Medicare for All - an Interview

We have seen protests across the nation over racial justice and the need for police reform. This follows the death of George Floyd and other African Americans. At the same time Covid - 19 still ravages the nation, particularly the African American community. This has shown the inequality of health care and health insurance in minority communities. As we have the debate about racial inequality in America, what about the imbalance in health care and health insurance? 

I had a chance to interview Dr. Hans Rechsteiner, a leading physician. Dr. Rechsteiner claims not only is the high expense of medical procedures a crime within itself, against African Americans but that these prices are too often overlooked and ignored even by well-educated doctors such as himself. He says this racial inequality we see in health care makes Medicare for All essential.

How has covid-19 highlighted the disparity in healthcare access between groups of people?
I don't know the actual numbers involved. Reporting of cases and hospitalizations and deaths have been widespread and confusing. Sorting out who was diagnosed and treated by whether they had insurance or not has not been possible. I have not seen any news coverage or editorials addressing this. But you don't need much imagination to know what happens to people without insurance who contracted Coronavirus. They stay home and take care of themselves because they cannot afford to seek medical help. They go without diagnosis. They probably do not isolate correctly because they have no diagnosis. They probably infect other people. And they probably present to medical facilities much later than they should and had higher morbidity and mortality as a result.

What groups of people are particularly affected by access to healthcare?
It is the lower class in America that suffers the most. Blacks and Hispanics are disproportionately affected as well. What it comes down to is having a job without benefits. The better jobs have benefits including health insurance. The jobs for these people do not have such benefits. They are forced to purchase their own, usually through Obamacare. This is an illusion of insurance because most Obamacare care policies have high deductibles. So the policyholder STILL is reluctant to seek medical attention because the deductible comes out of their pocket first. Most deductibles are in the neighborhood of $6,500. My wife avoids going to the doctor because her deductible is $6,500.

How does Medicare for all help alleviate these issues?
Medicare for all would guarantee basic medical insurance for every citizen and for illegal aliens that have a job and pay FICA. Medicare as we know it today has a stiff 20% copay. But that is less of a deterrent than the $6,500 deductible. For example, if you had a medical issue and visited your doctor and received a bill for $1,000, a Medicare patient would pay $200 and and and ObamaCare insured patient would pay $1000. Many employers, since they saved money over the old premiums they previously paid, would buy their employees supplemental insurance, which takes away the 20% copay responsibility.

How could medicare-for-all benefit people who currently have stable access to healthcare?
Again, a reminder that my Medicare for all plan means Medicare as we know it today, with the 20% copay. Most people who have stable access to healthcare today have it through insurance from work. If Medicare were available to everyone through a public option, employers would soon learn that they could save a tremendous amount by signing their people up for Medicare. Probably as much as 40% of their healthcare costs, even if they bought supplemental plans. That means all their employees would have first dollar, no deductible, no copay for a 40% savings. Once the employer's figured this out there would be an avalanche of Medicare applicants and the whole system would be converted in less than a year. Why, you may ask, is there a 40% savings? The problem with Healthcare in America is that the prices are too high. We pay two to three times per capita more for our Healthcare than the rest of the world. Existing Medicare is basically government enforced price control. When I do a colonoscopy for a patient, a bill gets generated for $1,200. An insured patient usually gets me a check for about $600. A Medicare patient gets me a check for $350. It's that simple and that's how tremendous money is saved. Why don't I go broke? 40% of the care in America is already paid for by Medicare. Adding the other 60% would not really hurt the bottom lines of most doctors and hospitals. I live in a retirement area where MOST of our patients are Medicare. We do fine financially. The claim that hospitals and doctors will go out of business under Medicare for all is industry propaganda.