Robert Reich writes: "So what do Obama and the Democrats do if the individual mandate in the new healthcare law gets struck down by the Supreme Court? Immediately propose what they should have proposed right from the start - universal healthcare based on Medicare for all, financed by payroll taxes. The public will be behind them, as will the courts."
Portrait, Robert Reich, 08/16/09. (photo: Perian Flaherty)
Medicare for All Trumps Mandate
16 August 11
Why the new healthcare law should have been based on Medicare. (And what Democrats should have learned by now.)
wo appellate judges in Atlanta - one appointed by President Bill Clinton and one by George H.W. Bush - have just decided the Constitution doesn't allow the federal government to require individuals to buy health insurance.
The decision is a major defeat for the White House. The so-called "individual mandate" is a cornerstone of the Affordable Care Act, President Obama's 2010 healthcare reform law, scheduled to go into effect in 2014.
The whole idea of the law is to pool heath risks. Only if everyone buys insurance can insurers afford to cover people with preexisting conditions, or pay the costs of catastrophic diseases.
The issue is now headed for the Supreme Court (another appellate court has upheld the law's constitutionality) where the prognosis isn't good. The Court's Republican-appointed majority has not exactly distinguished itself by its progressive views.
Chalk up another one for the GOP, outwitting and outflanking the President and the Democrats.
Remember the health-care debate? Congressional Republicans refused to consider a single-payer system that would automatically pool risks. They wouldn't even consider giving people the option of buying into it.
The President and the Democrats caved, as they have on almost everything. They came up with a compromise that kept health care in the hands of private insurance companies.
The only way to spread the risk in such a system is to require everyone buy insurance.
Which is exactly what the two appellate judges in Atlanta object to. The Constitution, in their view, doesn't allow the federal government to compel citizens to buy something. "Congress may regulate commercial actors," they write. "But what Congress cannot do under the Commerce Clause is mandate that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die."
Most Americans seem to agree. According to polls, 60 percent of the public opposes the individual mandate. Many on the right believe it a threat to individual liberty. Many on the left object to being required to buy something from a private company.
Had the President and the Democrats stuck to their guns during the health-care debate and insisted on Medicare for all, or at least a public option, they wouldn't now be facing the possible unraveling of the new healthcare law.
After all, Social Security and Medicare - the nation's two most popular safety nets - require every working American to "buy" them. The purchase happens automatically in the form of a deduction from everyone's paychecks.
But because Social Security and Medicare are government programs they don't feel like mandatory purchases. They're more like tax payments, which is what they are - payroll taxes.
There's no question payroll taxes are constitutional, because there's no doubt that the federal government can tax people in order to finance particular public benefits.
Americans don't mind mandates in the form of payroll taxes for Social Security or Medicare. In fact, both programs are so popular even conservative Republicans were heard to shout "don't take away my Medicare!" at rallies opposed to the new health care law.
Requiring citizens to buy something from a private company is entirely different. If Congress can require citizens to buy health insurance from the private sector, reasoned the two appellate judges in Atlanta, what's to stop it from requiring citizens to buy anything else? If the law were to stand, "a future Congress similarly would be able to articulate a unique problem … compelling Americans to purchase a certain product from a private company."
Other federal judges in district courts - one in Virginia and another in Florida - have struck down the law on similar grounds. They said the federal government has no more constitutional authority requiring citizens to buy insurance than requiring them to buy broccoli or asparagus. (The Florida judge referred to broccoli; the Virginia judge to asparagus.)
Social Security and Medicare aren't broccoli or asparagus. They're as American as hot dogs and apple pie.
The Republican strategy should now be clear: Privatize anything that might otherwise be a public program financed by tax dollars. Then argue in the courts that any mandatory purchase of it is unconstitutional because it exceeds the government's authority. And rally the public against the requirement.
Remember this next time you hear Republican candidates touting Paul Ryan's plan for turning Medicare into vouchers for seniors to buy private health insurance.
So what do Obama and the Democrats do if the individual mandate in the new healthcare law gets struck down by the Supreme Court?
Immediately propose what they should have proposed right from the start - universal healthcare based on Medicare for all, financed by payroll taxes. The public will be behind them, as will the courts.
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 publicradio.com and iTunes.
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NEVER VOTE REPUBLICAN !!
It's not free - you know? Without adding 200 million people to the current system, Medicare is already going broke.
