect as
every country with a national government run health system spends far less than
the United States and boast better results in many clinical areas. For example,
according to the Petersen/Kaiser Health System Tracker in 2016 the US spent
$10,238 on average per person for healthcare.
 (Petersen/Kaiser Health System
Tracker, 2019)

But as we know, many people went without healthcare at all, so this figure,
although higher than other industrialized countries by 50% represents the skewing
of healthcare services to a much small percentage of the national population. France
spent $4,600 per person and everyone has had access to an integrated health system
for decades. Japan spent $4,519. The average spent by industrialized countries
was $5,198, less than half of what the US spends. 
Further, an integrated national
health system will be less expensive to administer and a good example of that
is Medicare and here are some reasons why:

  1.  Medicare administration expenses are 6% of total
    plan expenses as opposed to 12-18% for private sector plans, which means it is
    less expensive. 
  2. Medicare requires Medicare Advantage plans,
    which are supplemental insurance, to spend at least 80 to 85% of the premiums
    collected on actual medical claims, which mutes excess profiteering. And CMS requires
    them to issue customer rebates if they do not meet those loss ratios for
    benefits paid out. This is similar to the standards private sector insurance
    must adhere to in Europe. 
  3. Medicare already determines what services are
    approved for reimbursement, which all private sector insurance plans adopt, so
    it would be efficacious for it to set national standards.

Myth #3 You won’t be able to see your private doctor

This assumption is also incorrect
as other countries with government run health systems do have private clinics
and private doctors which their citizens enjoy. In fact, the United Kingdom
Health System which is a totally government run health system is not the norm. Other
countries with national health systems, like France the Netherlands, or Australia
use a combination of public and private programs to provide healthcare. The
difference is, a much smaller segment is provided by private insurance
companies. Of course, the behemoth insurance industry in the US is not going to
be in favor of a smaller market share. However, this does NOT mean this position
is better for you, the consumer or the patient and I state this as a former
insurance broker.

Myth #4 Most Americans have Access to Health Insurance
Through Employer Provided Plans

Again, this assertion is false as
only half of US employers provide medical plans to their workers.
(Kaiser Health Facts, 2019) And of that number,
employers are increasingly forcing more of the costs of medical care onto their
employees through higher premiums, higher co-payments, and reductions in
benefits. Ergo, people already realize they are paying for the cost of their
healthcare, and paying more than anyone else in any other nation, but we need
to move toward the discussion of value. The question needs to be, is that
$1,000 monthly insurance premium and that $5,000 co-payment for surgery less
expensive than a national healthcare plan and that answer is profoundly no. No
one in any country with a national health system is expected to pay a $5,000
co-payment for medically necessary surgery. In fact, the joint replacement
surgery to which I refer could be done for that co-payment price in many
European countries. Americans need to start discussing value-what are you
getting for that extremely high cost of care.

Further, the Republicans promote the idea that worthwhile
residents have health insurance and the others must be lacking in some social
value and this is not in keeping with current employment practices. The gig
economy includes highly specialized and educated workers from throughout
the globe and they work without benefits. It is not only farm workers who lack
healthcare, but a huge swath of the workforce. An excellent reference for the
impacts of this work force change is Mary Gray and Siddharth Suri’s Ghost
Work-How to Stop Silicon Valley from Building a New Global Underclass. (Suri, 2019)

A better approach to improving US healthcare needs to
consider who is paying for services, not just how much they are paying, because
more and more the middle-class workers are being gouged for the cost of their
healthcare. This needs to stop and the solution is to reform the US health
system into a saner, less expensive, inclusive one, that is used by all other
industrialized countries in the world (national healthcare). Some things to consider in streamlining
the US healthcare system include things that Medicare is already doing with a national
impact:

  1.  The Centers for Medicare and Medicaid (CMS) are
    part of Health and Human Services Agency and are the main fraud detection arm to
    prevent criminal activity in the healthcare system. It is in the best interest
    of all patients and tax payers to have an independent government agency monitor
    and enforce anti-fraud efforts and prevent the use of unapproved medical
    devices and products in the healthcare system.
  2.  Medicare is best suited to bargain with private
    sector entities for pricing of products and with the largest customer base,
    also in the best position to get lower prices than anywhere else. Private sector
    companies exist to make money, which means you pay more. If CMS through Health
    and Human Services has the power to bargain with pharmaceutical companies, you
    will see an immediate drop in the cost of your prescription medications. Why
    should Americans continue to pay more for medications that are sold to patients
    in Europe, with socialized health systems for significantly less?
  3.  Medicare already uses medical evidence to inform
    changes in approved treatments and these are piloted through demonstration
    projects. Medicare with its huge patient population can provide excellent data for
    future health system improvements. An example of this was the move to spend
    Medicare money to keep seniors in their homes because it was proven to reduce
    hospitalization costs and improve patient health.

 

A national health system for all
will eliminate some of the conflicts of health system profit making procedures
versus lower cost more efficacious health treatments that are less lucrative. The current health system
relies on up-selling of medical imaging, laboratory, and elective surgeries to generate
margins and produce financial results. Healthcare should be focused on helping
people live quality lives, not producing profits. And the health of a nation
needs to be devoted to population health measures, methods, and outcomes, not designed
to benefit a few winners of the healthcare lottery.

And this is the healthpolicymaven
signing off encouraging you not to sign blanket releases for medical procedures
which require hospitalization, do specify that for which you agree and that
which you decline. And try to bring a healthcare advocate with if you are
mystified by medical terminology.

References

Kaiser Health Facts. (2019, September 1). 2018
Employer Health Benefits Survey
. Retrieved from Kaiser Family
Foundation.org:
https://www.kff.org/report-section/2018-employer-health-benefits-survey-summary-of-findings/
Petersen/Kaiser Health System Tracker. (2019,
September 1). How Do Healthcare Price and Use in the US Compare to Other
Countries
. Retrieved from Health System Tracker.corg:
https://www.healthsystemtracker.org/chart-collection/how-do-healthcare-prices-and-use-in-the-u-s-compare-to-other-countries/
Suri, M. L. (2019, September 1). Review of Ghosst
Work
. Retrieved from New York Journal of Books:
https://www.nyjournalofbooks.com/book-review/ghost-work