The health care debate rages on.  Our system has been flawed from the beginning.  Powerful Unions negotiated with employers to provide health insurance.  Good for the Unions and unionized workers, not good for everybody.  Insurance companies liked the deal because they could negotiate big lucrative packages.  Actuaries ruled the day.  It is actually simple math – what is the average age of the employees, what is the breakdown by sex, and what type of job are they doing?  The actuaries could quickly see that any particular population would cost them so much per member per month.  They just add 30% and that is the premium charged to the employer.  The employer negotiated with the Union for the individual employee share.  It works well for those employed by large companies.   One consequence is that people think of health care in terms of where they work.  The problem is that about 50 million people do not work for large employers and are thus left to negotiate with the insurance companies as an individual.  If you have a preexisting condition or are a woman of child bearing age or if you are an old man you are SOL.  (Does SOL mean seriously out  of luck?)

When Obama became President those fifty million became a priority.  The Affordable Care Act (Obamacare) passed and about thirty million more people purchased insurance.  (Still 20 million short of ideal).  But insuring everyone affordably only works if everyone participates – spreading the cost out across the population.  Two big complaints were registered by the GOP for sure and a lot of other people for cause.  Obamacare is too expensive.

I am an old man on medicare and I avoid visiting health care establishments because of the high cost of deductibles and coinsurance.  Those costs are included for exactly the reason mentioned – if it is free people will abuse it.  Add a cost to the customer and they think twice about visiting the ER to remove a splinter.  This is only one form or regulation – and it is prejudicial – it is health care that favors those with financial means.

Still, Medicare works pretty well.  I pay for Part B and a little more for another plan from United Health Care to minimize the out-of-pocket costs.  (For about $200 more per month I would have no co-pays or deductibles.  Too much for my current situation).

Medicare is different that the insurance companies because it is not-for-profit.  They calculate the costs in the exact same manner as the private insurance companies.  What is the population they are insuring?  What does that population cost?  Add 10% for administration – and there is the cost per month.  I wrote earlier that the private insurance companies add 30% – that was just a shot in the dark – Each of those companies adds as much as they can get by with – maybe 100% or 150% – who knows – they do not report their actuarial studies.

So I submit here, and I am not the first, that all Americans should be placed on Medicare – a single payer concept.  The money currently taken from their paycheck would still be taken – but it would go into a pool for everyone – administered by Medicare.  There are a couple of attractive elements to this proposal.

Medicare is already established.  They already have contracts with health care providers.  They already have a system in place to receive the bills from the health care providers.  they already have a system in place to make the payments.  The health care providers already have processes in place to manage the billing and receivables to and from medicare – no extra work there.  In fact, most health care providers have many employees dedicated to understanding the multitude of health care plans provided by multiple insurance companies.  The current system is quite complex.  The billing and receivables cost savings alone would be significant.

By removing the insurance companies from the equation there would be an immediate savings in the gross profits of those parasite companies.

Let’s have this debate.  Let’s put this option on the table.  Let the Congress openly discuss this option.