Medicare for All

April 04, 2017


I was interested in the commentaries of Walter Amses (March 28) and Esther Farnsworth (March 29) on the subject of health care and health insurance.

Walter pointed out that U.S. House Speaker Paul Ryan didn’t quite get the idea of insurance when he said, “Insurance cannot work if healthy people have to pay more to subsidize the sick.” This is precisely how all insurance works, fire, auto, life, etc. Esther extolled the benefits of Medicare for all pointing out that the administrative costs of the current Medicare system are 10 times less than those for the insurance based system.

These comments got me to thinking about Medicare for all and the ways other services are provided to us. Take education. I gladly pay my local property tax to fund our local schools because I believe the education of our youth is a benefit to all of us. In the same way, a healthy population is a benefit to all of us. I also pay my taxes to fund our local fire department and local and state police. Just like health insurance, I don’t plan to use these services, but, if my house caught on fire or was burglarized, I want to have these folks to help me. In like manner, I gladly pay my taxes so that the roads in town are kept in good condition. I don’t get out as much as I used to, but having well-kept roads is a benefit to all of us, and paying for them shouldn’t be an option for me. I know I pay more than some others for these services, and I also pay less than some others. So should it be for health insurance. Some will pay less than others and some more. But the help will be there for all of us when, or if, we need it because it is a benefit to all of us.

Another advantage is that the responsibility to provide health insurance would be removed from businesses and nonprofits, like our schools. The system of having businesses pay for health insurance was started in the late 1940s, and the reasons for it have long ago disappeared. Think of the benefit of having health insurance taken off the table when employment contracts are negotiated. Health insurance should be funded by the people who use it, and that is potentially all of us.

Paul Ryan says that we should be free to not buy health insurance. It seems that many folks in the 25 to 35 age range don’t purchase health insurance because they don’t think they need it. After all, they’re young, robust, healthy. Why should they have to buy health insurance they will likely not use? My question for Paul Ryan and these young invincibles is this: What happens if you are in an accident or contract an expensive disease? You go to the emergency room or a hospital and receive services, because it is a policy in Vermont that no one will be turned away. But who pays for those services? The answer is the rest of us. Is this a fair system?

Now, of course, a main reason the Legislature is reluctant to consider Medicare-for-all is that the insurance companies will lobby them day and night, even cut off their funding for election. But I see a role for insurance companies in a Medicare-for-all system. They could continue to serve as claim agents for the system. Now, the corporate culture would have to change because, in our current system, the goal is to deny claims not approve them. We have learned that claims agents are actually awarded bonuses for denying the most claims.

So, in summary, I see Medicare for all as having the following benefits: healthier people are good for all of us. Esther pointed out we rank 13th in the world on health issues, not a record to be envied. There are less days taken off from work. Minor health issues are dealt with before they become major issues requiring far more money to address. We all contribute funds according to our ability, just as we do for schools, road, police and fire services.

What is it going to take for us to convince our legislators to, at the very least, look at the possibility of Medicare for all?

David Grundy
East Montpelier