Letter: Medicare for All makes economic sense for WNC

Graphic by Lori Deaton

The COVID-19 pandemic shines a bright light on the inadequacies of our current health care system. Affordable health insurance does not mean guaranteed health care. What has become painfully clear is that we need a health care system that provides services regardless of income, background or job status.

The best use of tax dollars (our money) is to adopt a single-payer improved Medicare for All (M4A) health care system like every other major industrialized country. They cover more people for less money and have superior average health outcomes compared to the U.S. In 2017, the U.S. spent $3.3 trillion on health care. This equaled about 17% of U.S. gross domestic product, spending of about $10,000 per person. By contrast, peer countries spent between 9 and 11% of GDP on health care, averaging $3,400 to $5,700 per person.

We pay more and get less.

Twenty-two studies, from conservative to liberal, have documented that M4A would significantly reduce overall health care spending. M4A can only save money with a two-prong approach — cutting wasteful insurance industry bureaucracy and negotiating prices with hospitals, medical equipment companies and drug companies. Plans such as subsidizing COBRA, shoring up the ACA or adding a public option only add to the bureaucratic insurance industry, do nothing to decrease costs and do not guarantee care — a big waste of our tax dollars.

How do we pay for M4A? While details are negotiable, with the proposed M4A Sanders bill, employees would pay a flat 4% payroll tax and employers a 7.5% payroll tax, with the first $1 million being exempt. The remainder would be funded by closing tax loopholes and adding progressive taxes on corporations and the wealthy. Ninety-five percent of American families would pay less than they do now for insurance, deductibles and out-of-pocket costs. Average savings per employer is estimated at $8,850. We would pay less and get more health care.

According to the Chamber of Commerce, 96% of establishments in the Asheville metro area have 50 or fewer employees. With the first $1 million in payroll being exempt from proposed M4A taxation, our small businesses and local economy would benefit greatly with M4A. Local businesses would have a more level playing field and compete for talent on wages, quality and service.

M4A would inject a new dynamism into the local economy. Workers could go where their skills and preferences best fit the job. Entrepreneurs, gig workers, artists, farmers, young people, part-time employees and retirees would all have health care. Wages and job quality would be boosted by employers redirecting health care costs. There would be no medical debt bankruptcies, drug rationing or skipped doctor visits, and continued coverage during job loss.

M4A would also help eliminate racial inequities in health care and could be a beneficial part of Asheville’s reparations planning. Reimbursement rates under M4A could also be adjusted to incentivize providers to deliver services in communities with unmet medical needs, particularly in our rural and low-income urban areas. Asheville-area workers and families — regardless of race, gender or job status — would become a healthier, more financially secure local workforce.

What about local government? Health coverage, the source of most labor disputes in this country, would be off the table in union negotiations. Rising health insurance costs would no longer be passed onto employees, and M4A would eliminate future funding payments (other post-employment benefits) for retiree health benefits that are a huge financial strain on all government levels. Local governments will have more funds available for wages, infrastructure, capital improvements and public health.

Medicare for All makes economic sense for WNC. Our tax dollars should pay for actual health care, not insurance.

— Theresa Hash, Black Mountain
Dr. Ellen Kaczmarek, Asheville
Co-chairs of HealthCare for All WNC


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5 thoughts on “Letter: Medicare for All makes economic sense for WNC

  1. indy499

    Truly mind boggling how little these two authors know about health care in othwer countries. No, every other industrialized country does not have single payer health insurance. In fact, most do not. Spend a few minutes researching before leading out with such erroneous information.

    Might also be useful to talk about other components of health care. Like speed with which services might be delivered. Or how comprehensive the coverage might be. Most countries spend a small fraction of their health care $ in the final year of life because hail Mary procedures are simple not allowed and not funded.

  2. John P Stewart

    OK, maybe some are not technically single payer, but the government regulates and limits fees and prices. Much different than here. And as for speed of delivery, how about too late or never, as for millions here. We have poor outcomes as a result.

  3. Eric Halvorson, MD

    indy499 – indeed the authors are incorrect in that all industrialized nations do not have single payer. Some have multipayer systems, however they are highly regulated by government to achieve the same goals/results. You make it sound like this small error negates their entire argument – it does not. Speed with which services are delivered – you must be referring to “wait lines” for procedures in Canada , UK, etc. Indeed, in those countries care is rationed according to need. EVERY health care system must ration health care – the pie is not limitless. We ration it according to ability to pay, or ability to access the system through insurance. This is far less ethical than rationing according to need. In such a system, if you need a knee replacement, it’s not going to happen next week, as it doesn’t need to. If you need a coronary bypass, it will happen quickly. The idea that Canadians wait excessively is propagated by US health insurance industry PR firms – read the book “Deadly Spin” by Wendell Potter to gain more insight into all the insurance industry shinanigans – he was head of PR for one company and then became a whistle blower as he realized the harm that industry was causing. Coverage in single payer nations is far more comprehensive than what we have here. Here your coverage is determined by which one of the thousands of crappy insurance plans are available, and more likely by which one your employer has chosen for you because it was the least expensive option. I agree with you that we spend too much money at the end of life, and I’m not sure how to fix that. Americans need to stop thinking medicine can fix everything!

  4. WAVL1

    Couldn’t agree more – healthcare is a basic human right and it is way overdue for our tax dollars to be used accordingly.

  5. Padma Dyvine, Retired RN, MA, CHPN

    There is a difference between Insurance Care and Health Care. Health care is provided by trained, licensed healthcare workers. Insurance companies regulate who gets the care based upon their decisions of what a person’s plan covers. If we want vibrant, thoughtful, creative, healthy citizens, everyone needs healthcare that helps them to achieve their potential. This is what health care from womb to tomb offers. This is what expanded and improved Medicare for All offers. It would be incrementally introduced, initially by lowering the age eligibility. Those who are working for the insurance companies will be employed elsewhere, not just left unemployed. (By the way, there is great burnout among insurance care workers already.) And healthcare workers can spend their time with patients who want health care, which is offered to all and paid for by our taxes.

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