I am deeply concerned that the issue of single-payer health insurance, or Medicare for all, although quite popular with the party faithful, could be a losing issue for Democrats in a general election.
First, let me say that I am strongly in favor of a single-payer and have been for most of my adult life. The waste, abuse and inhumanity in our current system is a national embarrassment. Having said that, my concern is that Democratic candidates are framing single-payer as an issue of fairness; that healthcare is a right and not a privilege. Already we’re hearing pushback, not only from Republicans, but also from moderate Democrats who claim that our country cannot afford it. While the left takes a humanitarian position, the right comes at it from an economic angle. As Bill Clinton taught us a long time ago, in the end economics trumps fairness.
In order to make healthcare a winning issue, it must be portrayed in the context of an economic crisis that is eating up more and more of our domestic economy. Democrats must show voters that single-payer will save us all money, and lots of it. Here’s what I suggest:
First, add up all the costs of our current system of private insurance, including payroll deductions, employer and employee contributions to benefit plans, premiums paid for individual plans, deductibles, co-pays, retiree payments for Medicare Parts B and D, Medicare supplemental policies, and the endless red tape involved in managing such a disjointed system. I would bet that the sum of these alone would exceed the cost of a single-payer plan where Medicare could negotiate rates for goods and services from office visits to prescription drugs to wheelchairs.
Second, take a long hard look at Workers Compensation. This is a system born almost one hundred years ago when factories were dangerous places to work and most people lacked any form of health insurance. As a former small business owner over four decades, I paid well over $1 million in premiums and to the best of my knowledge, one of my employees once received about $300 for a cut finger. The workers comp system is antiquated, bloated and expensive, and its reform is overdue. With Medicare for all, we wouldn’t need a separate bureaucracy to handle workplace injuries. Payments for non-medical issues like lost wages, pain and suffering, or any other amounts awarded through litigation could be handled by employers’ liability insurance. To incentivize companies to provide a safe environment for their workers, penalties could be assessed for excessive claims, perhaps in the form of bigger contributions into the insurance pool.
By coupling Workers Comp reform with healthcare reform, Democrats can show that the savings to our economy would be enormous and the cost to taxpayers much less than what they currently pay. It would fund a level of healthcare to all citizens that far exceeds what the majority receives today. And just think of the support the Democrats would get from the business community that would benefit from Workers Comp reform.
Finally, come up with a way to fund the new system. Will it be through payroll deductions like Social Security, a national sales or value-added tax, or hybrid?
Single payer is indeed a humanitarian issue. But for practical purposes, Democrat’s failure to advocate for it as an economic issue threatens to turn it against them. Don’t let that happen.