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Robert Reich writes: "Estimates of how much would be saved by extending Medicare to cover the entire population range from $58 billion to $400 billion a year. More Americans would get quality health care, and the long-term budget crisis would be sharply reduced. Let me say it again: Medicare isn't the problem. It's the solution."

Portrait, Robert Reich, 08/16/09. (photo: Perian Flaherty)
Portrait, Robert Reich, 08/16/09. (photo: Perian Flaherty)

Medicare for All Is the Solution

By Robert Reich, Robert Reich's Blog

13 April 11


Mr. President: Why Medicare Isn't the Problem, It's the Solution

hope when he tells America how he aims to tame future budget deficits the President doesn't accept conventional Wasington wisdom that the biggest problem in the federal budget is Medicare (and its poor cousin Medicaid).

Medicare isn't the problem. It's the solution.

The real problem is the soaring costs of health care that lie beneath Medicare. They're costs all of us are bearing in the form of soaring premiums, co-payments, and deductibles.

Americans spend more on health care per person than any other advanced nation and get less for our money. Yearly public and private healthcare spending is $7,538 per person. That's almost two and a half times the average of other advanced nations.

Yet the typical American lives 77.9 years - less than the average 79.4 years in other advanced nations. And we have the highest rate of infant mortality of all advanced nations.

Medical costs are soaring because our health-care system is totally screwed up. Doctors and hospitals have every incentive to spend on unnecessary tests, drugs, and procedures.

You have lower back pain? Almost 95% of such cases are best relieved through physical therapy. But doctors and hospitals routinely do expensive MRI's, and then refer patients to orthopedic surgeons who often do even more costly surgery. Why? There's not much money in physical therapy.

Your diabetes, asthma, or heart condition is acting up? If you go to the hospital, 20 percent of the time you're back there within a month. You wouldn't be nearly as likely to return if a nurse visited you at home to make sure you were taking your medications. This is common practice in other advanced countries. So why don't nurses do home visits to Americans with acute conditions? Hospitals aren't paid for it.

America spends $30 billion a year fixing medical errors - the worst rate among advanced countries. Why? Among other reasons because we keep patient records on computers that can't share the data. Patient records are continuously re-written on pieces of paper, and then re-entered into different computers. That spells error.

Meanwhile, administrative costs eat up 15 to 30 percent of all healthcare spending in the United States. That's twice the rate of most other advanced nations. Where does this money go? Mainly into collecting money: Doctors collect from hospitals and insurers, hospitals collect from insurers, insurers collect from companies or from policy holders.

A major occupational category at most hospitals is "billing clerk." A third of nursing hours are devoted to documenting what's happened so insurers have proof.

Trying to slow the rise in Medicare costs doesn't deal with any of this. It will just limit the amounts seniors can spend, which means less care. As a practical matter it means more political battles, as seniors - whose clout will grow as boomers are added to the ranks - demand the limits be increased. (If you thought the demagoguery over "death panels" was bad, you ain't seen nothin' yet.)

Paul Ryan's plan - to give seniors vouchers they can cash in with private for-profit insurers — would be even worse. It would funnel money into the hands of for-profit insurers, whose administrative costs are far higher than Medicare.

So what's the answer? For starters, allow anyone at any age to join Medicare. Medicare's administrative costs are in the range of 3 percent. That's well below the 5 to 10 percent costs borne by large companies that self-insure. It's even further below the administrative costs of companies in the small-group market (amounting to 25 to 27 percent of premiums). And it's way, way lower than the administrative costs of individual insurance (40 percent). It's even far below the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

In addition, allow Medicare - and its poor cousin Medicaid - to use their huge bargaining leverage to negotiate lower rates with hospitals, doctors, and pharmaceutical companies. This would help move health care from a fee-for-the-most-costly-service system into one designed to get the highest-quality outcomes most cheaply.

Estimates of how much would be saved by extending Medicare to cover the entire population range from $58 billion to $400 billion a year. More Americans would get quality health care, and the long-term budget crisis would be sharply reduced.

Let me say it again: Medicare isn't the problem. It's the solution.

Robert Reich is Chancellor's Professor of Public Policy at the University of California at Berkeley. He has served in three national administrations, most recently as secretary of labor under President Bill Clinton. He has written thirteen books, including "The Work of Nations," "Locked in the Cabinet," "Supercapitalism" and his latest book, "AFTERSHOCK: The Next Economy and America's Future." His 'Marketplace' commentaries can be found on and iTunes. your social media marketing partner


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-74 # NCMike 2011-04-13 10:13
Insurance premiums and copays are costs that individuals bear; they do not add to the deficit. Even in instances where people don't pay their medical bills, the costs get transferred to those that do (higher premiums, rising prices for services). Stating that the average lifespan is less than other nations does not prove inadequacy of our health care system. There are a multitude of reasons for this, the biggest being obesity. Americans are largely heavier than citizens of other nations and that leads to serious health conditions. Our administrative costs are higher because of government regulation and our legal system. Precautions have to be taken to avoid lawsuits and to comply with a gargantuan regulatory structure. A universal system would lead to rationed services. It is the only way to cover everyone and get costly treatment for them all (look what other nations do). Not to mention that innovations in health care would cease. Companies could not make money bringing new drugs and equipment to the market, so they would stop doing so. America is the leader in new drugs and treatments because our system allows for people to take risks. Our system is not perfect but expanding Medicare is a sure fire way to financial ruin and decreased quality in medical treatment. There are other alternatives.
+42 # BradFromSalem 2011-04-13 11:43
Did you gag when the Insurance Companies stuffed that pant load down your throat?

