With one-fifth of the country’s uninsured countries, Texas has by far the largest health insurance problem in the United States.
Two years ago, the Texas Alliance for Health Care (which includes the Texas Medical Association) published a report: “The Impact of Uninsurance on the Texas Economy.” He claimed there were 5 million uninsured jeans and that number would increase to more than 6 million by 2040 if there were no changes. He also stated that the cost of uncompensated care (63% due to people without health insurance) for Texas hospitals / doctors would increase to more than $ 12 billion by 2040, from $ 3.5 billion in 2019. Of course, to offset these losses, Texas insured patient costs will grow.
The quickest and easiest way to alleviate the problem is to get Texas to expand Medicaid, as 38 red and blue states have done. But because of Texas GOP policy, this will not happen soon.
Month:Texas is holding public hearings and trying to convince the federal government to expand health care funding
At the federal level, President Biden advocates that Medicare be allowed to enroll people under the age of 65, but on a strictly voluntary basis. This is known as a “public option.” Obama had included this concept in his original Affordable Care Act (Obamacare), but withdrew after special health interest groups pressured moderate Democrats.
Recently, a major American hospital journal had a column on public choice. I agreed with his premise, that health care providers (hospitals, doctors, etc.) could make less money with Medicare compared to private pay. However, the issue is more important and complex than simply reimbursing the provider. The voluntary public option could be a positive first step toward Medicare for All, as described below.
In Canada, for example, one of its most popular government programs is single-payment health care. Also known as Medicare. But for some strange and illogical reason (i.e. U.S. policy), in the U.S. our Medicare only covers the elderly.
In 1970, Canada and the United States spent 6% of gross domestic product on health. However, in 2019, Canada with a single payment system only spent 11% of its GDP on health care compared to 17% here. The difference lies in other essential elements, such as infrastructure and education.
In Canada, where everyone is fully covered by their Medicare, per capita costs are also much lower ($ 5,418 per capita) than in the US ($ 11,071). And we currently have 29 million non-elderly people without any insurance (and many more underinsured), while they have none. Viously, obviously, the full expansion of Medicare, along with budgeting and pricing, is the only long-term solution to both our access problems and the ongoing health cost containment crisis. But that doesn’t mean it’s easy.
Month:Low-income jeans are struggling to find doctors after Planned Parenthood ripped off Medicaid
Politically, Medicare for All is a poor short-term element in dealing with a public option, which still retains private insurance and will not take away from corporate plans. The biggest technical hurdle is that voluntary enrollment in Medicare means sicker people will enroll, people who need more expensive care. This “selection of cherries” (called “adverse selection” by insurers) will cause Medicare premiums to increase in the long run for all enrollees. This increase in spending could force the United States to finally do what it should have done in the 1960s: provide Medicare to all its citizens to contain the costs.
Why will going to Medicare involve systemic costs? Because Medicare has a 2% over 12% overhead for private insurance companies, insurance can be managed more efficiently. In other words, more of the premium will go to patient care compared to marketing and administrative expenses. And that’s good for everyone except insurance companies and their wealthy CEOs.
Progressives already know that the only payer is the answer. But, at least in theory, cost containment should lead moderates and maybe even some conservatives to the real solution … Medicare for everyone.
But we have to keep in mind that before Obama ran for president, he was openly in favor of a single payer (as Trump was at the time). Obama later indicated that he changed his position (to promote the Affordable Care Act, which expands the role of private insurance) because we need to work with the system that currently exists. This is the DC code because I couldn’t handle the policy … the influential insurance / pharmaceutical / supplier lobby that opposes real reforms. And that’s why Biden will push for the public option, as opposed to a single, short-term payer, which is morally and technically better.
The uninsured situation in Texas is in a time of crisis. Therefore, all Texans should expect the next president to defend a single payer, with substantial bipartisan support. But that will not happen unless voters pressure lawmakers to do what is right and what special interests want.
Jack Bernard is a retired business executive who worked extensively with hospital systems throughout Texas.