Tuesday, January 10, 2006
Why not Medicare for all?
Right-wingnuts whine about how national health insurance would be this great big tax yada yada yada. But what they don't point out -- indeed, do their best to disguise -- is that healthcare in America is *already* a huge tax on every American. A dollar out of my pocket going to health care is a dollar out of my pocket whether it's going to a private insurance company or a government-run insurance company.
What we *should* be talking about is the fact that our competitor nations spend, on an average, 7.5% of their GDP on health care -- and we spend twice that much, and don't get as much health care for the average American. We are, in effect, *ALREADY* paying a 15% tax for health care. Why not make it official, rather than hidden in the closet? Given that 5% of that money is going for health insurance administrative expenses and other such waste, we could have a 10% payroll tax for health care plus a participation fee and *STILL* end up with less money out of pocket than we have with the current system, with the same quality of care. And because we'd have more money to spend on *productive* things rather than on paper-shuffling and profit for insurance companies (for example, General Motors and Ford would both be making a profit instead of losing money and could invest that money in new car designs and etc.), it would be of enormous help to the entire economy.
For those who say "but socialized medicine doesn't work", one word: Medicare. Ask any old person whether he wants Medicare eliminated. Once he finishes banging you over the head with his cane until you're a bloody pulp on the floor, he'll then note that Medicare allows him to see the doctor of his choice, pays for any major medical expenses he runs into, and costs him less than private insurance with the same coverage would cost because Medicare's administrative expenses are less than 5% of what private insurers' administrative expenses + profits are.
In my opinion, there's a simple way to handle national health care: Expand Medicare to cover *ALL* Americans, not just Americans who are 65 and older. Doctors already know how to deal with Medicare. The manpower, policies, procedures, computer systems and computer software are already there to deal with collecting the Medicare tax and disburse it to doctors and hospitals. Adding a few more mainframes to the Medicare admininistration's data farm and a few new incoming data lines for processing the additional claims is probably all that would be needed, and that's a lot cheaper than ramping up some new insurance program. About the only thing needed to turn Medicare into universal health care for all Americans would be a few new treatment codes (I doubt, for example, that Medicare has a "prenatal care" treatment code!). If Medicare is good enough for older Americans, why wouldn't it be good enough for the rest of us?
- Badtux the Practical Penguin
Posted by: BadTux / 1/10/2006 12:29:00 AM
"I doubt, for example, that Medicare has a "prenatal care" treatment code!"
Actually it does. There's a main book (can't remember the official name cause it's been a few years since I worked on billing software) that gives procedure codes for everything under the sun and everyone uses the same book.
There are more than just the over 65 population that is on the medicare rolls. The handicapped for instance. Medicaide is for the poor and Medicare is for the 'others'.
There has been a work in progress for at least 5 years to make all electronic medical records use the same layout and data formats. It's not going over very well due to propriatary issues. Also, for the most part, each state processes their own Medicare claims, not a central Federal location. There are few states that contract claims processing to other states or institutions (public or private). So, I don't think you'd need more mainframes or dedicated data lines. One would just need more bodies to double check the claims and help patients understand the bills.
ncr - mainframe programmer for a major public midwestern hospital
# posted by : 10/1/06 11:28 AM
Great blog I hope we can work to build a better health care system as we are in a major crisis and health insurance is a major aspect to many.
# posted by Blue Cross of California : 12/1/06 11:21 AM
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