None of your bilge made any sense nor did it actually address the critical point brought up by Prof. Reich.

-32 # NCMike 2011-04-13 15:27
Where did I support insurance companies? Stop jumping to conclusions.

Medicare does not cost less; it shifts the costs to the private sector. At the end of the day, someone has to pay. When Medicare and Medicaid reduce the rates, insurers get billed more, and they then pass that cost on to consumers. If there is no one to shift the burden to, then services and staffing will have to be reduced. You also omit that in one instance private individuals and corporations pay the bill and in the other the federal government pays the bills for everyone.
+21 # soularddave 2011-04-13 21:12
You need to go back and read the article again, sir. The point made over and over, is that many of the costs are ELIMINATED. The billing is direct, and there is none for the unnecessary profit generators like unnecessary MRIs. Medicine just coats less.

Medicare payments from workers and taxes on the population are LESS than insurance premiums that are no longer due. When you see a specialist or leave the hospital, there is NO PAY WINDOW.
-18 # NCMike 2011-04-14 08:38
And as I have said repeatedly, the article does not paint the whole picture. And insurance companies do not make huge profits. And doctors are not ordering unnecessary medical treatments just to line their pockets. And the reason that Medicare premiums are less is because the cost gets shifted to the private market (insurers and those with private insurance or no insurance at all).
+5 # billy bob 2011-04-14 22:38
And as I have stated, there is no reason for insurance companies to be profiting at all from interfering in something that is a basic human right.
+3 # rf 2011-04-15 06:05
Yeah! right! Insurance co.s are in it for their health...oh wait! their ceo's make big if there is no profit , it is because it is being hidden so no taxes are GE, like naseum
+6 # billy bob 2011-04-14 22:42
At the end of the day, we as American citizens ALWAYS are the ones paying. It's just a question of whom should we be paying. Should we be paying for health care as a society to provide for everyone. Or should we be paying extra for unnecessary profit margins of a redundant industry.

I'm glad that you don't support insurance companies. I guess you understand that whining about how low their profit margins are doesn't make much sense in a country where some people are being denied basic health care.
+35 # Paul 2011-04-13 12:08
You make some assumptions here that are ludicrous. Other countries have regulatory systems, maybe not quite as GOOD as ours but they are there. As for rationed services, services are rationed here much more than in countries with universal coverage. You ignore the fact that in order to even be able to get treated in the US, you have to have cash or insurance coverage up front. I know this for a fact because I have had to watch as 3 different family members died due to lack of treatment because the hospitals refused to treat them without a deposit of $75,000, which they did not have.
-21 # NCMike 2011-04-13 14:54
Paul - you are either not telling the truth or are not accurately portraying the situation. It is required by law that anyone with a life threatening situation be at least stabilized. Medical care must be provided to stabilize a person, any treatment beyond that may be denied without compensation.
+9 # sark 2011-04-13 16:15
Please go to AlterNet and search
One-Two Punch: Man Is Beaten In Anti-Gay Hate Crime and Also by America's Sick Health-Care System
"After a brutal attack, Barie Shortell is taking a whipping from one of the insidious antagonists of 21st century American life—the health-care system."
It is just one example among thousands.
I thought RSN covered this but could not find the link.
+1 # IntelPool 2011-04-14 09:17
Three family members died? That's a pretty dramatic story. What were the circumstances?
+23 # Paul 2011-04-13 12:08
This is a continuation of my comments. The system said it was too long.
This leaves the US with the most draconian of rationing in that only those with money get treatment. How in the world do you find this superior in any way. As for companies and innovations, you claim that America is the leader in new drugs and treatments, which it is not. If you will do a quick and cursory check on the Internet, you will find that the majority of medical advancements are now made in foreign countries by foreign corporations. Of course, this begs the question of what is a foreign corporation, since almost every corporation with the wherewithal to make any medical advancements is an enormous multinational corporation. Finally, you contradict yourself. You say we have a "gargantuan regulatory structure" stifling innovation and that precautions have to be taken to avoid lawsuits. Then, you turn around and say our system allows people to take risks. It can't be both ways. What are these other alternatives of which you speak?
-14 # NCMike 2011-04-13 15:31
Attempting to avoid litigation is not the same as avoiding litigation. Nothing prevents someone from filing a lawsuit; once filed, no matter how frivolous, a defense has to be set forth.