That will be on top of the current payroll tax for Medicare, which only goes to pay for current coverage for seniors already on Medicare.
Fortunately, under Bush, we implemented the very progressive premium scale for Medicare Part B - where instead of all paying the same monthly premium - it ranges from $110 to $369 depending on the recipients income (5 income brackets).
Of course, in order to make it work (read my other note) salaries for medical professionals (physicians, nurses, technicians, therapists, shrinks, etc.) will have to be slashed -- Remember, Medicare pays it's bills to providers on a scale much less than that that the open market allows, and even much less than the insurance companies negotiate with them. Nurses making $110,000 a year now - will have to go back to $40,000. Doctors making $250K, back to $75-$100K. They're going to be more like the folks you see working at the post office, or social services.
You come in and attack me, challenging me that I don't understand how Single Payer works.
For the most part, presently, only seniors over the age of 65 are on Medicare. Most are on Part A and Part B, and many took Part D so that they could have prescription drugs paid for. They are paying a premium for Part B ( income tested) and for Part D.
The rest of the cost of Medicare is paid for out of current income taxes (Medicare payroll taxes). Basically, It takes all of it, plus seniors premiums, to pay for the medical costs of seniors.
You see - everyone else in the country who pay taxes are already paying for their (seniors) health care - not their own. And, the current system is collapsing - with out expanding it.
If we went to Medicare styled single payer for all, suddenly the rolls of enrolled in Medicare would be expanded by leaps and bounds - However, there is no funding in the pipeline to pay for their medical care.
New funding - many times the current size of the Medicare budget will have to be raised - from tax revenues - hundreds and hundreds of billions.
It's not free. And Medicare is not comprehensive health care - far from it.
I'm sick to death of all this nonsense about the Obama health-care reform, which doesn't even go into effect until 2014, when if he is not re-elected and a Republibagger gets into office, it will be so quickly overturned our heads will spin off.
This is why we must TAX THE MEGA-RICH at a VERY high rate NOW, not the poor or middle class. Read Warren Buffet's article on Tax the Rich; he's rooting for it.
And, "for parity," you know so much about Medicare, what's your answer? What's your alternative to Single Payer Health Care? How do the poor and the middle class who have no jobs get health care other than on the backs of OTHER poor and middle class who are the ONLY ones being taxed at the rate we are for our paltry incomes? If we don't do something that is equitable, if we don't begin taxing the rich at a WAY higher rate, we will become the sickest kind of welfare, madder-than-hel l corporate State EVER!
We're one step away from loading up the car and moving into "tramp camps" vis a vie the Great Depression.
Get down on your knees and pray your family does not get devastatingly sick after 2014. I pray they never do.
N.
The one I'm thinking of definitely earns it. Neo Natal intensive care. But, as Reich would admit - we're going to have to start letting a large percentage of her babies (mostly preemies) die - System can't continue to pay for hundred of thousands of $million dollar babies.
Some nurses are union some are not. Union members usually have higher pay and better benefits, FTR --
For Medicare for all to work, of course, all unions would have to be busted.
Teachers make more? Well, probably depends on where you live. Certainly, I know a teacher (Public) who worked her way up thru the system - total career was 25 years. Retired as a HS principal at age 54 8 years ago, who's current annual pension is around $112,000, with full lifetime medical, Dental benefits, etc.
As with the business community - the administration - the CEO's - the brass - the principals, the superintendents , etc -- make much more.
I know a nurse named Shirley that was paid 50-60K PT at a major Boston hospital.
The Brackets under Bush worked to a limited extent but were blown away by not allowing Medicare/cade to bid out the supply for the pharmaceuticals . This has transferred over 40 billion taxpayer dollars to big pharma. Some doctors do make a lot of money in the U.S. Mostly plastic surgeons. Most of the other medical professional’s pay is right in line with other industrialized nations that have no problem supplying medical care through a government run system.
The “$5,000 additional tax per person per year range – immediately” requirement you site is based on everyone using Medicare/cade at the same level that the current recipients are using this service at today. If everyone in the U.S. is in, that usage rate per contributor goes down precipitously.
With all these savings I have read that the rate would be in the range of $1600 to $2200 per year. This is quite a difference from the $629.00/ month I spend per employee at my business.
There is really no reason to not do the public health insurance programme. Unless you are employed by the insurance corporations or a politician using their graft.
