The United States, the wealthiest nation on the planet, remains the only industrialized country that fails to provide health care for everyone. Our dysfunctional health-care system is bankrupting families and killing people by failing to provide needed care.
Contrary to the headline on J. Peter Nixon’s November 21, 2017, article advising Democrats to “Slow Down on Single Payer,” we ought to be ashamed at the mere tinkering that is being done to our health-care system. Slowing down in our response to the health-care crisis is the worst thing we can do. Nixon correctly points out that a single health plan that covers all Americans has been a goal of progressives since the 1930s, yet he warns about pushing too fast. I share his concern about the strength of the political opposition, but that does not justify inaction when lives are at stake. And lives are at stake. Occasionally these tragedies catch the public eye. But there is virtually no public awareness that, week in and week out, people die from a lack of access to medical care. Preventing those senseless tragedies and making sure everyone has access to health care should be our first concern.
In my thirty years in the Minnesota Senate, I have been fighting Republican efforts to take away access to health care. However, I am also frustrated at Democratic politicians who are unwilling to propose real solutions. Yes, the Affordable Care Act expanded insurance coverage for millions and a “public option” might give better coverage to some. These Democratic proposals are far better than Republican efforts to eviscerate Medicaid or weaken Medicare. But they fail to meet the essential goal of providing care for all. Instead of devoting our energy to dismissing the idea of a more rational health-care system as “extreme and unrealistic,” as Nixon does, let’s begin by examining our goals. Here are some basic principles that any good health-care system must meet:
- Cover everyone.
- Cover all medical needs, including dental, vision, hearing, mental health, prescriptions, long-term care, alcohol and drug treatment.
- Let patients choose their doctors and hospitals.
- Reduce costs by fair pricing and cutting administration, not by denying care.
- Affordable to all (premiums based on income).
- Focus on preventive care to improve health.
- Ensure sufficient providers to avoid waiting lines.
- Maintain our nation’s leadership in medical care, research, and technology.
- Pay providers in a fair and timely manner.
- Simple, understandable funding, and payment system.
Each of these principles is important and must be met. Republican “repeal and replace” attempts fail to meet any of these goals. But neither do Democratic attempts to plug gaps in our broken insurance system. These gaps will not be closed until we replace private health insurance with health care for all. In Minnesota, we have proposed a Minnesota Health Plan to cover everyone. The MHP would be bound to these principles. It is a health plan focused on well-being and public health, not profits or politics. Although I would welcome passage of such legislation at the federal level, the urgency of the crisis calls for a push at both state and federal levels. In Canada, passage of universal health care in Saskatchewan led to universal coverage across the country within a few years.
A commonsense system like the MHP would prevent the problems that Nixon is concerned about, such as waiting lines for care. The comprehensive benefits, along with the elimination of copayments and deductibles, mean that even people with “gold” or “platinum” insurance plans would be better off under MHP. Equally important, it is patient-centered. Patients choose their providers, and medical decisions are made by patients and their doctors, not by government or insurance companies. Payments under our MHP model would be made through a “single-payer” system (roughly analogous to Medicare). Economic analysis of single-payer proposals in the United States and the success of such systems in other countries show that universal coverage is actually less expensive than our current patchwork system.
Nixon cites a dubious analysis of Senator Bernie Sanders’s health proposal that claims it would cost $32 trillion over ten years. But continuing to pay for that care in the current irrational, bureaucratic manner will cost far more than that.