Look deeper into the numbers. Look at who has the the better numbers for success at treating the truly deadly diseases. Compare apples to apples. The US has more costly medical treatment because it has better results.
+2 # billy bob 2011-04-14 22:35
I wonder why 28 other countries were able to avoid infant mortality in 2010 than the U.S. since our health care is so much better...

No, actually the U.S. has more costly treatment because it has more hands in our pockets and more private profit involved in our health care system.

Profit costs money.
+3 # billy bob 2011-04-15 08:19
I meant, "I wonder why 28 other countries were MORE able to avoid infant mortality in 2010"

I thought I'd fix that before I invited ncmike's comment questioning that other countries have no infant mortality at all. My point is that, at least they try to avoid it. Sadly, in our country we don't.
0 # rf 2011-04-15 06:07
come on...only those with money matter...they create jobs. screw the rest and real small business
+7 # Observer 47 2011-04-13 13:16
"America is the leader in new drugs and treatments"? Where did you hear THAT?
+33 # maddave 2011-04-13 15:03
You nailed it, Sir! As a retired 30 year Navy Man, I have the world's best medical care: Medicare (primary) & Tricare for Life (secondary). Both systems are run by the U S Government and neither has an overhead even approaching the 30%-of-net premiums logged in by commercial health care companies . . . which, incidentally, is a misnomer. Our private "health care providers" are NOT providers at all. They are strictly for-profit brokerages that slice profits from both ends of the loaf by denying as many procedures as possible for patients and beating up on the true providers for drastic discounts on such procedures as are allowed . . . and those such savings ARE NOT passed on to patients in diminished co-pays.

Since I pay a max of $9.00/month per prescription, I'll never have to decide whether to "afford" my food or my pills.

Basic dental health care is a low-pay option, too, and my wait to see top-rated physicians is no different from that experienced by Mr. or Mrs. Got-rocks, the self-insured plutocrats.

Yes, Sir! Medicare-for-al l, if enacted, would be an economical step upward. It would save lives and was the outcome anticipated under President Obama's 2008 mandate!
+13 # sark 2011-04-13 16:00
I would so like to see you giving testimony in a congressional hearing and in front of Obama!
Thank You for your service and thank you for speaking the truth!
+9 # maddave 2011-04-13 16:52
[quote name="NCMike"] Our administrative costs are higher because of government regulation and our legal system. Precautions have to be taken to avoid lawsuits. . . . A universal system would lead to rationed services.

There has to be a Kool Aid fount here somewhere! To orthodox conservatives , Lawyers, who uniquely police the medical professions - like Unions who policed workplace safety, who won a 40 hour week and who drove out child labor sweat shops - are the evil bane of management's existence. But, Hey! If MD's were to assiduously purge their ranks of their incompetent brethren, their legal woes, like a cauterized hemorrhoid, would largely dry up and go away.
Big Health care, a purely for-profit $2.5 trillion business, claims 30% of gross revenue for overhead expenses. Single payer Medicare and Tricare-for-Lif e each claim (for expenses) from 3% to 6% of a much smaller premium pool for the same services.
". . . will lead to Rationed health care"? Americans die every day because Big Health Care, Medicare or Tricare for Life denied benefits, and that's OK. Eg,. a 400 lbs, 80 year old diabetic, with lung cancer and a two-pac-a-day habit just can't qualify for a heart-lung transplant. Less clear-cut cases arise hourly, and although very difficult, calls have to be made. Mistakes will occur, but the object is to minmise them.
-17 # NCMike 2011-04-13 19:41
Pointing out a fact does not equate to a dislike for an entire profession; I have no issue with the legal profession and you should not assume otherwise.

Doctors are human. Humans are not infallible, so mistakes will happen. You can not elimiate all mistakes, what you erroneously call incompetence. Further, many doctors have to deal with frivolous lawsuits from people looking to hit the litigation lottery.

Americans do not die because of any provider of health insurance; they die from medical conditions.

Healthcare is not rationed in this country. Some people don't have health insurance and therefore can't pay for the service being offered by medical professionals. The number of people that truely have no options for health insurance in the private market can and should be protected; this is a very small number. The rest are choosing to spend money on other things; it is not my responsibility to make up for their poor choices nor is it the doctor's duty to provide free services to the person. The government should never be determining who gets treatment and who doesn't; not to mention that the government is not granted this power in the Constitution.
+3 # billy bob 2011-04-14 22:32
I'd hardly call it a small number. You should get out more.

I don't know if "rationing" is what you'd call it, but it is publicly financed already. When people can't afford healthcare (because they "are choosing to spend money on other things" like food and shelter), they still get sick. In fact, they get more sick because they have no access to preventative care. When they get a little sick they wait until they're extremely sick and then they enter the emergency rooms like the one where my wife works. They come in droves and they aren't turned away.

