I was pleasantly astounded by a recent study on public health released by the Mercatus Center at George Mason University. The Center’s analysis concluded that single-payer health care would cut health costs, increase wages, and promote better health for the American public. I was astonished because the Center is funded by the arch-conservative Koch family.
The Mercatus report was written by Senior Research Strategist Charles Blahous, a conservative who served in the Bush administration from 2010-2015 as public trustee for Social Security and Medicare and has written books on various aspects of health care. Among his other publishing credits are articlesin journals such as the Financial Times, the National Review,and the Wall Street Journal.He has appeared on Fox News, C-SPAN, and National Public Radio.
Blahous uncovered a $3 trillion error in the projections made by the Bernie Sandersorganization regarding the costs of a single-payer system. Despite that huge error, which Sanders accepted as legitimate, Blahous found that Sanders’proposed Medicare-for-All legislation would produce an annual $2 billion lowering of health costs.
Most of the savings are in administrative costs which are much lower for Medicare than in for-profit insurance companies.Another major savings would stem by allowing the Department of Health and Human Services to negotiate with pharmaceutical companies regarding drug prices. The projected savings are not hypothetical but based on the much lower prices currently paid by European nations.
More benefits derivefrom eliminating employer-managed health insurance policies. Given the lower total costs of the Medicare system, the take-home wages of those in such plans would rise. Large corporations and small businesses also would benefit by being relieved of providing health insurance. The major losers would be insurance companies and drug manufacturers. Rather than the super profits they now enjoy, their profits would decline to conventional corporate norms.
Portside and the Intercept, two leftwing websites, asked David Himmelstein and Steffie Woolhandler to review the Blahous report. Himmelstein is a physician who is a professor of public health and health policy at Hunter College (CUNY). He has published over a hundred articles in peer-review journals.Woolhandler, also a physician, serves on the Hunter College faculty but also lectures at the Albert Einstein College of Medicine and Harvard Medical School.
Himmelstein and Woolhandler calculate that Blahous undercounted savings over a ten-year period by $8.3 trillion. Partly, this is due to Blahous estimating that Medicare-for-All would result in over a million more annual doctor visits and hospitalizations. Himmelstein and Woolhandler note that no such increases occurred when universal health care was introduced in Canada. Nor have the per-person number of doctor visits and hospitalizations changed since Medicare was introduced more than fifty years ago during the administration of Lyndon Johnson. This may be due to people, freed of onerous costs,not delaying going for medical care until their health deteriorates to a crisis situation. A question always raised is if income taxes would increase in a Medicare-for-All system. The answer is yes. Medicare-for-All is not a free ride. But government coverage also eliminates the need to pay for basic health insurance, whetherprivate or employer-sponsored. The net result is a significant decline in the total income spent by individuals for health care. Employers, large and small, also benefit as the burden of paying for health care is off their shoulders.
The Mercatus report is a bitter bill for establishment Democrats and many Republicans. Even using theoriginal Blahous numbers, rather than the higher savings projected by Himmelstein and Woolhandler, the Mercatus report confirms the health care positions advanced by the insurgent populist wing of the Democratic party associated with Bernie Sanders.Despite numerous polls to the contrary, the Pelosi-Schumer leadership still considers Medicare-for-All an extremist and economically unsound position that will not appeal to mainstream voters.
The Republicans have a related dilemma. Also ignoring public opinion polls, outgoing Speaker of theHouse PaulRyan, the Republican Freedom Caucus, and their allies remain fierce advocatesfor privatizing health care as much as possible. TheFreedom Caucus habitually links Medicare-for-All to shortcomings in Obamacare in an effort to prove they are the House’s “true” conservatives.President Trump, once a supporter of Medicare enlargement, now seems more interested in overturning any legislation linked with Obama rather than addressing the health issue on its own merits.
Ralph Nader has argued that Americans are not as deeply politically divided as often stated. Lowering the cost and improving the standard of health care are goals shared by both right-wing and left-wing populists. Moreover, fewAmericans have expressed any desire to return to the pre-Medicare era. Want to call Medicare-for-All a socialist reform? Fine. Want to call it universal health care? Fine. Whatever the terminology, Americans want to stop paying twice as much for health care as the rest of the world with results that are inferior to those of nations with single-payer systems.
The study from the Mercatus Center of George Mason University isan example of how common sense and principled research can result in nonpartisan consensus.The time to achieve health reform is long overdue. The forthcoming elections will be the best immediate opportunity for the public to elect politicians committed to expanding rather than contracting Medicare.