I had a birthday last week. It was a big one. This was the year when I got the best birthday card ever, my Medicare Health Insurance card.
As an American, it seems to me access to health care should be a human right. On the Fourth of July, our nation's birthday, we celebrate our founders' commitment to "life, liberty, and the pursuit of happiness" enshrined in our bold Declaration of Independence. We underwrite our military, police and firefighters to help protect our life. We provide free public education to enhance the pursuit of happiness. Shouldn't all people have access to medical care to protect their lives and safeguard their potential for liberty and for the pursuit of happiness?
As a Christian, it seems to me that access to health care should be a human right. Jesus spent most of his public ministry working as a healer. He offered the same gifts of healing to foreigners and Gentiles as he gave to his own people. Healing was at the center of Jesus' priorities and activity.
It is a wonderful thing for Americans when we reach age 65. We have insurance coverage for the rest of our life -- the most expensive part of our medical lives for most people. Nearly everybody I've talked to who is older than I am is pleased with Medicare coverage.
From time to time in my pastoral role, I've had to act as an advocate for parishioners needing health care that was being denied by their insurance carrier. I've also begged for services on behalf of people who had no insurance. But I can't remember an incident when I needed to go to bat for someone because Medicare was not treating them fairly. It seems like an excellent health insurance program to me. I will stake the rest of my life's health on it.
I wonder: Wouldn't our current health care kerfuffle be better solved and more efficiently addressed by putting everyone on Medicare?
Medicare is far more efficient than private insurance. The nonpartisan Kaiser Family Foundation calculates Medicare's administrative costs at 2 percent, including the costs for collection of taxes and investigation of fraud and abuse. Insurance industries' administrative costs are harder to document because they are not always transparent, but estimates that I have seen place costs at 11 percent to 14 percent, and one industry defender says they are 17 percent. Some companies' administrative costs are much higher.
There is no question Medicare gets more health care for the dollar than private insurance can. It makes sense. Medicare doesn't have to spend like private firms for marketing, sales and advertising; for complicated billing and review processes, or for profits and stockholders.
Medicare also appears to be able to control medical costs better than private insurance. The nonpartisan Center for Medicare and Medicaid Services tracked a 10-year review of per capita spending for common benefits. Medicare costs rose 4.3 percent while private insurance cost rose 6.5 percent. One of the reasons Obamacare costs have increased is that Medicare Advantage is administered by private companies whose costs continue to go up. The Congressional Budget Office predicts private insurance will continue to rise considerably faster than Medicare for the foreseeable future. Medicare is in a stronger position than private insurance companies to negotiate prices for medical services.
These data track international norms as well. Most developed countries have universal coverage with low or no deductibles. They spend far less per capita than we do and have far better health results than we do. Among the wealthy nations, we are first in costs and last in outcomes.
So, at a time when Congress is debating a very poor bill that cuts medical services to the poor and vulnerable while giving tax breaks to the wealthy, couldn't we just extend the medical program that we know works well and efficiently? Instead of waiting until age 65, let's offer Medicare from birth. It's the right thing to do.
For the past 30 years wealth inequality and income inequality has expanded dramatically. The economy has not been kind to the lower 80 percent. Economic policy, automation and tax policy have tilted the economic tables so that more wealth is in fewer and fewer hands, increasingly concentrated among the wealthiest 1 percent and especially the 0.1 percent. A more progressive tax policy could underwrite a more efficient universal Medicare system and bring new energy, prosperity and productivity to the whole nation.
Life, liberty and the pursuit of happiness is the right of every person. It starts with health.
Commentary on 07/04/2017