The rest of us absorb the cost, because health care costs money and someone has to pick up the tab. This is why it seems wasteful to be donating money to hungry middle men in the insurance industry who don't provide health care, but are good Vegas-styled odds makers.
-9 # NCMike 2011-04-13 19:45
My point is that the author of this article omits important information, misstates other things, and over-simplifies the health care system. There are numerous factors totally ignored in reaching his conclusion. Any discussion that argues for a radical transformation of an entrenched system needs to listen to all sides, take all information into consideration, honestly assess that information, and then reach a conclusion after all of those steps.
+3 # billy bob 2011-04-14 22:48
By all means ncmike, provide us with all of the missing information. So far, you've made several comments, and none of them has done that. What are you waiting for?
+1 # rf 2011-04-15 06:02
If you really want a private system that controls costs, then you have to make it illegal for employers to give it away. If everyone had to earn money and then write the check every month, they would be pissed, and demand change. Republicans know that this is the fastest way to single payer and so refuse...HYPOCR ITES.
-2 # NCMike 2011-04-15 08:01
Some republicans have argued to untie health insurance from employment. It isn't hard to find who and when (some made this argument last year).
+1 # billy bob 2011-04-15 10:33
What function does the health insurance industry provide?
+4 # OhioMike 2011-04-15 06:14
NCMike, you need to do more research and not use right-wing talking points. How about reading the independent econometric study done by the California Nurses Association as a starter. Then maybe look up Physicians for National Healthcare Plan and read their reality based studies. Then, we welcome you to a fact based world built on common sense and knowledge, not partisan spin and nonsense.
+2 # billy bob 2011-04-15 08:14
OhioMike, Right-wing talking points are the only things ncmike will accept as "facts". Anything that disagrees with these "facts" will get a stern lecture about how it "fails to understand" his "facts".
+1 # Dhamma 2011-04-15 06:27
NCMike, here is some fact-based information that blow a whole in your whole post. You need to google the California Nurses Association independent, econometric study on what Medicare for All would do for our nation, then go to the Physicans for a National Healthcare Program website and start reading their fact-based information. Then, we will welcome you to the reality based community that forms thinking and decisions upon common sense rather than nonsense. Nonsense just feeds money into the for-profit system that is draining the wallets of Americans and our nation.
-5 # NCMike 2011-04-15 07:51
I like you how have two handles for you as one person. Why don't you look at the Heritage Foundation's studies on Medicare, Medicaid, and Obamacare? Or any of a number of other studies done by those opposed to the programs? Why don't you look at the CBO's numbers for these programs and what they cost us? Then when you are done, go read the Constitution and show me where it says that we are a collective and that the government has the authority to do these things.
+1 # billy bob 2011-04-15 10:22
Of course you admit that the Heritage Foundation is a right-wing "think" tank, right?

Quoting the CBO is the last thing I would expect from a conservative. Usually, it's considered your enemy.
+2 # JCM 2011-04-17 18:29
Section. 8.
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

Or to simplify:
The Congress shall have Power To provide for the general Welfare of the United States;
+30 # Kenwood 2011-04-13 10:36
Hallelujah! Why don't corporations lobby hard for this, releasing them from the costs of insurance and making them more competitive, here and overseas?

It's too simple?
+9 # BradFromSalem 2011-04-13 11:52
I have wondered about that myself. Oddly enough, WalMart actually is in favor of single payer. Probably because they know what they pay overseas?
+8 # maddave 2011-04-13 17:05
Quoting Kenwood:
Hallelujah! Why don't corporations lobby hard for this, releasing them from the costs of insurance and making them more competitive, here and overseas?

It's too simple?

Big Health Care, with its phalanx of lobbyists, is fighting just as hard from the other direction. They stand to lose big if a single payer system were to be adopted, so ultimately, the issue will be decided by which side has the most efficacious K Street advocates. This, of course, begs the ULTIMATE question, to wit " Which group of lobbyists controls the larger stable of beholden legislators?" Isn't that what all of these legislative squabbles boil down to?
+15 # BradFromSalem 2011-04-13 11:51
Isn't it curious that the Right Wingers are all in favor of allowing near monopolies by letting 2 or 3 companies control a market. They claim the big size allow for efficiencies and better service.

Yet for something as critical as our health care, we should farm it out to Corporations that will look to preserve a profit frirst, then look to preserving a life.

I secretly taped a rich persons response:

"The medical care industry is at least 15% of our economy and growing. Theres a lot profit in them premium premiums. Can't let the gummint use all that money to help people when we an get it to buy another yacht or a mansion or 2!"
-10 # NCMike 2011-04-13 19:53
Your so called right wingers do not support monopolies. Did you not hear all of the too big to fail is too big arguments made during the Wall Street bailouts? Do you not hear all of the arguments for competition?

