Isn't Medicare plagued by too much fraud and overuse?
Yes, it is. Any is too much, and that must be corrected.
But it is small
compared to the private sector because the state laws and
enforcement are not as strict. Overuse and abuse is said to account
for 30% of our overall healthcare costs. Add the 31% of
bureaucratic waste and easily half is not useful expenditures.
Health care is a very lucrative industry.
Roughly 10% of overuse occurs when physicians order tests for
defensive purposes, that is, to avoid a malpractice lawsuit.
Another 10% is due to patient pressure. The remaining 80% is due because the tests are profitable. A
study demonstrated that when physicians have an ownership in the
lab or equipment, they order up to eight times more tests than
do physicians without such ownership.
Worse are the excessive ordering of tests in nursing homes,
where patients have been sat in front of a TV set and Medicare
billed for a therapy session. Or sat in a coffee klatch and
billed for a group therapy session. (Don't laugh; these are real
Whether we achieve single-payer or
not, a law must be established that requires all healthcare
providers to educate their employees on the whistleblower laws
and rewards. With the employees providing oversight these
violations will disappear quickly.
As well, physician ownership in equipment and labs must be
eliminated, and hospitals must be prevented from employing
physicians that refer patients to them. And this, whether we
have a public or private system.
But isn't government management more expensive than the private
Certainly not in the field of health care. For example,
Medicare has both a public and private component. Instead of
signing up to traditional Medicare, seniors may opt for a
private HMO that has been approved as an alternate source.
Nineteen percent have done so. Unfortunately for the taxpayers,
these plans cost about 15% more than the government version,
which serves 81% of Medicare patients. The best thing about the
Medicare Advantage plans is that they put to rest the claims
that privatized "free market" health care is cheaper than the government. For
more on this go HERE:
Isn't health care cheaper when the free-market creates
There is no such thing as competition in the health care
industry. Never has been and never will be. What "bidding" that
does go on is to increase the insurance company profit margins, not to lower costs
to patients. As well, if there ever was "competition," few
patients would seek out the lowest bidder. Just the opposite
would occur as people mistake high prices for better care.
Aren't high Malpractice awards our biggest problem?
The malpractice system indeed needs to be reformed, but it isn't the
monster driving the system. Malpractice awards have increased by
the same 87% since 2000 that health care costs have risen, but
they have remained essentially steady at 1/2 of 1% of total
costs. But it's not as simple as that. The 87%
increase is due to an increase in administrative waste, and
though malpractice costs are not levied against waste, "premiums"
rose with it. Even when medical mistakes are not on the
rise, the insurance premiums often go up because the insurers
need to make up losses in other categories, like hurricanes
and forest fires.
And, frankly, doctors and hospitals are an easy target and do
not dare go without insurance, so they become a captive market.
To mitigate these issues we should establish medical courts
with a three-judge panel of retired physicians and nurses.
Doctors should be judged by their peers -- other doctors -- not by 12
jurors without medical knowledge. And the medical societies
should establish a co-op malpractice provider that pools all
physicians and hospitals and insures them at cost, just as they
do in Canada. (Wait a minute. We don't like to do things the way
How do doctors feel about a single-payer system?
Recent polls show that over 64% of physicians prefer a
single-payer system to the one we have now. Not only would it
cut office billing personnel, it would eliminate bad debt caused
by patients that cannot afford care. Study the single payer
popularity at Physicians for a National Health Plan
Importantly, physicians and patients alike should be
concerned about where medicine is going to end up if we do not
implement a Medicare-for-all system. Think free-market, CEOs,
shareholders and profits. Add them together and you have a
managed-care-for-all system. Businesses will not sit still for
the uncontrolled rise in health care costs.
Why don't we leave it to the free market?
Because what is a free market to the health care industry is
unaffordable health care to everybody else. It is the so-called
free market system that has gotten us to where we are today,
with costs rising by 87% since 2000 alone. Frankly, there are
some things that are better left to the government; funding
roads and health care are good public-private ventures, as are funding
police and fire protection being totally government. Can you
imagine a privatized highway patrol getting paid on the basis of
how many tickets they wrote?
Leaving health care to
the whims of CEOs and shareholders should not be our goal in
If the system is so broken, why don't the
politicians fix it?
Follow the money. Over $200 million dollars per year in
campaign contributions pass hands from the for-profit interests
that want to keep the system broken, inefficient and profitable
-- to the 535 members of congress willing to oblige them as they
pocket the funds. Many congressmen also have their private
investments in industries like health care and pharmaceuticals,
so they become very conflicted. It's not a pretty sight.
Get the private money
out of the electoral system and we'll fix health care virtually
overnight. As well, require that all congressmen put their
personal finances in a blind trust that grows with the economy
and you'll see changes in both attitude and action.
If you think health care is expensive now, wait
until it is "free."
That's one of the most contrived statements ever. It
is geared to instill fear, as are the words "rationing" and
"wait times." But Medicare has neither wait times or
rationing, so they speculate for the worst (as if it could
Indeed, we will never make health care free. But
we can take the waste out of it and make it affordable if we
spread the risks to a single pool of 300 million people and get
rid of the current, bloated insurance bureaucracy. Every other industrialized
country has a single-payer of one sort or another, and in most
cases they've achieved better medical outcomes than ours at half
Our great American experiment -- Medicare -- has been
going on for half a century, and seniors love it. It's an
investment they paid into all of their working lives, and it's
now working for them.
We don't need
any more experiments; we need to expand Medicare to everyone.
And think about it. The insurance industry is shining today,
but that won't last. Corporate leaders will not stand still
while their profits are eaten by the system. They are already switching to managed care systems, which will be run
by the CEOs and shareholders. A "managed-care-for-all" system
will not be good for anybody -- not the employees,
physicians or hospitals, or even the insurers that lose out to
the CEOs. Nor do the corporations gain because they still pay
the bill, albeit a smaller one.
Why are we jumping through these hoops for a system
nobody will like? Because it delays the inevitable, a
Medicare-for-all system. Businesses must demand an immediate
How is a single payer system to be paid for?
would pay an additional 3.3% healthcare tax on payroll, but this
would be more than offset by the 10-15% of wages they'd no
longer have to pay for health benefits. Workers would also be
taxed an additional 3.3%, but this would be offset by the
elimination of co-pays, deductibles, and the costs for
prescription drugs, mental health, long-term care, vision and
dental. And it would be portable, so employees changing jobs
would no longer suffer delays, pre-existing denials, and costs for COBRA (which often
is picked up by the new employer).
What about Health Savings Accounts?
They aren't what they appear. They benefit those looking for
a tax free investment vehicle, but not those seeking health
care. See a complete article HERE.
Who would oppose such great savings to the
Clearly, those who make their money on the current system
weaknesses. Private insurance companies, banking and credit card
companies that want to expand health savings accounts, even
bankruptcy attorneys who represent one side or the other when
health care debt has driven patients into default (which
includes over half of all bankruptcies).
Strangely, many business associations like the Chambers of
Commerce and other business associations oppose single payer
because an estimated 10-20% of their members are either in the
insurance, banking, credit card or other industry that would
lose money on an efficient health care system. Some also have a
conflict of interest in that they profit by selling insurance
plans to members.
That the other
80-90% are corporations that are eaten alive by those 10-20%
seems not to interfere with this inherent conflict of interest.
Associations would be wise to sit this issue out, but not all business
leaders are wise.
We also have many state and federal politicians who
receive substantial campaign contributions from the industry,
adding yet another conflict we must deal with. How do they
represent both factions? Being able to justify it makes them
what they are: politicians.
More FAQs at