I do not think much of Donald Trump. In fact, due to his temperament as much as anything else, I was very disappointed when he was elected. I continue to see his administration’s failure to achieve consensus as a national disaster. But, theoretically that can change.
Take health care reform. Trump once supported the single-payer health insurance position, as do most Democrats. In his own words, per an August 2015 town hall meeting: “As far as single payer, it works in Canada. It works incredibly well in Scotland.”
I strongly agree and believe Medicare for All is the right direction for our nation.
Of course, now Trump needs to solidify right-wing support and get a “win,” so he adopted the long-standing intellectual wonk line: Privatize Medicaid via block grants, abolish Obamacare and replace it with some new version of a convoluted private system, Trumpcare.
To his credit, Trump has not advocated abolishing traditional Medicare under the guise of keeping it solvent.
House Speaker Paul Ryan, the intellectual leader of the GOP Congress, proposes to turn it into a private program like Medicare Advantage, which is a colossal financial failure.
The originators said it would save the government a substantial amount of money. Instead, it costs the federal government a tremendous amount of taxpayer money each year, funds that could be spent to cover the uninsured. It is also riddled with provider fraud.
But, that does not mean I give the Democratic power structure a pass. The Democrats passed Obamacare, which covers an additional 20 million, but ignores the fundamental problem to start with by building on a flawed, expensive, unfair, private system.
Prior to that, Hillarycare in the 1990s was building on existing private insurance to create private HMO-like organizations controlling costs, very likely at the expense of the patient.
It ultimately bit the dust because the public believed, true or not, savings would come as a result of poor patient care. It was quickly dumped, and Hillarycare was never heard of again. (To be fair, Hillary Clinton did go on to initiate a commendable federal program for children.)
After Clinton won the Democratic presidential nomination, she suddenly and cynically backed the public option under the Affordable Care Act. But she had never mentioned it before. Her halfhearted endorsement was just a cheap way to get Bernie Sanders supporters, who want the Medicare for All plan guaranteeing universal health care coverage.
Some folks on the left still push the public option as a way of getting the camel’s nose under the edge of the tent (the tent being single payer). It may be better than no further reform at all, but it is a flawed interim measure with many hidden consequences.
For instance, only the sickest will try it after other private options are exhausted. This will drive up costs significantly for the public option, and encourage those wonks and politicians opposed to Medicare expansion.
The real solution to the health care reform issue is single-payer Medicare for All. Based on any reasonable analysis of cost, access and quality, the European single-payer systems snidely denigrated by the right, all outperform our ridiculously decentralized, uncoordinated model of insurance and care.
The Commonwealth Fund has issued several detailed reports stating this fact. The latest reviewed 11 wealthy nations. We are last or second to last in every category, so much for our health care being “the best,” a frequent refrain of right-wing politicians.
As a retired senior vice president with a publicly held firm, I know private enterprise is usually more efficient than government. But, I also know there are exceptions, the largest being health care insurance, where Medicare has 2 percent overhead versus an average of 12 percent for private insurance firms.
Trump and Barack Obama have both acknowledged numerous times that single payer would be the best option in an ideal world. What they have not publicly stated is the obstacle to achieving that goal: huge campaign donations and lobbying by Big Pharma and insurance companies.
Please think about the nation and not just yourself, Mr. President. If not now, then after the GOPs private-sector reform plans fail again next year. Get behind Medicare for All and help Americans get the health care that will make us great again.