20 March 2019

My take on Medicare for All and acceptable variants

I think we need to be crystal clear on one point concerning Medicare for All, and we need to insist on it from all our candidates. And that is that while we may need to utilize a mixed system, at least as a transition, and allow something like Medicare Advantage as it now exists (which is where private insurance provides Medicare services plus additional services, for regulated additional premiums, in lieu of the Single Payer Medicare standard). Alternatively, we may allow for supplemental plans that provide additional coverage as a supplement to the standard, now-expanded to cover everyone-Medicare.

But what is absolutely essential, and which must be part of any plan on a quick phase-in at minimum, is that ALL HEALTH INSURANCE PROVIDERS MUST REORGANIZE AS NONPROFITS. This is crucial to the insurance based systems in France, Switzerland, Japan, and Germany. The for profit insurance model simply does not work for health care. There is too much of a conflict of interest: profit depends on denial of care, not providing the best care. Private nonprofits will compete to provide the best care, and grow their businesses based on performance and awards of contractual advantages from excellent performance, not profitability. Any companies that don't want to function in that market are free to go into some other line of business, because, as Dennis Kucinich used to say at every opportunity, there is simply no place for profit in health care.


 

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