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Medicaid and Medicare
Public programs such as Medicaid and States Children Health Program (SHIP) are programs set up to provide health insurance to low income families. Both programs provide good coverage for those who qualify. However, strict eligibility requirements and complex enrollment procedures make these programs difficult to access and even more difficult to maintain. A small pay raise can sometimes be enough to disqualify a family form these programs. Since both of these programs are dependant on state funding, they are vulnerable to state budget constraints. When the state is having a difficult time financially these programs often suffer from budget cuts.
Medicare has provided universal health coverage for all US citizens age 65 and older and some people with disabilities that are “uninsurable”. The Federal government established Medicare under the Social Securities Amendments of 1965.
"No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings they have so carefully put away over a lifetime so that they might enjoy dignity in their later years." (Independence, Missouri, July 30, 1965) Lyndon B. Johnson
Despite gaps in benefits Medicaid has been able to provide coverage to all US senior citizens with much lower administration cost than the private insurance can. Single payer systems, such as Medicare generally are considered to have substantially lower administrative cost than private insurance plans, because the need for advertising, underwriting and much eligibility and billing work disappears. Medicare spends 3% on overhead compared to 15 – 25% the insurance industry spends.
Universal Single Payer Health Insurance
A universal public system could be financed this way: The public financing already funneled into Medicare and Medicaid would be retained. The difference, or the gap between current public financing and what we would need for a universal health care system, would be financed by a payroll tax on employers (about 7%) and an income tax on individuals (about 2%). The payroll tax would replace all other employer expenses for employees’ health care. The income tax would take the place of all current insurance premiums, co-pays, deductibles, and any and all other out of pocket payments. For the vast majority of people a 2% income tax is less than what they pay now for insurance premiums and in out of pocket expenses such as co-pays and deductibles.
Single payer health insurance is not socialized medicine. Socialized medicine is a system in which doctors and hospitals work for the government and draw salaries from the government. Doctors in the Veterans Administration and the Armed Services are paid this way. Examples also exist in Great Britain and Spain. But most European countries, Canada, Australia and Japan have socialized financing or socialized health insurance. The government pays for care that is delivered in the private (mostly not-for-profit) sector. This is similar to how Medicare works in this country. Doctors are in private practice and are paid on a fee-for service basis from government funds.
A single payer health insurance system would work like this: every American citizen would receive a national medical ID card in which they would show to the front desk clerk at the time of service. All American citizens would be eligible regardless of health or income status. Providers would bill the government directly. Provider billing procedures would be simplified because there would be no need to determine the secondary health insurers, and standard forms for all enrollees would make it easier for those submitting bills. The cost of the healthy and the sick would be averaged across the entire US population.
The long-run sustainability of a single payer system would depend on containing cost increases; many potential cost and utilization controls would reside at the federal level. Because nearly all the health spending would be aggregated under the federal budget, the decision about what society deems affordable would be both very public and unavoidable.
If we continue to address the issue of healthcare in this country with a business as usual attitude, we will most certainly face ever-increasing rates of uninsured citizens. When large portions of people are uninsured; families, businesses, the economy and the well being of our society as a whole pay a large price. Health insurance in America has been looked at as a “fringe” benefit, not a right. As a society we need to put politics aside and start addressing health care policy. We need to make access to health care for all, a Right, not a privilege that goes out to the highest bidder.
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Posted by: cacadmin on Thursday, December 01, 2005 - 11:45 AM
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