by dlindorff
As I wrote months ago in an article titled America's Stupid Health Care Debate: Keeping Some Ideas Off the Table and several subsequent pieces on my website, President Obama and the Democrats who currently run Congress have been hoist on their own collective petard by their craven and gutless refusal to consider adopting a Canadian-style single-payer system to finance health care in the US, or simply to expand Medicare, which is a successful single- payer program, to cover everyone, instead of just people over 65 and the disabled.
Instead, because they are the recipients of hundreds of millions of dollars in legal (and probably plenty of illegal) bribes from the health care industry, they have cobbled together a "reform" in name only, which preserves not just the central role of the vampire-like health insurance industry, but also ensures the continued rapacious profitability of the other segments of the medical-industrial complex—the hospitals, the pharmaceutical industry, and the specialist doctors.
Now, like Hillary and Bill Clinton before them, these weasels and slimeballs who pose as the people's advocates are left with nothing but a Potemkin Health Plan that looks on the outside lie a reform, but that changes little or nothing, leaves vast numbers of Americans uninsured, forces tens of millions to buy crappy plans from private companies, and that will end up doing nothing to halt the continuing rise in health care costs that is bankrupting the people, employers and the country.
Nice going guys!
Let's for a moment consider what could have happened.
Medicare, which is wildly popular among seniors and the disabled according to every poll I've seen, currently covers 45 million of the highest-cost segment of this country's 300 million people—its elderly and its permanently disabled. It does this at a cost of $484 billion.
Now that's a heck of a lot of money—about 13% of the federal budget—but it's money well spent. We're talking about our parents and grandparents here, and because they're all covered by a government single-payer plan that pays virtually all of their doctors' and hospital bills, we don't have to pay those bills for them out of our own pockets. Okay, there are problems—the drug industry managed during the Bush/Cheney dark ages to get a prescription drug law passed that bars Medicare from negotiating group discounts for drugs, and that has added enormous rip-off costs to the program, but that's just another example of corporate scamming of the system that needs to be fixed. The important point that needs to be made is that according to Medicare analysts, 10 percent of Medicare beneficiaries account for fully two –thirds of the total annual cost of Medicare.
What that tells you is that the cost of treating that 10% of the elderly is $320 billion, while the healthier 90% of the elderly—roughly 40 billion people--only cost $160 billion a year to care for.
Now, given that the rest of the population under 65—about 255 million people—need on average far less care than the 90% of seniors who are in that lower-cost group, extending care to them all would clearly cost less than $1 trillion. Add in the cost of the 10% of high-cost elderly, and you've got a total bill of $1.34 trillion to care for everyone in America.
That's a big number, but now you need to subtract out the total cost of Medicaid—the crappy program that, primarily funded by the states through income and sales taxes—pays for the crappy care of the poor. That would be about $400 billion in 2009. So now we're down to $944 billion to care for all Americans. But from that we need to subtract the cost of Veterans health care—another successful single-payer program that already cares for veterans (or at least some of them—it's grossly underfunded). If we had a single-payer system for all, we could just fold the Veterans Hospital system into the national program. That would mean eliminating another $100 billion that would be saved (because remember, we calculated that original expanded Medicare budget for covering all 300 million of us. So now we're down to an annual budget of $844 billion for a single-payer program to cover all Americans. Finally there is uncompensated care provided by hospitals to those 47 million Americans who have no health insurance but who don't qualify for Medicaid. This care is funded in two ways—one by state and county revenues, which come out of state income and sales taxes and also out of local property taxes, and the other is in the form of higher hospital charges and insurance premiums and Medicare costs for the rest of us. Uncompensated care is estimated to cost about $200 billion, all of which would be eliminated if we had a single-payer plan for all.
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