Medicare-for-All: The Answer to a President’s Call and a Nation’s Woes

Open Letter to President Obama on Health Care Reform

Dear President Obama,

I was overjoyed to hear you say in your State of the Union address on Wednesday night:

“But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.”

My colleagues, fellow health advocates and I have been trying to meet with you for over a year now because we have an approach which will meet all of your goals and more.

I am a pediatrician who, like many of my primary care colleagues, left practice because it is nearly impossible to deliver high quality health care in this environment. I have been volunteering for Physicians for a National Health Program ever since. For over a year now, I have been working with the Leadership Conference for Guaranteed Health Care/National Single Payer Alliance. This alliance represents over 20 million people nationwide from doctors to nurses to labor, faith and community groups who advocate on behalf of the majority of Americans, including doctors, who favor a national Medicare-for-All health system.

I felt very optimistic when Congress took up health care reform last January because I remember when you spoke to the Illinois AFL-CIO in June, 2003 and said:

“I happen to be a proponent of a single-payer universal health care program.” (applause) “I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single-payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.”

And that is why I was so surprised when the voices of those who support a national single-payer plan/Medicare-for-All were excluded in place of the voices of the very health insurance and pharmaceutical industries which profit off the current health care situation.

There was an opportunity this past year to create universal and financially sustainable health care reform rather than expensive health insurance reform. As you well know, the United States spends the most per capita on health care in the world yet leaves millions of people out and receives poor return on those health care dollars in terms of health outcomes and efficiency. This poor value for our health care dollar is due to the waste of having so many insurance companies. At least a third of our health care dollars go towards activities that have nothing to do with health care such as marketing, administration and high executive salaries and bonuses. This represents over $400 billion per year which could be used to pay for health care for all of those Americans who are suffering and dying from preventable causes.

The good news is that it doesn’t have to be this way. You said that you wanted to “keep what works” and that would be Medicare. Medicare is an American legacy of which we can feel proud. It has guaranteed health security to all who have it. Medicare has lifted senior citizens out of poverty. Health disparities, which are rising in this nation, begin to disappear as soon as patients reach 65 years of age. And patients and doctors prefer Medicare to private insurance. Why, our Medicare has even been used as a model by other nations which have developed and implemented universal health systems.

Mr. President, we wanted to meet with you because we have the solution to health care reform. The United States has enough money already and we have the resources, including esteemed experts in public health, health policy and health financing. Our very own Dr. William Hsiao at Harvard has designed health systems in five other countries.

I am asking you to meet with me because the solution is simple. Remove all of the industries who profit off of the American health care catastrophe from the table. Replace them with those who are knowledgeable in designing health systems and who are without ties to the for-profit medical industries. And then allow them to design an improved Medicare-for-All national health system. We can implement it within a year of designing such a system.

What are the benefits of doing this?

  • It will save tens of thousands (perhaps hundreds of thousands) of American lives each year, not to mention the prevention of unnecessary suffering.
  • It will relieve families of medical debt, which is the number one cause of bankruptcy and foreclosure despite the fact that most of those who experienced bankruptcy had health insurance.
  • It will relieve businesses of the growing burden of skyrocketing health insurance premiums so that they can invest in innovation, hiring, increased wages and other benefits and so they can compete in the global market.
  • It will control health care costs in a rational way through global budgeting and negotiation for fair prices for pharmaceuticals and services.
  • It will allow patients the freedom to choose wherever they want to go for health care and will allow patients and their caregivers to determine which care is best without denials by insurance administrators.
  • It will restore the physician-patient relationship and bring satisfaction back to the practice of medicine so that more doctors will stay in or return to practice.
  • It will allow our people in our nation to be healthy and productive and able to support themselves and their families.
  • It will create a legacy for your administration that may someday elevate you to the same hero status as Tommy Douglas has in Canada.

margaret_flowers1

Mr. President, there are more benefits, but I believe you get the point. I look forward to meeting with you and am so pleased that you are open to our ideas. The Medicare-for-All campaign is growing rapidly and is ready to support you as we move forward on health care reform that will provide America with one of the best health systems in the world. And that is something of which all Americans can be proud.

With great anticipation and deep respect,

Margaret Flowers, M.D.

Margaret Flowers is a pediatrician in Baltimore, co-chair of the Maryland chapter of Physicians for a National Health Program (PNHP) and PNHP Congressional Fellow.

Originally published at Common Dreams. Republished with permission.

Published by the LA Progressive on January 30, 2010
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About Dr. Margaret Flowers

Dr. Flowers is a Maryland pediatrician with experience as a hospitalist at a rural hospital and in private practice. Currently working on single payer health care reform fulltime. Active with Maryland Universal Health Care Action Network and co-founder of the Conversation Coalition for Health Care Reform. Medical school:University of Maryland School of Medicine. Residency: Johns Hopkins Hospital

Comments

  1. Making Medicare available to all Americans is a great idea, but not for free. Medicare should be opened up on a fee basis. The two main problems with the Democrat’s/Obama’s health care bill is that 1) It creates a huge burden on the middle and working classes, and 2) It’ll result in a huge backlash by Independents and moderate Dems because it creates the next big welfare system that will force the working Americans to pay for freebie healthcare for everyone who chooses not to work, including people who are not even legal citizens!

