Medicare for all? Let's copy what works with health care in other nations instead - The San Diego Union-Tribune

Medicare for all? Let's copy what works with health care in other nations instead - The San Diego Union-Tribune

What is Medicare for ALL

The San Diego Union-Tribune Editorial Board 9/5/17

It’s now clear that creating a single-payer health care system is the top priority of the Democratic Party and millions of Americans.



In California, Assembly Speaker Anthony Rendon, D-Lakewood, made the right call in June when he pulled the plug on a bill creating a state single-payer system. He did so because the measure, Senate Bill 562, didn’t explain how to cover its estimated $400 billion annual cost — triple the state’s general-fund budget. This reasonable decision led to national blowback. Now Rendon plans to hold hearings to discuss how to get to universal health care.



In Washington, the “Medicare for All” bill that Sen. Bernie Sanders, I-Vermont, plans to introduce this month is picking up support, including from Sen. Kamala Harris, D-California. It’s hard to imagine any Democrat winning the party’s presidential nomination in 2020 without backing single-payer.



But it’s time that Republicans started thinking big about health care as well — and stop equating any expanded government role with socialism. According to a study by the American Journal of Public Health, taxes already pay for 64 percent of U.S. health care. The study found that, “At $5,960 per capita, government spending on health care costs in the U.S. was the highest of any nation in 2013, including countries with universal health programs such as Canada, Sweden and the United Kingdom.”



It’s a stunning statistic. Here’s another: A 2015 Commonwealth Fund study found the U.S. spent per capita at least 47 percent more of its gross domestic product on health care than 12 other wealthy, First World nations — yet had among the worst health outcomes, with the exception of treating cancer. The U.S. had the lowest life expectancy.



Any CEO would look at this picture and say the U.S. must do better. Republicans must do the same. Instead of tinkering with — or gutting — the Affordable Care Act, the Trump White House and congressional GOP leaders should consider setting up a commission to examine how to emulate other nations which deliver better outcomes at a lower cost.



Some answers are obvious. In 2009, journalist T.R. Reid chronicled how 20 percent of U.S. health spending goes to “marketing, underwriting, administration and profit,” compared with 4 percent in France and 2 percent in Taiwan. This bloat is created both by the profit motive in insurers’ provision of essential care — which Reid says is unique in the developed world — and the vast complexity of U.S. health care, with dozens of government systems and hundreds of private systems. Simple is better.



“Given our remarkable medical assets ... the United States could be, and should be, the best [at health care] in the world,” Reid argues. “To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.”



Amen. This is why Democrats who want universal health care should look for inspiration from the rest of the world, not embrace “Medicare for all.” The same holds for Republicans who don’t like how much U.S. health care costs and who think Obamacare is a clunky mess. Americans’ national pride shouldn’t include reverence for a flawed, costly and eminently improvable health care system.