Note: This was originally written and published on Medium and Steemit on 8/23/18.
The debate on universal healthcare has been heating up again. Just in time for midterms. Of course, the election of Ocasio-Cortez has a lot to do with that but the issues first came to the surface somewhat in 2008, then got dropped. Next it arose in 2016, as we are all aware. The obvious hope of corporate America and the elected officials owned by the corporations on both sides of the aisle was that it would again fade away, which has not happened.
Much of the time, we hear how universal healthcare is far less expensive than the system we have. What we rarely if ever hears is why this is true. And we NEVER hear how it would benefit the economy in general. The MSM is NEVER going to explore universal healthcare in a favorable light because they make too much money from insurance and drug company advertising. Elected officials get $millions per year in campaign “donations” from the same entities, so of course they are against even discussing any alternative.
So, this is going to be the first installment of a series. I was considering making this only one article but the subject is extensive and complex. The first part explains HOW universal healthcare costs less than our current corporate system or private pay models. The second part will focus on how universal healthcare benefits the economy in general. Beyond that, I will keep adding as needed, mostly debunking the arguments against universal healthcare.
Let’s begin with why it is far less expensive than the current corporate insurance system.
1- Advertising. If there is only one system and everyone is included, why advertise? The corporate insurance system spends many $millions of dollars PER DAY on advertising. TV, radio, internet, full page magazine and newspaper ads, telephone, email and snail mail. It’s not just one company but all health insurance companies competing with each other for your money.
2- Corporate executive pay. Universal healthcare may pay the administrators high sums but it would not be possible that it could equate to the amounts paid to all the major insurance groups ruling healthcare today. Not just CEO’s but CFO’s, COO’s and on and on for corporation after corporation receive $multi-million pay plus stock packages and bonuses annually. Narrow all of that, eliminate numerous positions and the money saved on healthcare decreases dramatically.
3- Stock dividends. If what we had were a public system with no investors, owned by the people, then there would be no stock dividends to pay out. These account for an unknown total but it would be easy to wager a guess of hundreds of millions, even billions of dollars a year. Stock holders themselves demand decreases in costs, meaning more care being denied to the people who need it most.
4- Criteria. Right now there may be similarities between various insurance plans but each insurance company has their own set of criteria in approving any medical charge submitted. Some of those criteria I actually agree with because they make sense. (Like requiring an x-ray before doing an MRI for a suspected chronic fracture.) The problems lies in the fact that each office or facility must check the criteria for each procedure according to the individual procedure, company and specific insurance plan the patient has. Even then, the charge can be denied. With only one system, one set of criteria, there is no confusion. The cost of hours researching, calling and submitting multiple forms to multiple payment offices would be reduced to a fraction.
5- Agent fees. Across the country, there are tens of thousands of insurance agents who get paid for every insurance policy they sell. They get what is termed “residual income”, which means they sell you a policy once but then they get paid some portion of your payment each and every month you keep the policy. While nobody begrudges them earning a decent living, the combined total of each agent being paid each month for each policy drives the cost of medical care much higher than is ever truly examined.
Summary so far- Have you noticed anything in common with all the issues listed above? What each of them has in common is that they all drive up the cost of medical care significantly, yet not one of them have ANYTHING to do with the delivery of medical care. They are ALL administrative and investor-driven costs and they account for at least half of your cost of medical insurance. They also have great determination of what care you receive, what care is denied and even laws regarding insurance, more than any medical criteria. Medical criteria are debated for years based on results and science. How it gets paid for and how much gets paid is determined by corporate entities.
However, those are not the only ways that universal healthcare saves money.
6- Fraud, waste and abuse. With only one authorization, record keeping, billing and payment system for all healthcare, the opportunity for fraud, waste and abuse becomes narrowed greatly. Most of us have had instances where insurance records state a doctor, lab, etc was paid by our insurance yet we receive a bill stating we owe money for the exact same service. If we have multiple insurance providers, each one gets billed for one service provided. And we may still receive a bill on top of that. Plus duplicate procedures like MRI’s when a second one is not needed would be less common. Fraud, waste and abuse accounts for $billions in healthcare dollars each and every year. While insurance companies may pursue the issue, they do not have the same power as the government, who can impose fines and even criminal charges for extreme abuse instances.
7- Simplified paperwork. Medical facilities and offices spend massive amounts of money on paperwork and billing, even if done properly. In the end, it is we, the consumer, who foot the bill for this expense. If all billing goes through only one system instead of being forced to submit paperwork to numerous entities, calculating, appealing denied claims, recalculating and on and on, the cost of this expense would plummet dramatically.
8- Indigent care. We have all heard that many indigent people are forced to use Emergency Rooms as their primary care system. This is because by law an ER cannot turn patients away. Yet because they are low income, many of those bills go unpaid. This drives up the cost of care for those that can afford care because the cost is split among them. Still, it may limit the ability of not-for-profit facilities to expand services. Some facilities have such a high proportion of indigent patients that they cannot afford to stay in business. Which results in hospitals and clinics closing in the areas where they are often needed most. That means access to care become MORE expensive due to longer ambulance rides and patients waiting longer to seek care. Which can mean their condition deteriorates further.
9- Chronic care. Low income patients with chronic health conditions such as high blood pressure and diabetes often delay care and may not know they have a condition until it does become critical. Most often this is due to financial concerns. The earlier many conditions are detected, the better they can be treated and controlled. Better control means they stay healthy longer, able to work and cost LESS money in the long term. You can treat a diabetic for years for less than the cost of one hospital stay. The same is true of treating high blood pressure caught early and NOT allowing it to progress to heart attack or stroke. Insurance continuously looks at the short term profit, actually functioning with the hope that many of those patients will DIE before needing care. And many do. Or they become so ill that the first thing they must surrender is medical insurance just to eat or keep a roof over their heads.
10- Cost to society. Millions of Americans go bankrupt each year due to medical bills. Some lose their homes. This becomes a cost to all of society in terms of money, morale, fear and anxiety. Those who suffer such fates often wind up with more health problems from anxiety, depression, high blood pressure, possibly sinking into substance abuse, homelessness, exposure and suicide.
11- Administrative costs. I covered some of this above but there are other aspects to consider. Like the fact that doctors, physician assistants and nurse practitioners are currently forced to spend many hours per week on the phone personally to debate/defend their own decisions with insurance companies. In some cases, I will state clearly this is well warranted. However, more often it is because of arbitrary criteria which does not fit a medical case they are handling. These are hours spent for which they get paid nothing. Instead, it forces them to raise prices on all patients or take on more patients than they can handle effectively, spend less time with each patient and even less time than that keeping current with new medical information (which changes constantly).
I could probably keep listing more items in this article but this is a good starting point and none of it is ever included in the so-called “reports” or “debates” on the subject on MSM. Frequently, many of these subjects are not covered even on Progressive media in any detail. Yet each point is valid and important. These are issues which should be discussed widely and openly.