I think you would be hard pressed to find a nurse making 110,000 - unless it is a nurse practitioner.
Amazing how there was plenty of money for Medicare Part D with no negotiation with the drug companies -- the other beasts of giant cost in health care.
MEDICARE FOR ALL -- IT'S THE ANSWER, NOT THE PROBLEM!
Well, many might have done Part D differently. However, the big news was that seniors on Medicare finally got a prescription drug program from the government which tthey'd never had before. It's also interesting to note that Part D came in below budget for it's first many years. The approved plan that Bush signed called for $400 billion over ten years. Interesting to note that the 1st competing plan put on the table by the Democrats was a $1.2 Trillion monstrosity - then they pared their offer down to $800 billion - it ended up at $400 billion.
Yes - and in all circumstances - better negotiation with the Rx companies would have helped keep the costs down.
The insurance companies have their issues with us - no doubt - but their forte is in negotiating and trying to keep down skyrocketing health care and Rx costs. Their profit margins have remained rather low for a long time now compared to the rest of the big boys on Wall Street - Rx companies especially called out.
health care doesn't have to be rationed if it's not a profit making business. here, of course, when half your premium has to go towards the CEO's $10 million a year salary, yes health care is rationed to those who have the money to pay
For one, Reich is on record in stating that his approach will cost more, that we will have to let the sick elderly die sooner, and that young people, in addition to paying more, won't live as long as their parents. He has stated that we will have to give up on a lot of the drug advancements and medical technology advancements on which we have become so dependent upon.
Now secondly, there are two major issues with Medicare that are not easily addressed.
One being that without expanding it - it has already turned into a ponzi scheme - nothing will keep it from a complete financial crisis - certainly not adding tens of millions of new recipients to it's rolls.
The other is the usually not discussed fact that Medicare benefits, as they currently exist - if even Obama were to give one of his speeches describing the short comings of the plan (high deductibles, exclusions to coverage, high out of pocket costs, caps for services, and limited Rx (but thank you Bush for at least giving seniors some Rx benefits - they had none before), he would smear it as evil - just the way he attacked insurance plans which have high deductibles, high co-insurance, and exclusions.
If everyone, meaning 100% of the persons inside the borders of the United States was covered under a single comprehensive Health Insurance policy what makes you think that it would cost significantly more than our half baked health care system is today?
In the current system, especially prior to the so called mandate, many young persons with good health are not covered. The actual cost of adding them is frequently minimal, so that becomes a plus as you add their $$ into the system. How many people pay separately for health, dental, and eyes? One plan one payment. There are other subsets in our current hodge podge. How much do hospitals and medical private practices pay to a track the multitude of payment rules, deductibles, cross coverage issues.
Simplification, Single Payer, will reduce the per person cost and increase profit vs. cost margin for providers. Will the total costs rise? Maybe, maybe not.
But by providing everyone the human necessity of health care we have a healthier and more productive nation. And that will pay for itself many times over.
Regardless -- there is a lot of support for simplification (universal processes) in the paperwork from most all - including the insurance companies.
It will still have to be rationed, as it is in other countries (note - NHS in the UK, recently stopped paying for chronic back pain injections), in order to get the costs to stop rising meteorically, as it has been - and in order to cover all.
Naturally, I agree that much must be done to cover all.
_________________________________________
For one, Reich is on record in stating that his approach will cost more, that we will have to let the sick elderly die sooner, and that young people, in addition to paying more, won't live as long as their parents. He has stated that we will have to give up on a lot of the drug advancements and medical technology advancements on which we have become so dependent upon.
Now secondly, there are two major issues with Medicare that are not easily addressed.
One being that without expanding it - it has already turned into a ponzi scheme - nothing will keep it from a complete financial crisis - certainly not adding tens of millions of new recipients to it's rolls.
_________________________________________
Are you in agreement or are you claiming that Robert Reich is trying to pull a fast one?
"what makes you think that it would cost significantly more than our half baked health care system is today?"
I responded - that I dd not say that?
You shifted to challenging me on my reference to what Reich has stated.
Professor Reich (former Labor Sec) stated to his students that his concept of what needed to be done, would cost them more, " you're going to have to pay more," he stated.
Reich understands/bel ieves that the only way to get everyone covered and to bring down the skyrocketing costs of our "we want everything possible done, no matter what society" will be to ration medicine and care under a single payor system.