Here is a fact for you: Health Insurance companies have a profit margin of 3%. 3%. Hardly exorbitant. In fact, at least 85 other industries in the US have a higher profit margin. Some of those with a larger profit margin include the Waste Management industry, Specialty Eateries, and Confectioners.
+2 # billy bob 2011-04-14 22:24
Here's a fact for you: the health insurance industry is providing a service that is not needed. Why should we pay extra people for health care. What we need is not universal insurance. We need universal care.

The health insurance industry should not be making any profit at all for a service that is totally redundant.
+21 # medicareblogger 2011-04-13 12:31
I agree with you! And I'm an insurance agent. I am experiencing one of the problems with our health care system, even though I am generally healthy. I have a bad shoulder and am getting physical therapy. I have good insurance, but my co-pay for physical therapy is $40 per session, and I'm supposed to go twice a week for four weeks. That's $320. I'm not poor, but I'm thinking I'll go three times and that's it.

So why is the PT co-pay set at a level that discourages people from getting treatment that will prevent the need for an expensive operation? It doesn't make sense - but then again, our whole system doesn't make much sense.

But if we think of rationing care, I am rationing my own care by deciding I don't want to pay for more than 3 PT sessions. That is called "consumer-drive n health care", and it the model for most health insurance today. What a stupid system!
-1 # billy bob 2011-04-15 21:11
ncmike? Where are you? Shouldn't you be telling this insurance agent that he doesn't understand the insurance industry or captialism for that matter?
-22 # Wild Buffalo Bill 2011-04-13 12:36
Mr. Reich,
Your article contradicts itself. First, you say medicare is the solution, then the cost of it is the problem. I am for covering medical costs among all legal Americans, not illegal Americans; and if the additonal costs can be covered only by revenue (changing tax code to receive more revnue from the wealthy. Who are the wealthy; they are big corporations (i.e., GE & Koch), CEO's, Politicians (including Congress, President, etc.), Wall Street tycoons (i.e, George Soros), movie stars, athletes, etc. That said, I am against letting anyone to join Medicare. Again, illegal Americans have not paid their dues, as my American born parents and myself. How unjust, unfair and discrimanting is your statement for those who have worked during their healthy years paying into the system!!!! Also, I don't agree with you that Americans get far less medical treatment than other nations. If so, then why so many Canadians seek medical treatment in USA? Medical cost do need to be cut through restricting false law suites against doctors, reducing hospital charges and lowering cost of medications. Would you pay a retailer $1 to $5 for a handful of aspirin? Of course not, so why pay the hospital this enormous amount of money? So, in closing, let's resolve the real problems rising medical costs first, then look toward expanding Medicare to those who are legal Americans!
+13 # rumigirl 2011-04-13 13:46
Quoting Wild Buffalo Bill:
to those who are legal Americans!

If we all work together instead of feeling threatened by "the other," we can all live well.
Amazing! Human! Get hurt in most of the developed world and you will be cared for, no questions asked.
Healthcare is a human right, not a privilege.
+12 # BradFromSalem 2011-04-13 14:03

What is this hang up on persons that are not citizens? Lets just leave it at two points. First, they are not coming here for our medical system; second xenophobia is just a fancy big word for racist and you are a xenophobe.

Canadian are not streaming over the border to use the American medical system. Just not true.

Law suits against doctors is not a major drag on our medical system, especially in terms of cost. There are numerous efficiencies through automation, standardization , eliminating duplication, and as medicare blogger points out inefficient care plans.

Then lets cover all that are present, rich, poor, young, old, American, and guests too. After all, you would be covered in many of their backward, hole in the wall, piss poor, filthy countries.
-1 # Wild Buffalo Bill 2011-04-15 10:57
There is no hang up or hatred toward persons not being citizens. You are so quick to judge me as racists when all I indicated was a limit or border on who recieves Medicare benefits. So you don't want limits or borders, then let's give Medicare benefits to those on the other side or our borders. Those that come to our country illegally had a choice legal or illegal. By the way, you don't have to be a citizen of our country to receive Medicare, you just have to here legally (called legal alien), such as a guest. Some of my best friends are from the poorest countries. When they have entered our country appropriately as our guest, I am glad to see they receive Medicare benefits.
PS Do be careful to judge and who you call a racist. They might be as kind and forgiving as I am.
Wild Buffalo Bill
+16 # todd williams 2011-04-13 13:06
So NC Mikester, what insurance company do you work for? I knew the Greedy Lawyer issue would come up. It always does when Repugs talk about medical reform. Those damn lawyers! Why do they have to go after those poor doctors who cut off the wrong limb? Hey, the doc had other things on his mind, such as how his stock portfolio is doing. And NC Mikester, I guess you are also an economist because of your statement, "expanding Medicare is a sure way to financial ruin and decreased quality in medical treatment." Where do you right wingers get this crap? Do you have a right wing bible that you consult for these ignorant talking points? All you creeps sound the same. It's like a freaking broken record. And guess what, a lot of Americans are getting damn sick and tired of your constant BS. Go peddle it somewhere else.
-8 # NCMike 2011-04-13 15:35
I never defended the insurance companies and nothing I wrote even implied that. Thinking that I hate lawyers is also a mistake.

