Single payer is answer to Trump Care failure
To the Editor:
There is a lot to learn from the recent defeat of the Senate Republican effort to replace the Affordable Care Act (ACA). Every bill Republican leaders introduced had the same problem: massive cost shifts to purchasers of health insurance, resulting in 23 to 30 million Americans losing their insurance over the next few years because they could not afford it.
Although conservatives blame three "rogue" Republicans for defeat, in fact, no one liked their bills. Moderate Republicans objected to the millions of people losing their health insurance. Conservatives objected to the continued government requirement that everyone purchase private health insurance or be penalized.
Senator Mitch McConnell ended up pushing a bizarre "skinny repeal" bill that got rid of the ACA taxes on the wealthy and medical device manufacturers and replaced the ACA itself with. NOTHING. A shocking proposal considering Republicans have claimed for over seven years they had something better than the ACA.
Conservatives argue health insurance can be "fixed" when you "leave it to the free market." Do they really think it is possible for private insurance companies to make money insuring sick people? These companies already get huge government subsidies to entice them to stay in the so-called "free market" and they are still floundering, leaving communities, and continuing to demand more and more money from the government and from their customers. Your skyrocketing premiums, deductibles and co-pays are a result of free market failure - not the ACA.
Is the ACA perfect? No. Although it gave millions of Americans insurance, it still left 28 million Americans without health insurance. In addition, costs under the ACA will continue to rise as long as we are forced to subsidize the huge overhead generated by multiple private insurance companies and as long as we continue to allow the pharmaceutical industry to charge Americans much higher prices than what people in other countries pay.
The real solution? A single payer health insurance program, "Medicare for All." Contrary to the super well-funded marketing campaign that alleges single payer is "too difficult" or "too expensive," in fact, it would be quite simple and far cheaper than our present system (in which we spend about two times what other industrialized countries pay). Currently, every
American goes on Medicare at age 65. All we must do is change the age of eligibility from 65 to 0. Then we empower Medicare to negotiate drug prices for the country the way the Veterans Administration already does.
Researchers estimate that doing these two things would save the country $500 billion annually.
There is a federal House bill, HR 676, and a soon-to-be introduced Senate bill (sponsored by Senator Bernie Sanders) proposing a single payer improved Medicare-for-all program. A majority of House Democrats, including RI Congressman Cicilline, have co-sponsored the House bill. I urge you to demand all our federal politicians (Langevin, Reed and
Whitehouse) also co-sponsor single payer legislation and truly fix the problems left unresolved by the ACA.
J. Mark Ryan, MD, FACP
Dr. Ryan is chair of the Rhode Island Chapter of Physicians for a National Health Program.