Let’s build on what works for our health care
Private companies have profited enormously off of the ACA Exchange and Medicaid. For example, Well Care, whose revenues come primarily from Medicaid in Arizona (just recertified) and a few other states, made over $100 million in the first three months of 2018, because it was providing less care, according to its own report.
But that’s how the health-care system is gamed. We pay tax subsidies to employers and individuals for health insurance so they can “afford” it. What do insurers do in return? They don’t provide universal coverage, they deny care to those covered, hassle us over claims, charge high co-pays and don’t pay a dime until huge deductibles are met.
Arizona’s Medicaid and ACA Exchange are just stops on the gravy train for these companies, including big profits in the second quarter of 2018 for Cigna ($193 million) and Centene ($300 million), and for their executives who make between $20 to $66 million per year. Shareholders, especially in the drug companies, make out like bandits, because they are bandits. The price of insulin, without any formula changes, has climbed over 500 percent in just a few years because Novo Nordisk and the rest can charge whatever they want and people need it to live.
Hospital corporations also did very well during the prime years of the ACA. Now — after further consolidations under new care models that emphasize high margin boutique services, concierge doctors for the wealthy, and mandates for the rest of us to get procedures done in clinics not governed by hospital safety rules — profitability is rebounding.
Since hospitals, prescription drug corporations and insurance companies set their prices without any limit, runaway health-care costs overwhelm us. The solution to these costs is simple:
And that requires a mind twist for some — maybe all of us — who have seen government identified first as the problem and now the enemy: Our taxes will go up, but our costs will go down.
It turns out that Medicare — a publicly financed and publicly administered health-care system that guarantees health care to all Americans over 65 — spends a fraction (3-6 percent) on administration compared to the 12 percent (or more) by private insurance companies. It also effectively controls costs: Annual increases are consistently below overall medical inflation. We can complete the American system of guaranteed health care for all by improving and expanding Medicare. People in Medicare now and in the near future should welcome healthy, younger people into an improved system that eliminates the co-pays and deductibles of Part B, and eliminates the need for expensive private drug coverage. Dental, vision and optometry will be automatically covered. All the benefits of Medicare Part C will be available, without the limits and restrictions on what doctor you can visit.
Even conservative economists acknowledge that improved Medicare for All will enable the U.S. overall to spend less on health care and get more coverage. That’s why 70 percent of people (and 52 percent of Republicans) in the latest Gallup poll support Medicare for All. Let’s build on what’s popular and works: a publicly governed, democratically accountable healthcare system that doesn’t make money but makes better health outcomes.