Please explain to me how the government can expand coverage to everyone and it not cost more.
+6 # Ken Hall 2011-04-13 20:55
Gosh, NCMike, how do all those other industrialized nations do it? Must be smarter than we are...
-5 # NCMike 2011-04-14 08:32
Looking at the absolute cost of expenditures does not tell the whole story. You have to dig deeper. What percentage of the budget is spent on health care? What percentage of private funds go to healthcare? What is the difference in similar treatments? What is the difference is service? What are the differences in treatments available? What are the differences in time to be seen by a medical professional? Do the figures account for the differences in currency? Throwing one or two numbers out in an article does not mean that the entire picture was presented before a conclusion was reached. Why are so many on here unwilling to look at the bigger picture and compare apples to apples? If, and this is a huge if, costs can be brought down do you expect that the quality of care and service and technological advancement will be the same? There is no magic answer and you can not have everything you want, regardless of how bad you want it.
+2 # Ken Hall 2011-04-15 02:45
By most all the measures you reference in your questioning manner, other industrialized countries are doing way better than the US. Canadians and Europeans I've talked with admit that their systems aren't perfect but none of them would trade for the US system. For less money spent per capita and at less a percentage of GDP, they get better results as expressed in greater longevity, fewer days lost to illness, lower infant mortality. Some of your questions are disingenuous or poorly reasoned, as in "Do figures account for difference in currency?", and "Why are so many here unwilling to look at the bigger picture and compare apples to apples?" You are the one injected the idea of a magic solution.
-2 # NCMike 2011-04-15 07:58
Anecdotal evidence from people you meet is not evidence for the entire system. Go look at the cancer survival rates in the US compared to other nations. Then do the same for HIV, then do the same for treatments for heart attacks, and so on. We are the best. Longevity can be explained by a variety of factors and looking just at medical treatment fails to account for the cultural differences in diet and exercise (US is the second most obese nation in the world). I never said there was a magic solution - I said that Medicare was not the solution.
+1 # billy bob 2011-04-15 10:30
How would you propose we pay for it? Obviously the insurance industry is not the solution.

You're right about the U.S. doing well treating wealthy patients once they've already contracted cancer though.

It's just too bad that you have to cherry pick which details you're willing to discuss rather than discussing the whole subject.
+1 # billy bob 2011-04-15 13:12
Concerning cancer survival rates, what help has the insurance industry provided on that front? Is it possible that cancer survival has nothing to do with whether we have single payer or continue having welfare for the insurance industry? In FACT, cancer survival rates would probably IMPROVE if we'd get the insurance industry out of the equation. Who knows, maybe the cancer INCIDENCE rate could be helped as well with some preventative medicine - something the insurance industry largely doesn't cover.

Maybe we should be discussing a few statistics that have a STRONG correlation to the insurance industry - like infant mortality rates, for instance. Why is it that conservatives are so concerned about abortion before a baby is born, but have no problem with killing babies once they are born by not providing universal health care for them, not to mention the pre-natal care that's necessary to give birth to a healthy child?

While we're at it, why would anyone against abortion want to shut down family planning and take away the only chance millions of American children have at pre-natal care? It sounds like the right wants to use the budget to murder innocent babies.

+1 # billy bob 2011-04-15 13:13

Speaking of "cultural" differences, poor people who work two part time jobs don't really have the same amount of free time for exercise, or the "extra" income for healthy food. You claim to be big on "looking at all of the variables before making wild claims". Are you capable of accepting that there's a lot more than just a "cultural" divide that affects the health of the poor vs. the rich in this country? Or would you rather just stick to transparent paper thin fox talking points that always come from from someone other than fox?
+4 # sark 2011-04-13 16:04
He shows up on other sites, probably a paid troll.
+4 # soularddave 2011-04-13 21:22
They would call him a "sock puppet". Someone who pops up from nowhere to defend whoever pays him to do what he does.