    Instead of giving us better, less expensive health care, Obama’s faux reform gives our country a huge unwieldy system that will block true healthcare reform for decades. By forcing people to buy insurance instead of helping us fund actual health care costs, the federal government will be forcing us to support the very industry that is sucking our life blood already. Obama’s plan reinforces the insurance industry’s death grip on healthcare, reinforces their ability to buy off Congress and codifies wealth redistribution from the middle class to the rich. Obama want us to bolster the coffers of the very people who have given us this crisis and who are currently blocking reform. That’s exactly what Obama and our Dems in Congress did for the banksters, and we know well how that worked out…

    We have three major problems that Congress can fix:
    1) Medicaid can’t possibly cover all the poor people.
    2) People & businesses that have been paying for health insurance and healthcare are being priced out of the ability to pay.
    3) The insurance industry has a non-sustainable, for-obscene-profit model, and they already own too many of our elected members of Congress.

    The problem with the healthcare bill is that it only tries to address #1 & 2, and likely won’t solve those problems anyway. If progressives can temporarily let go of the desire to create a big new welfare-healthcare system, we can at least solve problems #2 & 3 now, and work on #1 later.

    The current bill will obviously make problem #3 (Congress members in the pocket of the insurance industry) much worse than it is already. If the healthcare bill passes, costs will still go up, more people will need subsidies, and the average working/middle class American will pay more for their own healthcare while being saddled with paying for the poor as well. Many progressives think Congress should pass this bill so that we can “tweak it” down the road to make it more sustainable. Unfortunately, if it passes, we’ll have blocked true reform for decades. You just can not “tweak” the basic foundation of this law that forces working Americans to buy insurance instead of health care.

    Our best solution would be to allow all citizens to buy Medicare, and use some of that new influx of money to bolster Medicare for seniors and to fund more Medicaid recipients. Most seniors already pay monthly fees for Medicare, as well as a portion of the cost of their medicines. If we open up our currently existing single payer Medicare system to all Americans at cost, we could consolidate our resources and get health care at a reasonable price. Seniors and the disabled already pay monthly fees for Medicare, as well as medicine costs. If Congress made Medicare available for purchase by all citizens (not to “residents” as HR676 stipulates), it would certainly cost less than what companies and individuals currently pay to insurance companies. It wouldn’t be socialized medicine, because anyone can still choose to pay rip-off insurance companies instead of buying Medicare. It wouldn’t available to non-citizens, so it won’t become part of the incentive for bypassing immigration laws (a key issue for conservatives). Since many companies and individuals would be happy to reduce their healthcare costs by about 30%, it would be popular with voters on both the left and the right. We’d avoid the angry backlash by Independents and conservatives that we just saw in Massachusetts because it’s fee-based, not a big new expensive welfare giveaway.

    Expanding Medicare would mean pooling our resources (a primary function of government!) for real health care cost reductions, not just propping up the destructive and greedy insurance industry. Right now, the insurance companies get most of the least inexpensive customers as clients, while the government pays for the more expensive pool of elderly and low income Americans. This would balance government costs by pulling in our younger Americans with fewer health care problems. Furthermore, since it’s not a giveaway, we’ll actually see real savings for companies and the middle class, which will stimulate the economy. Once it’s in place, the left can push to expand Medicaid, the free and low cost healthcare for the poor. The purpose of offering fee-based Medicare would not be to create socialized medicine, but simply to allow working Americans and our companies to obtain healthcare without paying for the obscene CEO salaries and investor’s profits.
    Socialized medicine might be a good idea in the long run, but it’s not necessarily the solution to our healthcare crisis right now. A big new healthcare-welfare system will be a sure-fired failure in this economy, and will result in the biggest political backlash since Nixon and Reagan sucked up moderate voters who were angry about liberal social programs that encourage intergenerational poverty.

  2. Right. Medicare is unsustainable going forward (as the Baby Boomers retire), and even now it’s increasingly hard for new enrollees to find doctors who will accept them, since Medicare’s reimbursement rates don’t cover doctors’ (and hospitals’) costs. But if we put **everyone** on Medicare, presto, problem solved!

    That’s like the old joke about the retailer who loses a little on every item sold but compensates with volume.

    The Washington Post and 60 Minutes both ran stories showing that Medicare fraud amounts to about $60 billion/year. (Part of the overhead that insurance companies are reflexively demonized over goes to fraud prevention, a significant benefit.) Why not do incremental things that make sense, like rooting out this ongoing, virtually uncontested fraud, to show that the government can actually do **something** right, before attempt to tie everyone’s medical care to that corpse-to-be, Medicare?

  3. David Lentz says:

    This is a wonderful article. However I firmly believe that Obama has been bought and paid for. A better path is to start a new party that will provide for real reform in Washington and America. Asking the democrats or republicans to change is a waste of your valuable time. The stick needed is a new party that will eliminate these crooks from office…

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