Universal Medicare: Free Healthcare or Your Worst Nightmare?

by Carol A Westbrook

“Medicare for All” is a battle cry for the upcoming national elections, as voters’ health care costs continue to skyrocket. Universal Medicare, they believe, will provide free health care, improve access to the best doctors, and lower the cost of prescription drugs. Is it a dream, or is it a nightmare?

I am 100% in favor of universal health care, but believe me, it ain’t gonna be free. True, I’m not an economist–I’m a doctor–but I can do the math. I’ve had years of experience, both practicing under Medicare’s system and as a Medicare patient, and I understand something about health care costs. Few voters under age 65  understand what Medicare provides, and even fewer have a grasp on what it will cost the government–and ultimately the taxpayer–to extend it to all.

What Medicare provides for free is Medicare A insurance, which covers inpatient hospital, costs. To cover outpatient and emergency room visits, the senior must purchase Part B, which covers 80% of these charges. Medicare B costs $135/month plus a sliding scale based on income. Prescription drug coverage requires purchasing Medicare D from a private company. (Medicare C is alternative private insurance). Medicare A, B and D premiums are all deducted from the monthly Social Security check. Additionally, a senior may purchase a Medicare Supplement from a private insurance company, which covers the un-reimbursed Part A, and B costs. Confusing? Here are two examples. Read more »

Why We Should Repeal Obamacare and not Replace It with Another Insurance Plan: Thinking Out of the Box for a Health Care Solution

by Carol A Westbrook

Before you, progressive reader, quit in disgust after reading the title, or you, conservative reader, quit in disgust after reading a few more paragraphs, please hear me out. I'm proposing that we repeal Obamacare (The Affordable Care Act, ACA) but not replace it with another medical insurance program. Instead, I propose that we re-think the entire concept of how we provide health care in this country. 110126_obama_sign_health_bill_ap_605

The ACA's stated purpose is "to ensure that all Americans have access to high-quality, affordable health care." Regardless of whether or not you believe good health is a fundamental human right, it is inexcusable for an affluent, first world country like ours not to provide it for its citizens. The good health of our nation is vitally important to its success, guaranteeing as it does a capable workforce, a strong military, and a healthy upcoming generation. However, I have seen the results of Obamacare from many perspectives, including that of a physician provider in a rural community, as well as that of a personal user of both insurance and Medicare. I do not believe the ACA succeeded in meeting its objectives.

It is true that the ACA provided health care insurance for millions of Americans who didn't have it previously, expanded Medicaid for the uninsured, got rid of the pre-existing condition exclusions, allowed our grown adult children to remain on our policies longer, and started the ball rolling on electronic records. These are great results.

GTY-Obamacare2-MEM-161222_12x5_1600But the ACA also caused the cost of health insurance to skyrocket, caused many people to lose their coverage, and, for some, their jobs. It forced many small doctors' practices to close, especially in rural areas, resulting in an overall decline in the quality of care in many regions. It limited patients' choices of physicians and hospitals, separating patients from their longstanding doctors. There were no checks on health care costs, which even today continue to increase. But worst of all, it mandated that our health care would be taken out of the hands of doctors and put into the hand businessmen–the insurance companies.

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The Counter Revolution

by Akim Reinhardt

FDRThe United States boasts a deeply conservative economic tradition. From its origins as a colonial, agricultural society, it quickly emerged as a slave holding republic built on the ethnic cleansing and occasional genocide of Indigenous peoples. After the Civil War (1861-65), it reshaped itself in the crucible of unfettered laissez-faire capitalism straight through to the Roaring ‘20s. A post-Depression Keynesian consensus led U.S. leaders to reign in the most conservative impulses during the mid-20th century, but the Reagan Revolution of the 1980s set the stage for the current neo-liberal moment.

Consequently, ever since the industrial revolution, the United States has typically trailed other developed nations in establishing a basic social welfare system. It has never fielded a competitive socialist or labor party. It was the last major nation to implement an old age pension. More recently, ObamaCare made it the last major nation to mandate that all of its citizens receive some sort of healthcare coverage, even if it's quite wanting in many cases.

Amid its overriding conservativism, the United States has had only three presidents with any real socialist tendencies: Franklin Delano Roosevelt (1933-45), Harry S. Truman (1945-53), and most recently Lyndon Baines Johnson, whose presidency (1963-69) ended before half of current Americans were born (median age 37.9).

The election of Donald Trump as president and, just as important, the impending Republican dominance of Congress, make certain that the United States will not correct its social welfare shortcomings anytime soon. Indeed, the nation may take significant steps backwards.

However, a quick review of America's stunted progressive history suggests that the opportunity for a progressive counter-revolution may be closer than it appears at this dark moment.

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Selling a disability

Socsec If you're an American and you have a job, you're supposed to get an annual statement from the Social Security Administration explaining how much money you stand to receive at retirement. It also reports what your dependents will get from the SSA if you die, and what you'll get if you become disabled.

For me, the statement is a stark reminder of how much I rely on my wife's income to survive. As a writer, my income is sporadic, and if I couldn't work, I'd have a difficult time living on my Social Security benefits alone. Many people see the Social Security program as a sort of charity, but fundamentally it is not: The more you put in, the more you get back from it. If a person hasn't made much money, they won't be able to collect enough benefits from Social Security to live on. But even when people do pay in, the system has made it nearly impossible for some people to receive the benefits they deserve.

For physical laborers, the very work they do can end up causing disabilities that prevent them from working. My stepbrother Mark had always had a bad back, but he'd dealt with the problem by loading up on Advil and taking an occasional day off. He never visited a doctor about the problem because his jobs never provided health coverage. Often, before starting a job, his boss would pull him aside and remind him that he was not an employee; he was an “independent contractor,” which meant that the boss wasn't responsible for any injuries or other problems that occurred on the job site. There was no health coverage, no unemployment insurance, no safety net at all, physical or financial.

Once Mark was working on a makeshift bit of scaffolding in the cavernous great room of a partially-completed McMansion. He was 30 feet above the rough plywood floor, balancing on a narrow plank, attaching blocks to the rafters with a nail gun so heavy it was difficult for him to hold it over his head, weakened as he was by his deteriorating back. A nail got caught in the gun, causing it to backfire; the 15-pound piece of equipment glanced off the ceiling before crashing down on his face. The blow cracked a tooth and nearly knocked him unconscious. He's still not sure how he managed to stay on that plank. If he had fallen—supposing he managed to survive—he would have had no way to pay his medical bills.

About eight years ago, Mark realized that he wasn't going to be able to continue doing construction work and other low-paying manual labor. He enrolled in a vocational school to become a dental technician, but as I mentioned last month, even this quickly became too demanding for him. Hours of sitting in class only made his condition worse.

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