Reich is Reich. Anyone who understands the issues here, who is not wiling to have the full adult conversation with the American people while trying for force changes that will not work, upon them, is pulling a fast one.
I took it that your quotes of Prof. Reich was to be taken as your coinciding with your own.
If I interpreted your use of Prof. Reich's statements incorrectly, then I am sorry.
Here is where I am coming from. I draw on Prof. Reich as a source, but I also add in my own opinion.
Go back to my last statement:
By providing everyone the human necessity of health care....
Everything prior to that point was written to demonstrate why I am willing to possibly increase costs initially, in order to achieve better care at lower cost over the long run.
Even here in MA where the crappy RomneyCare has been in effect for about 6 years, the rate of increase is beginning to decelerate. And the highest % of the population is covered, and jobs are increasing. This is a greater good.
I am not sure where you stand as your comments, when challenged are all over the place.
I have attempted to remain consistent, that is for you and others to decide.
Are you for Single Payer public health care plan or not? If you are, then we are bickering over details that get worked out once we get there (if ever).
In the moment - the American people do not want single payer. It is up to the Democratic party to make it's case - not cram it down the people's throat.
I'll give you that polls are all over the place here. One problem with polling, especially when asking whether folks want Medicare for all type of single payer - is that so few folks understand the basics of Medicare; like, it has large deductibles, Part B and Part D, Rx, are separate plans that you have to pay for - and that you still have to buy a supplement plan from an insurance company to get close to full - comprehensive coverage. And, of course, it does not include nursing home coverage.
There is a major conversation to be had with the American people. Both President Obama and the opposition did a lousy job - there was no honest presentation by either side.
Simple mistakes - or the hospitals refusal to keep the patient in the hospital for the required 3 full days time can completely disqualify the member from the nursing home care.
Better put - stupid government red tape.
"Dr Jonathan Richardson, a consultant pain specialist from Bradford Hospitals Trust, is among more than 50 medics who have written to NICE urging the body to reconsider its decision, which was taken in May.
He said: "The consequences of the NICE decision will be devastating for thousands of patients. It will mean more people on opiates, which are addictive, and kill 2,000 a year. It will mean more people having spinal surgery, which is incredibly risky, and has a 50 per cent failure rate." "
---
Thousands of British cancer patients denied vital drugs :
http://www.telegraph.co.uk/health/healthnews/7909907/Thousands-of-British-cancer-patients-denied-vital-drugs.html
“a ponzi scheme, nothing will keep it from a complete financial crisis - certainly not adding tens of millions of new recipients to it's rolls, will cost more, that we will have to let the sick elderly die sooner, and that young people, in addition to paying more, won't live as long as their parents.” These are just right wing talking points.
The truth is this is something that will save our country trillions of dollars. I could hire at least one more person at my small business.
You don't even have a clue as to what you are talking about.
I'd agree that I'd done it differently, around the edges as well - but seniors got a prescription drug plan for the first time in Medicare history. It was not a ponzi scheme. It was not something to destroy Medicare - it did cost money and seniors loved having it.
Come on - politics is dirty business. ObamaCare cut $500 billion out of Medicare so that they could make the numbers work - so that they'd come back in and re-authorize the money on the back end. Dirty politics.
Bush's Rx Plan was - is - $35-$40 billion a year -- this was not a budget breaker - just another clog.
Did you hate that Bush pushed for and signed the progressive income adjusted premium scheme, where higher income earners pay more now for Medicare part B? Premiums range from $110/mo to $369/mo for higher income earners (5 brackets).
What I'm saying to you, is that if Democrats had passed Bush's Rx bill - you'd love it. You might want to fix it a bit - but you'd been a cheerleader for it. That's just the way politics works.
Of course it could have been done better, differently, or not at all.
Obama's stimulus plan could have been done differently. Obama Care could have been done differently. Libya could have been done differently.
The housing bubble that Clinton/Cuomo created could have been done differently.
The Dot.Com (Enron) bubble could have been handled differently so that it didn't collapse in March, 2000. The two major financial deregulation's of the late 90's could have been done differently - or not at all.
How about complaining about the issues and the politics separately?
Seniors loved getting Part D.
Are you one of those who do, and how much is your income? Do you have supplemental insurance from a job or militry service?
Without her Navy medical from my Dad's service I'd have to help pay for my Mom's meds, and at 80 she's lucky to have just a few chronic ailments.