Talk blah blah blah....
-2 # NCMike 2011-04-14 08:35
Gentlemen, obviously I must be a paid troll if I disagree with you. There is no other logical explanation. Everyone in America thinks exactly the same and there are no differences of opinion. Or, maybe, just maybe, I like to visit sites with opinions different than my own to see what people are saying and try to engage people in conversation. Maybe I don't like sitting in an echo chamber listening to people agree with me all day long so I come here to get other perspectives and ask people to defend their positions.
-1 # billy bob 2011-04-14 22:21
The problem is that you get personally offended when they do that, and disgusted by the fact that others are forcing you to defend your positions.
+12 # m 2011-04-13 13:22
The PROBLEM with that is our 'TWO PARTY SYSTEM'
The Republican Party is now the openly Insane Party that is still always and steadfastly, first and foremost, The Pro-Global Corporate Party. Then secondly, its The Fringe Rightwingnut Party long before its a Party with any thoughts or considerations for the 'Collective American - WE THE PEOPLE'
In the eyes of this Global Corporate-Fring e Alliance known as the Republican Party, MOST Americans are simply little more than Consumers for Corporations to squeeze.
The Democratic Party, also know as the 'We lost Our way and now represent NOTHING except a fretting Obsession over daily polls and how to get reelected' Party has a Mission Statement that seems to be: ALWAY TRY TO GET ALONG AND DON'T MAKE WAVES EXCEPT WHEN SMILING AND WAVING FROM A STAGE'
Democrats are a disaster because of their collective lack of originality, spine, cohesion, sense of purpose, zero ideology and a compulsive, knee jerk psyche which delivers them to the lesser status of a REACTIONARY PARTY stuck on playing the 'Offended Ones' whenever Republicans open their mouths.
Their strategy seems to be based entirely on--- 'Look, WE ALWAYS TRY TO GET ALONG WITH THOSE CRAZY REPUBLICAN. So wouldn't you rather have US instead of them.., huh?... Wouldn't you?... Come on, please...
+11 # BradFromSalem 2011-04-13 14:10
The Dems don't even look at the polls anymore. At least then they would know that the American people agree with the Progressives when it is presented accurately.

The Dems listen to Fox and the rest of the Right Wing Media and therefore believe distorted versions of reality.
+15 # Erica 2011-04-13 13:40
I am a psychologist in private practice and I strongly favor Medicare for all. Would it be a perfect system? No. But would it be a more straightforward and accessible system? Absolutely. People on Medicare now can opt to have supplementary insurance, but at least everyone would have the right to basic health care. Blue Cross and Blue Shield, which has a monopoly in my area, hasn't raised my rates of reimbursement in over 15 years so I am basically getting a pay cut every year. Meanwhile, the copays and deductibles of the so-called insured keep going up and up. And you can bet the corporation is doing just fine with excessive wealth concentrated at the top. A single payer system would be fair and equitable and would definitely take the profit out of the system.
+4 # BradFromSalem 2011-04-13 14:14

I hope you are not in MA. I had bc/bs and from the consumer point of view it was not bad. My company dropped it this year since their rates increased so much. I should have known none of those increases were going to the actual providers.
+18 # Susan W 2011-04-13 13:41
We hear all the time about large pools of people bringing down the cost of insurance. Well you couldn't get a bigger pool than one created by letting anyone sign up with Medicare. It makes so much sense on so many levels but of course it was rejected during the "health insurance bail out bill" discussion. As long as this country believes it is morally right to make money off sick people we will never join the advanced countries.

Of course the biggest money maker is war so there seems to be a theme working here. Dead and dying people are cash cows! Wow, what a nation!
+13 # wfalco 2011-04-13 13:57
First of all Medicare has never been available for non- residents. For someone to inject such nonsense is a clear example of how low the right wing always stoops to inject wedge issues into every single national policy debate.

Medicare is absolutely the answer.

I always thought the major mistake in Obama's Healthcare reform was not expanding Medicare.The best starter would have been to expand the popular program to include everyone at age 55.

Medicaid could be expanded to include lower income single individuals.(Wh ich I think the reform plan is attempting to do.)- Probably why so many Republican governors are opposed.
Simple, but effective- as compared to the largely incomprehensibl e insurance reform bill that was passed.

Lastly, whenever a tea drinker rails against government intrusion in their lives and the need to cut government programs I always inject by advising them to NOT accept their Social Security and Medicare benefits. Doesn't seem like many like that helpful suggestion.
+3 # Observer 47 2011-04-13 14:18
You might also advise them not to visit National Parks, not to let their children seek Pell grants when applying to college, not to use paper money or coins; and, on the local level, not to let the fire department save their houses, or let their kids go to public schools, or not to drive on the roads.... All of these things are government responsibility, at one level or another, and we're lucky to have such "intrustions."
+17 # Judy Ford 2011-04-13 14:33
I live in England where there has been an National Health Service "free at the point of delivery" since before I was born. Of curse it isn't perfect and there is a big debate about how to improve efficiency and maintain standards while protecting the tax payer from ever increasing costs, but at the end of the day I can't imagine living in a a country where access to healthcare depends on the ability to pay.

One of the first pieces of advice that anyone contemplating visiting the US is given is "Make sure that you have enough health insurance - it will cost you far more than you think if you are ill while you are over there."

