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What’s all this about Single Payer and Medicare For All?

It’s the worst kind of government over-reach.

It’s an easy solution to a huge problem that will cost nothing.

And everything in between. Between now and Election Day you are going to hear a lot about Medicare for All and Single Payer, and most of it will be utter nonsense.

So, this week is Single Payer/Medicare For All explanation week.

Proponents of Single Payer/Medicare for All say it will reduce overall costs and ensure everyone in America has great healthcare; At the other end of the spectrum, it’s fiercest opponents say it will bankrupt the country while giving bureaucrats control over your family’s healthcare.

Reality is, since there is no actual agreed-upon “Medicare for All” or Single Payer legislation, each of us sees what we want to see – MFA as the Holy Grail or a Total Disaster.

Let’s take a step back and think about how voters are affected by the core problem – or rather problems, with healthcare and health insurance.

The focus on voters is critical here – most are covered by employer-based health insurance, and most of the rest are covered by Medicare. For the non-elderly:

  • Health insurance is stupid expensive.
  • For many of us, deductibles are so high “insurance” just protects you from catastrophic injuries or illnesses.
  • Insurance companies control the doctors and hospitals you can use and the care you get.
  • The paperwork is mindboggling, confusing, and adds billions in unnecessary cost.

For workers, healthcare “costs” are a combination of insurance premiums and cost-sharing payments – mostly deductibles and copayments. (While about 75% of premiums are paid by employers, economists argue that most of those premium dollars would be paid in cash wages if health insurance wasn’t provided.)

Today family health insurance premiums are almost certainly more than $20,000 a year.

Over the last two decades, healthcare costs have eaten up wage increases – one of the main reasons families aren’t getting ahead.

For those who actually have to use their health insurance, it’s worse. Deductibles are so high that many families can’t afford them.

Add this all up, and you understand why healthcare was the top issue for most voters in the mid-terms.

Voters like simple answers to complex questions – and for many, some form of Single Payer sounds great.

The takeaway – voters want healthcare solved and they don’t care much about the details.

5 thoughts on “What’s all this about Single Payer and Medicare For All?”

  1. For what it’s worth, Kaiser Health News podcast this week was specifically around this topic. You’ve likely seen/heard it since you are referencing KFF info. If not, it’s a good listen.

  2. I have a unique perspective on this Joe. I am originally from Canada so I have been a patient and a provider in both countries. Obviously both systems have their pros and cons. But, I can tell you of late I am leaning toward the single payer system or hybrid of sorts. Canadians do not worry about their healthcare or stress about it. I am realizing (as I age) what a burden this can be on people. Sure the rich don’t care and will generally fight this but most of us are on the verge of bankruptcy should we be stricken with some bad luck and misfortune. A single payer system is not great for providers and it creates issues with access to providers especially specialists. I think if we can look at a system that can address some of the negatives folks might be more apt to support it. Just look at what it can do for business who would not have to bare the massive burden of paying for healthcare. Frankly I am tired of the private commercial for profit insurance monopolies and Wall Street greed running healthcare. They do no better at it than the government in my opinion and I trust them less.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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