An ex co-worker of hers (retired schoolteachers) with several critical health problems can barely afford to eat when the Medicare "doghnut hole" hits. And most pf their peers are in the same shape.
So where's all these seniors who "love it"? Besides in your "I just have to say black because you said white, so I can get some attention" mind.
I really do feel sorry for people like you...
I'm very empathetic about your mom's situation and your needs to care for her.
Polls have shown that most medicare recipients are very pleased with their Part D.
And why not - before that most didn't have prescription drugs paid for - and were going broke trying to pay for them out of pocket.
I feel very sorry that your partisan ignorance prevents you from thinking clearly.
I've been an advocate for improving the system for many years - work every day on it, and especially an advocate for providing coverage for uninsured Americans.
How do you know that Reich "and his minority" area minority? You talk as if you know from the facts that he and the poor, disadvantaged, and the fast disappearing middle class are not indeed the majority on this issue. Would you be willing to let every American citizen vote up or down on this issue of Medicare For All? Reich is simply telling it like it is. It is understandable that those on the right would find fault. That's what they do best. After all, it was the asinine conservative economic policies of the past 30 years that has caused this and and most other problems we are now faced with. And it wasn't just the GOPers that caused all this is. The spineless Donkey Party is just as much at fault as the backwards facing conservatives in the GOP. I find it rather foolish that the right keeps looking for answers to 21st century problems using their 19rth century ideology. Jesus said, if the blind lead the blind won't they both fall into the ditch? I think with today's leaders in Washington, we're standing at the very edge of that ditch. But, trying to solve them with the same old ideas is bound to fail.
N.
When it is passed in a state like California, the trick will be to keep people like "for parity" from profiting and taking advantage of such a system.
When Medicare for All is enacted on a federal level, the funding must indeed be placed in a locked box, so as to prevent the thieving politicians from raiding such funds for bridges to nowhere…and then screaming that such programs are not sustainable. The same locked box approach must be taken to protect both Social Security and Medicare.
It's time for us to rejoin the first world, and health care for ALL is the first step.
The mandate is just that, a tax deduction. If you purchase an item such as a hybrid car, you may be eligible for a tax deduction. That is how the mandate was constructed. How is the hybrid car example different from saying, when you purchase Health Insurance, you are exempt from paying the Health Insurance tax.
If the mandate is overturned, it is possible that our entire tax system will unravel.
I am not really sure on which side I fall. We do need to rebuild our tax system from the ground up. But I fear for the chaos that would follow such a ruling; and it would be very difficult (but necessary) to exclude the Tea Party and other idiots from the discussion.
NEVER VOTE REPUBLICAN !!
Your first statement is misleading. while on paper it was true, in reality many of those Dems in the Congress and Senate were "Blue Dogs." In your second statement regarding a secret deal with the Insurance industry and the President, I invite you to show us what evidence you can, to prove this statement true. By the way, if it was secret, how could you come to such a decision in the first place?
We are just one Justice away from a slight Liberal majority on the court! One impeachment or retirement is all that is needed. The Court is one area I think Obama has been fairly succesful.
people without coverage postpone diagnosis and avoid expensive treatment which results in premature death, lingering suffering and other bad outcomes
this is not a free market system - a second opinion is not free or any easier or cheaper to get than the first one
this country has invented many fine things, but has succeeded in uninventing this one by allowing the system to truly refuse service to the weakest and sickest among us in the name of cost saving
Australia and New Zealand evidently have a two-tier system where everyone in the country is covered but those who have money can pay for private insurance.
The FACT is these systems work and ours doesn't unless you are healthy and/or have lots of money. Any system that means 50 million people do not have access to health care is a failure. On top of it all, our system is much more costly than any of the systems I mentioned.
Americans want every kind of service from perfect roads to good medical care but don't want to pay for it. To me that's a form of welfare or theft.
Instead of kicks to the HICS, Pres. OhBombAh always picks the licks and kisses up to the villainaires instead of saying, firmly:
"That's not open for arbitration."
All it would take is a president willing to use his bully pulpit both to stand up to the insurance industry and to educate the public that the $12,000/yr premiums they pay to insurance companies would be replaced by $6,000/yr (less for lower income people and the unemployed, higher for those who can afford it) in Medicare taxes with equal or better coverage and voila, instant sale.