I don't know what the solution is for the US, but from this side of the Atlantic it's difficult not to feel that this is one area where we may be a bit closer to the right answer.
+4 # Elliot Hoffman 2011-04-13 17:49
As Robt. Reich said, we spend more than double per capita than the next 6 highest cost countries, all of whom rank in quality 1-6 by the World Health Organization. the U.S. ranks 36th in the world. So, we pay more than double while quality suffers. We do not have a health care system - it is a system rigged by and for the "heath" insurance industry, the pharmaceuticals and other robber barons. Read the June 1, 2009 issue of The New Yorker - Health Care by Atol Gawandi (spelling?).
Since we pay nearly $8000 per capita, if we reduced costs to the next highest cost country (under $4000 / capita), and covered all 300 million Americans, we'd save over $1 Trillion per year - right? (currently paying $2.8 trillion). Our health system IS THE answer - as Reich tells us.

Now - where's the political cahones to make it happen (no laughter, please).
+2 # Hugh Mann 2011-04-13 19:59
His lower back pain example is spot on. I'm limping proof.
+11 # leafar 2011-04-13 20:03
Stop Making Sense!

Until we accept basic health care as human right and not a privilege, we get nowhere on this issue.
+7 # walworth 2011-04-13 20:45
If you are talking about Democrats Elliot, then the phrase "political cohones" is an oxymoron. I'm 61 and have no health insurance. I can't go for a check-up because I risk discovering a "pre-existing condition. Sometime in 2014 I may be able to get insurance..just before I switch over to Medicare. Why not let me sign up for Medicare now, get checked out and pay into the system for the next four years. There are millions my age and in a similar situation. Let younger people 27-30 also begin to sign up and pay in gradually. Over the next 10 or so years, gradually increase the availability until everyone (who wants to) can participate.
+4 # Ken Hall 2011-04-13 20:48
Other countries have universal healthcare, pay much less per capita than the US, and have better outcomes, i.e., live longer, have less days off work because of illness, lower infant mortality rates, etc. Healthcare is rationed for those who can't afford it. It really is a no-brainer.
+3 # racejim 2011-04-13 23:41
Medicare for all is the true solution, everyone covered, half the cost of today . The US ranks # 43 in the world , but pays twice as much as the second highest in price .A single payer system (Medicare)is the only way to make a national system sustainable. Look around the world and you can see there is not one other country that has a system like ours .Taiwan, Switzerland 2 countries that put in national systems in the last 12 years or so , searched the other countries and found out that only a Single Payer System (Medicare) will provide care for all at the lowest cost .Madave said it all, he has the best healthcare in the world Medicare & Tricare ! See Physicians for a National Health,Heal for the facts .NCMIKE you must work for the insurers,or big pharmas....Heal thcare today is rationed by your ability to pay ,and its failing us all & it will bankrupt the country if not corrected !
+1 # Wild Buffalo Bill 2011-04-14 06:06
There is no hang up or hatred toward persons not being citizens. You are so quick to judge me as racists when all I indicated was a limit or border on who recieves Medicare benefits. So you don't want limits or borders, then let's give Medicare benefits to those on the other side or our borders. Those that come to our country illegally had a choice legal or illegal. By the way, you don't have to be a citizen of our country to receive Meidcare, you just have to here legally, such as a guest. Some of my best friends are from the poorest countries. When they have entered our country appropriately as our guest, I am glad to see they receive Medicare benefits.
+6 # rm 2011-04-14 06:38
Reich is correct. Health care insurers are bleeding the nation blind. The solution is very clear and simple -- single payer or medicare for all. But American don't have the courage or wisdom to choose it. They will do what their corporate masters tell them to do and so America will collapse and shrivel into a third world nation -- with a small elite of fabulously rich and a huge population of struggling poor.
+1 # George Strycker 2011-04-15 19:22
When does anything run by our goverment run in the black or efficently? The post Office? Freddie Mac? Medicare? Social Security? They have all gone bankrupt, or are ready to. Why should we believe that letting the goverment take over health care insurance for the entire population should be any different. The goverment should be the watch dog regulating and over seeing the private insurance companies.
+1 # George Strycker 2011-04-15 19:23
I have a very simple solution to the health insurance problems in this country. The country should be broken up into reigions, North East, South East etc. Any insurance company writing a policy in one of those regions has to treat the entire region as one pool. For example: The same price to insure a family from a company that has 2 employees as the company that has 50,000 employees. No pre existing exclusions etc. The result, cost would come down drasticly for small business' which employ about 70% of all americans and more of them would be able to insure their employees instead of being priced out of the market. It would cause a slight increase for the large companies, but you can bet the insurance companies are not going to walk away from all those premiums, they will have to get compeditive.
0 # JCM 2011-04-17 18:32
In response to NCMike 2011-04-15 05:51

Why don't you look at the Heritage Foundation's studies on Medicare, Medicaid, and Obamacare? Or any of a number of other studies done by those opposed to the programs? Why don't you look at the CBO's numbers for these programs and what they cost us? Then when you are done, go read the Constitution and show me where it says that we are a collective and that the government has the authority to do these things.

Section. 8.
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

Or to simplify:
The Congress shall have Power To provide for the general Welfare of the United States;
-1 # billy bob 2011-04-19 19:13

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