Blog #129 – Medicare and Beyond — For a Secure Health System


Blog #129 MEDICARE AND BEYOND – FOR A SECURE HEALTH SYSTEM

Beyond Medicare. How about a Secure Health System, analogous to the existing Social Security System?

We are a better country than we often want to acknowledge. We have a Social Security system, out of concern that old age should be secure and free of financial worry. We have an Unemployment Insurance system, out of concern that workers unable to find work in the open market should not be left in poverty or indigence. And we have Medicare, which can be seen as a fumbling step towards a health security system. We recognize, though we don’t often say so, that the Declaration of Independence’s call for government to provide for the security of life, liberty and the pursuit of happiness as inalienable rights is an appropriate, indeed indispensable function of government, that that means measures guaranteeing all members of society security in having at least minimum access to what it takes to make those rights meaningful.

Wouldn’t a Secure Health Care system fit right into that pattern? Isn’t ill health, like old age, like joblessness, like physical vulnerability, a cause of painful insecurity that  we would like no one to have to suffer from – need we doubt the parallel appropriateness of police protection for all, or environmental protection for all?

Doesn’t every civilized country care, both practically and legally, for the health and welfare of its citizens, and directly implement minimum standards for what that entails?

What, then, would a “Secure Health System” in the United States mean? – a system in which every person can count on the fact that , if  they become ill, they will be taken care of, will receive the  treatment and the care that  they need??  

It would mean the setting of minimum standard of health care to which all are entitled, without regard to incomes or health problems, the treatment, the medications, the comforts, that their condition requires. If individuals are able to provide that for themselves without government assistance, good and fine, let them; do so, but whether or not they can do so on their own,  all are entitled to security in having the minimums, no questions asked. We don’t deny the rich police protection because the can afford private security, nor deny the children of the rich public education because they can afford private schools. Beyond that, if they want and can afford more, more power to them. We don’t ask social security recipients it they have better pensions, children if their parent can afford better schools, home owners if they have private security systems. All members of society are entitled to security in obtaining the benefits of civilization, period.                                                                 

Why should health care be any different? It shouldn’t. Yet it involves one of the few necessities of life in which direct provision by government is now very limited, in which major provision is by private entities and personnel, by and large, by the private sector, with  an interest in high  prices for their  own benefit.

Health care in the U.S. needs fundamental change today.  

What might a system providing Secure Health in the United States look like? It would not deal with insurance companies or facilitators. Doctors and hospitals and drug companies would submit their bills to it, and be paid, verifying only that the services billed for were actually rendered. The plan would be financed by a small tax akin to a payroll tax, levied on all adults. If proceeds were insufficient to cover all claims, the national government would keep it solvent, just like social security.

If necessary, some of Elizabeth Warren’s revenue proposals might be adopted as needed. The savings from eliminating paper-work and enhanced bargaining-power with providers, i.e. pharmaceutical companies, private hospitals, should produce major savings in cost – and annoyances..

              For more limited improvements in the current Medicare system,               see        Pmarcuse.wordpress.com, Blog #128, Solving the Fake Medicare Opt-out problem:    

Author: pmarcuse

Just starting this blog, for short pieces on current issues. Suggestions for improvement, via e-mail, very welcome. pm35@columbia.edu

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