The only ones who "don't want to pay for it" are the tea baggers and libertarians, the most selfish people on earth, whose concept of a society is "me me me". They resent the idea of anything that is theirs being used to benefit society as a whole, which is what taxes and "entitlement" programs do.
Without health care for all, taxpayers are 'forced to buy' coverage in the form of paying overblown Emergency Room health care costs for those without coverage. Everyone deserves to have health care coverage, but Mr. Reich says, it's much more affordable to include everyone if we all buy coverage, just as we have to buy other kinds of insurance. There are programs to help those who can't afford it.
If it should becomes a universal such as the proposed Medicare healthcare plan, mandate into law that Medicare cannot ever be privitized.
I still think Medicare for all would be the most civilized option. That's what we should have demanded in the first place.
Democrats were timid even though 80% of people wanted him to go to a single payer health system. Physcians for national Health care (PNHP.org) sent doctors and nurses to DC: they were arrested. Wendell Potter (insurance co. insider and whistleblower told the truth. Medicare is ADMINISTERED by the govt at $.035%...for profit health care steal 45Cents out of every health care dollar for CEO's, shareholders and advertising! not a penny of that is health care. A study was done in my state by an independent review committee. They looked at every possible aspect and finally determined ONLY a medicare for all, single payer plan would cover everyone, cost less, be more effective than all for profit plans. there was so much savings it would not only cover medical, but dental, long term care, prisoners, aids, etc & saved the State $4M first year. The insurance lobbyists & corporate media purposely bamboozled the public abd created teabaggers themajority on medicare. Koch Brothers funded Heritage Foundation, Cato Institute wrote the Romney for profit bill in Mass. Obama thought repukes would support? The teabaggers have another shot now Ryans plan destroys the safety net. The Mass legs twice sent single payer bill, Romney vetoed them.
Medicare for all or even a puny public option would have been an improvement over this piece of shitty legislation that was nothing more than a bailout for the health insurance companies. Can you imagine the profits they will make if everyone has to buy their crappy product and they can use tax dollars to finance it? The sky is indeed the limit.
Until this backwards country wakes up and eliminates private health insurance there will be no universal healthcare because one does not equate with the other.
It is amazing to me how the Repubs loved the Mandate idea until they couldn't kill Obamacare.
Repubs wanted private carriers to provide coverages NOT a public option.
The Repubs always say "The Courts" should not legislate; congress legislates. They says THAT UNTIL they lose in Congress.
Congress HAS legislated and Obamacare has the POTENTIAL to help our healthcare
system.
Justice Kennedy...don't fail the American people...THEY deserve a Healthcare system with a CHANCE to improve.
I have a "good plan"-$350 per month deducted from my pay for family coverage. And this is the second tier plan(the best is about $500 per month.) Not included is a $36 per month vision care fee and a dental premium of $30.
It certainly seems to me (for those math whizzes out there who like to throw around their fancy numbers about how it would be too costly to have Medicare for all)that we can do better. If I had my employer's "best plan" it would cost me a total of $566 per month as opposed to my current $416. Would a new tax for national health care cost that much? Seems like we have a bunch of number crunchers on this site-figure it out for me please.
More importantly, Americans would no longer be going bankrupt and losing their homes because they got sick and would no longer have to suffer needlessly because they can't afford treatment.
People worried about the government's rationing care need to realize that it is the for-profit insurance companies that ration it now.
I suppose those who say government has no right to force people to buy health insurance are driving uninsured cars and thinking they have a right to jeopardize my welfare by doing so.
1. Require co payments with a sliding scale fee. Ex; Wealthy patients would pay a larger co-payment while lower income patients would have a co-pay as low as $2.00. This would lower taxpayer cost and also discourage frivolous visits.
Some of our retired senior citizen make frequent doctor visits even when they don't have a new problem. They will visit the doctor as a way to assuage loneliness.
2. Use Nurse Practitioners more to contain costs and set up more neighborhood community health clinics to promote prevention.
Private insurance companies are driving up the cost of health care. They are lowering doctors' fees and cutting patients' while their CEOs are lining their pockets.
My husband, who is an ophthalmologist , performed an eye exam that revealed the patient had a torn retina. He treated the tear with a laser and billed the insurance for $800.00. They mailed him a check for $5.74!
Unfortunately, the spineless wimp we have for a president won't go there or follow the wise advice of Robert Reich.
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