MEDICARE FOR ALL?

Examining single-payer health care

Re: “Why not try ‘Medicare for all’? Glad you asked,” June 11 Megan McArdle column.

Megan McArdle doesn’t really examine “Medicare for all.” Instead she discusses, and dissects, something totally different: the option to buy into current Medicare. She correctly indicates that this scheme would be plagued by adverse selection and possible problems for hospitals. What she should have examined is the more valid and promising proposal: tax-supported true universal health care, financed by a single payer (the U.S. government).

This is the objective of H.R. 676, the Expanded and Improved Medicare-ForAll Act, introduced by Rep. John Conyers, D-Mich., and now supported by 112 co-sponsors (58 percent of House Democrats).

This well-crafted measure would cover everybody; require, through a variety of taxes, everybody to contribute; virtually eliminate the medical insurance industry; rein in rapacious pharmaceutical companies; and, by its simplicity, achieve the economies that are the only way to reduce America’s crippling health care costs. In other words, the Canadian system, more or less.

Louis Balizet, M.D., Pueblo

Megan McArdle is concerned about the cost of allowing everyone to opt in to a public, non-profit plan (Medicare) for health insurance. Rep. Allan Grayson’s bill provides that Medicare set appropriate rates for premiums. Would those premiums cost less than what we pay for-profit corporations now and still cover all health needs? The benefit of Medicare is it does not pay many CEOs millions of dollars a year, it needs no huge marketing budget to compete, as everyone over 65 gets it, and it makes no profit for stockholders. Imagine that!

With so many people now unable to afford to see a doctor, this bill makes a lot of sense as a first step to a truly universal plan.

Judy Danielson, Denver

I thought Megan McArdle’s premise regarding the payment basis was wildly off base. Of course it would fail if it were based on the cost of signing up voluntarily, rather than the real thing that more and more of the public and us physicians (well over 50 percent?) are advocating: single-payer Medicare for all, with its 2 to 3 percent cost of doing business, not the 30 percent cut that insurance companies now take.

Len Wheeler M.D., Arvada

Yes, all potential systemic changes need careful analysis, but Megan McArdle conveniently leaves out the huge administrative waste of the existing U.S. health care system in her warnings about “Medicare for all.”

As reported in the New England Journal of Medicine in 2012, the Institute of Medicine estimated that the U.S. spends $361 billion a year on health care administration, of which about half is wasted. Medicare and other single-payer systems dramatically reduce administrative costs.

Perhaps the simple notion of allowing people to buy into Medicare as one of many options doesn’t solve this problem. What’s really needed is to compare single-payer to all alternatives.

Christopher Juniper, Indian Hills