Reform versus ‘Medicare for all’

Re “‘Medicare for all’ won’t fix soaring costs,” Opinion, Nov. 15

Economist and physician Kevin Schulman missed several key points.

He cites hospital consolidation as a major cause of increased healthcare costs. However, one of the main causes of hospital closure is uncompensated care, which only “Medicare for all” would fix.

The author says that simplifying the complexity of hospital billing would reduce administrative costs, which is correct. However, the simplest billing possible would be done with a single-payer system, like Medicare for all.

Additionally, under Medicare for all, “secret” payments, or any relationships between Big Pharma and pharmaceutical benefit managers, would cease to exist.

Small reforms aimed at billing and “secret” payments will not deliver the change we need. The problem isn’t that the for-profit healthcare system needs an overhaul; the problem is that it exists at all. Eagan Kemp

Washington The writer is a healthcare policy advocate for the group Public Citizen.

Schulman points to a central flaw of Medicare for all: It does not even address costs.

There is very little left of a free market for medical care in the United States. That will be completely obliterated if politicians just seize control of everything and send taxpayers the bill.

As has been the case for U.S. military veterans and medical care in much of the rest of the world, the likely result will be waiting lists for all.

More free markets and eliminating things like undisclosed rebates to pharmacy benefit managers would help more. Richard E. Ralston

Newport Beach The writer is executive director of the group Americans for Free Choice in Medicine.

Healthcare costs are a lot more than a “pocketbook challenge”; for many people, they can be a death sentence.

Furthermore, the author lists many points about our malignant healthcare system that cry out for a major structural change like Medicare for all. Then, he declares that Medicare for all is not realistic, but without explaining or defending this position in any way.

He cites as alternatives controls on the market that are far more likely to fail in providing relief, as insurance companies and for-profit hospitals and pharmaceutical companies have shown they are experts at evading regulations and gaming the system. Margaret Copi

Oakland