The other day an older woman in my social circle mentioned that she had to finance unpaid charges from her dual cataract surgery. “Four thousand dollars per eye,” she said. “Eight thousand in total.”
This woman is not indigent. She’s a retired public school teacher on Medicare. She also has supplemental Medicare insurance through Anthem.
This suggests that neither Medicare nor Anthem is all that great.
What options are available for those who are too young for Medicare? The Affordable Care Act (ACA)—aka Obamacare—insurance plans provide high-priced, privately available health insurance plans that come with high deductibles. And there’s another catch—many physicians do not treat patients on ACA plans.
The Affordable Care Act was enacted in 2010 in an effort to make health insurance more accessible to individual purchasers. But the ACA preserved the oligopolistic structure of the preexisting healthcare insurance market. This factor (combined with the inefficiencies of government planning) made ACA expensive and inefficient, despite the underlying intentions.
The typical ACA plan costs $650 per month, with a deductible in the $5,000 to $10,000 range, and a very limited selection of network physicians. This is not good health insurance.
“Medicare for all” has therefore entered the public debate space again this election cycle. DSA-backed Democrats like Abdul El-Sayed are advocating for single-payer public insurance, and this is taken as evidence of the Democratic Party’s sudden lurch to the left.
But the first Democrat to make such a proposal was Harry S. Truman. In 1945, just seven months after he took office, Truman made a written proposal for the creation of a national healthcare program. Universal healthcare was also an animating cause for the Democratic Party in 1992—the election that brought Bill Clinton to power. Neither Harry Truman nor Bill Clinton are widely regarded as wild-eyed left-wing radicals today.
America’s healthcare system is expensive, inefficient, and often unavailable—in practical terms—for anyone who is not insured under a top-tier corporate plan.
The linkage of health insurance to specific corporate employment is a longstanding flaw that is no longer appropriate in the age of the gig economy, entrepreneurship, or—for that matter—the family farm. Recent headlines indicate that large banks and other corporate employers are gearing up for massive downsizing because of anticipated AI-related efficiencies. The demand for health insurance not linked to a corporate plan is likely to increase in the coming years.
This does not mean that the only solution is to put everyone on a free government plan. I majored in economics. Whenever you make anything absolutely free, you tend to get the tragedy of the commons. Where healthcare is concerned, this means overuse and frivolous use.
We should all have some skin in the game where our health insurance is concerned, but perhaps not quite as much skin as many of us now have. Americans should be able to purchase affordable health insurance in the same way that most of us can purchase affordable automobile and home insurance.
This would involve not eliminating the private health insurance industry, but expanding it beyond the few oligopolistic players that now dominate it and maintain high prices. And yes, the government would have to be involved in setting up such a system. But the government has done this before. The government did the same thing with the breakup of the Bell System in the late 1970s and early 1980s, and we all enjoyed cheaper long-distance phone rates as a result.
This is not a socialistic solution. This is the government addressing an acute market failure—something that has long been part of our free enterprise system.
Since returning to power last year, Republicans have shown zero interest in any form of healthcare reform. Democrats, on the other hand, have once again picked up the unworkable solution of Medicare for all. (As noted in my opening paragraph, “Medicare for all” isn’t even working very well for senior citizens at present. Why does anyone believe that it will magically get better if expanded to the entire population?)
This means that at present—and into the foreseeable future—the only way to obtain thorough, affordable health insurance is via employment with a corporate entity that has its own in-house healthcare plan.
Or maybe the government could just pay for and administer everyone’s health insurance.
No one thinks that either of these options is a good idea for home insurance or auto insurance. So why are both parties unable to think outside the box where health insurance is concerned?
-ET